Updated March 25th, 2020:
BCBS of WNY:
To help reduce administrative burden on all providers, BCBS of WNY is removing pre-authorization, concurrent and post-payment review for all provider types, facilities and specialties for 90 days with dates of service on or after March 20th, 2020 through June 20th, 2020.
For more information on if this exception applies to your practice, please visit:
https://www.bcbswny.com/content/wny/provider/news/coronavirus.html , go to the FAQ 'Are you reducing or removing pre authorizations in this state of emergency?'
Please Note: This information is subject to change and is current at the time this blog post was created.
In response to the directive to lessen the administrative burden during this time, MVP Healthcare will make the following Utilization Management (UM) changes:
MVP has suspended prior authorization requirements from March 20, 2020 to June 18th, 2020 for:
- Inpatient surgery and inpatient admissions for hospitals in NY and VT
- Post-acute care after discharge from Hospitals in NY and VT including prior authorization requirements administered by naviHealth
- All Radiation Therapy and High-Tech Radiology (MRI's, MRA's, CT's, Nuclear Cardiology and PET Scans) managed by Evicore
- All musculoskeletal codes managed by Magellan/NIA
For more information on if this exception applies to your practice, please visit: https://content.mvphealthcare.com/provider/fast-fax/2020-23-COVID-19-Utilization-Management-Updates-3-24-20.pdf
*Currently, other payers such as IHA, Univera or United Healthcare do not have similar holds on prior-authorizations in place.