Journal of Urgent Care Medicine

UnitedHealthcare Plans Nix Code S9083 Global Fee Urgent Care Center in New Jersey

UnitedHealthcare Commercial in New Jersey and UnitedHealthcare Oxford of New Jersey will stop reimbursement of HCPC code S9083 as of January 1, 2018, according to a letter sent to providers. Instead, the plans are advising providers to “only report the evaluation and management and/or procedure code(s) that specifically describe the service(s) performed.” S9083, they say, is “informational” and relates to a type of reimbursement rather than a specific service. Charges billed for S9083 will be …

Urgent Care Should ‘Watch and Learn’ as Illinois Deals with Medicaid Headaches

Illinois is not unique in wrestling with Medicaid managed care plan problems, but the situation there seems to have reached a boiling point and can serve as a cautionary tale for urgent care stakeholders across the country. Health system officials there complain that getting providers approved by Medicaid managed care plans has taken anywhere from 6 months up to a whole year. Prior authorizations and reimbursements have been similarly slow in coming, making it so …

Urgent Care Operators Look to Telehealth to See More Patients

Six months after it started offering video visits through Doctor on Demand and American Well, UnitedHealthcare says it expects to “see” 20 million patients that way by the end of 2016. More than half of the visits, to date, have been for respiratory issues. Statistically, the average user is a 31-year-old female. UnitedHealthcare says the vast majority of employers it covers like the idea, but have concerns about how many of their workers will actually …

Update: Humana’s Four-State Exodus Leaves Alabama in a Tough Spot

Last week we told you about Humana’s plans to drop out of Affordable Care Act (ACA, or “Obamacare”) insurance exchanges in certain states. Now the company has revealed that one of those states is Alabama—leaving just one ACA exchange in the entire state, effective Dec. 31, 2016. The other states (so far) are Kansas, Wisconsin, and Virginia, though news regarding more states may still be ahead. The company first said it would consider exiting certain …

UnitedHealthcare Tries to Cut Costs with ‘Free’ Primary Care

UnitedHealthcare (UHC) is testing a no-cost primary care model to see if it equates to greater use of preventive care and, ultimately, lower costs for the company. It farmed out the program to Harken Health, which gives members unlimited no-fee access to primary care services and a 24-hour helpline, a personal health coach, psychological counseling, and classes in fitness and nutrition. Access is limited at this point, however, as Harken has just six clinics in …