UnitedHealthCare Begins Review Cycle for the UnitedHealth Premium Designation Program

This month, UHC sent out an introductory letter to practice administrators regarding the process for the new UHC Premium Designation Program assessment period. The assessment reports for the next designation cycles are based on refreshed paid claims data and will be sent to physicians in October 2008. Comprehensive information about the program is available on UnitedHealthcare’s physician web site located at www.UnitedHealthcareonline.com.  Materials available at this web site are the UnitedHealth Premium detailed methodology which provides a complete description of the 2008 program methodology, the UHC Premium reconsideration process, commonly asked questions, and the UHC principles for transparency-consumer disclosure. 

Physicians are encouraged to access this information in order to prepare for the review of their individual data when the reports are issued in October. UnitedHealthcare will notify physicians of their individual designation status at least 45 days prior to any public disclosure of the results to give physicians the opportunity to seek clarification and, if necessary, to request reconsideration. 

From October 8th through December 1st UHC will take input from physicians on their data and recalculate scores if necessary and based on new information. Physicians are provided with passwords to the UHC site to review their designation status and their ratings. There have been some changes to the program – for example the sample size was increased – a minimum of 30 rules among 5 patients are needed to be evaluated for quality. In addition, there is now a wider set of rules applied to certain specialties.

New designations will be available on UHC’s consumer web site by the end of 2008.

UHC Premium program advisors are available to answer questions toll-free at 866-270-5588 or via email at unitedpremium@uhc.com