Typically these codes would require a prior authorization under the Experimental / Investigational codes section for Unity and Gundersen Health plan members.
Please note that these new Category III codes are not a covered benefit, even when a prior authorization is requested.
The claims submitted with the codes in this linked list will be denied.
If you have questions, please contact your Provider Coordinator.
Unity Health Insurance will begin accepting electronically submitted COBA Medicare Crossover claims for services provided to members with Medicare coverage A & B pending CMS approval.
This will apply to the Commercial, Medicare Supplement and Medicaid lines of business for members with coverage where Medicare is primary. This process will not apply to Quartz-administered health plan participants.
More information to come.
We have many important updates in the June Provider Manual that's online now. Postcards letting providers and practitioners know it's available will be arriving soon.
View List of Summer 2017 Unity Communicator Articles
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Quartz Health Solutions, Inc., Unity Health Plans Insurance Corporation, Gundersen Health Plan, Inc., Gundersen Health Plan Minnesota, Physicians Plus Insurance Corporation, Gundersen Health System, UnityPoint Health and UW Health are separate legal entities. Plans are underwritten by Unity Health Plans Insurance Corporation unless otherwise noted.