UnitedHealthcare is launching a Gold Card Program, effective Oct. 1, that will recognize qualified providers that have consistently adhered to evidence-based care guidelines.
Providers that become part of the Gold Card Program are not required to submit requests for prior authorization for certain medical, behavioral, or mental health services that would normally require authorization. Rather, providers that reach Gold Card status must complete an advance notification for Gold Card services that will confirm their eligibility and coverage for the services requested.
UnitedHealthcare cited several benefits of this program, including provider care coordination, allowing other providers and facilities supporting care for Gold Card Plan members to easily validate whether a service is covered.
To qualify, providers must be in network for at least one UnitedHealthcare health plan, including UnitedHealthcare commercial, UnitedHealthcare Individual Exchange, UnitedHealthcare Medicare Advantage, or UnitedHealthcare Community plans. Providers must also meet a minimum annual volume of 10 eligible prior authorizations each year for two consecutive years across Gold Card-eligible codes and have a prior authorization approval rate of 92 percent or greater.
To check eligibility, providers can visit the UnitedHealthcare Provider Portal.
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