Didn't get a Gold Card? Dispute status with UnitedHealthcare by Sept. 30
UnitedHealthcare (UHC) recently announced the CPT codes that are eligible for its new Gold Card Program, which launches on Oct. 1, 2024. The program will exempt qualified practices from certain prior authorization requirements, but will still require “advance notification.” Practices can look up their Gold Card status for the upcoming year and must dispute by Sept. 30 if you were left off the list.
According to UHC, practices granted Gold Card status will be required to adhere to the payor’s advance notification process for Gold Card services, despite the prior authorization exemption under the Gold Card Program. UHC said it may also require medical records as part of the monitoring and continuing evaluation of practices qualified for the Gold Card status.
Currently, approximately 500 current procedural terminology (CPT) codes for medical services are included in the program, and United Healthcare has indicated that eligible codes may be added or eliminated in the future based on the latest clinical evidence.
Gold Card statuses will be updated and published annually on Sept. 1. Practices who wish to dispute their status can request a review within 30 calendar days of publication. UHC has published an interactive guide that will walk practices through the process of looking up their Gold Card status. Practices are encouraged to look up their Gold Card status as soon as possible, so you will have time to dispute your status if needed for the upcoming year. Disputes must be filed by Sept. 30, 2024.
Share your observations with us: As this program gets going, the Colorado Medical Society wants to hear from you about whether or not the program actually makes a difference for your practice, how it is working, and other observations from practices that received a gold card status and those that did not (and perhaps those who dispute this designation). Share any comments or observations by replying to this email or contacting Chet Seward directly at chet_seward@cms.org.
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