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Arkansas Authorization Requirements and Clinical Criteria

A. Prior Authorization of Non-Urgent Healthcare Services (A.C.A. 23-99-1105) UnitedHealthcare Life Insurance Company (UHCLIC) acting on behalf of the Health Plan must make an authorization or non-authorization determination and notify the subscriber (member) and provider of the determination/decision within 2 business days of obtaining all the information needed to make the determination.

B. Prior Authorization of Urgent Healthcare Service (A.C.A. 23-99-1106) UHCLIC acting on behalf of the Health Plan must make an expedited authorization or adverse determination on an urgent request and notify the subscriber (member) and provider of the determination no later than 1 business day after receipt of all information needed to complete the review.

C. Retrospective Denial (A.C.A 23-99-1108) UHCLIC may not revoke (cancel), limit, condition, or restrict an authorization for a period of 90 days from the date the provider received the authorization.

D. Written Clinical Criteria Written clinical criteria can be found on UnitedHealthcare Medical & Drug Policy and Coverage Determination Guidelines pages. Per A.C.A. 23-99-1104 Statistics are made readily available regarding prior authorization approvals and denials.

Information for members of Connecticut Insurance Plans:

• Surprise Bill Information
• Out-of-Network Costs Information

You may request a printed copy of a network provider directory by:

1. Contacting us at the toll-free number on the back of your ID card.
2. Faxing your request in writing to (801) 478-7561.
3. Mailing your request in writing to Claims Department, P.O. Box 31374, Salt Lake City, UT 84131-0374.

Please Note:

Every Delaware provider that you use must clearly disclose to you in writing if they (or any provider practicing in their group practice or facility) are not in your network (non-network). Each non-network provider in Delaware must obtain your written consent prior to treating you, and require you to sign a network disclosure statement indicating you will accept financial responsibility for any non-network services which may not be covered by your plan. You cannot be balanced billed by a non-network provider if the non-network provider (or the facility based provider employing non-network facility based providers) fails to provide you with the required network disclosure statement and obtain your written consent. This requirement includes the disclosure of non-network lab services ordered by your provider or facility.

Maryland insureds or enrollees may access information about proposed rate increases and submit comments regarding proposed rate increases on the Maryland Insurance Administration’s website.

Find information on the Maryland Gap Referral and Appeal Review Process.

Information pertaining to dental plans - providers, benefits and estimates

If at this time you find it hard to pay your dental plan's premium, there is guidance in place for COVID-related relief that may help you. In summary, if your plan was in good standing (premium paid) as of March 1, 2020, then you may elect:

• To have your plan's grace period extend to 60 days, either retroactively starting on April 1, 2020, or begin on May 1, 2020.
  • During this grace period your coverage will remain in force and any claims you may have will be processed.
• After the extended grace period, you have the option to pay the owed premium broken-up over the remaining months of the policy.
  • For example, if there are 6 months remaining on the policy, you have the option to pay the unpaid premium in 6 installments, in addition to your regular monthly premium.

To activate this option if needed, simply give us a call at 1-800-657-8205.