UnitedHealthCare (UHC) Releases Annual United Health Premium Physician Designation Program Assessment Results

UHC has recently completed their annual UnitedHealth Premium physician designation program quality and cost efficiency assessments. Designation letters were sent out by UHC to physician offices last week. The letters notify physicians if they have met the criteria necessary for a specific designation under the program. UHC plans to make the results available to the public no earlier than March 4, 2009. Physicians can access their performance assessment report online through a specific link provided by UHC and with a user ID and temporary password provided in the correspondence sent out to physicians by UHC.

For physicians that are notified that they have successfully achieved a UHC designation, you still have the option of reconsideration to address concerns you may have with the data contained in your assessment. Physicians that are notified that they did not meet the program’s criteria to obtain a specific designation by UHC also have the opportunity to review their assessment report, seek clarification and, if necessary, request reconsideration of their designation. If a physician does not receive the Premium program’s designation, it could be for various reasons, including insufficient UnitedHealthCare paid claims volume (sample size) for analysis, having a specialty that is not evaluated or practice patterns that did not meet the program’s criteria. 

A physician may request reconsideration at any time during the designation cycle. 

However, if the physician does not want their new designation to display on UHC Web sites until they receive the outcome of the reconsideration, their request for reconsideration with all supporting information they want considered will need to be postmarked by January 27, 2009, email and fax must be received by January 27, 2009. 

When UnitedHealthcare receives the requests by this date, they will display the physician’s designation results only after completing their reconsideration. 

However, if the request and all information physicians would like considered in the review are not received by January 27, the designation will be displayed according to the timetable noted above.

UHC states that they utilize national industry, evidence-based and medical society standards with a transparent methodology and data sources to evaluate physicians across 20 specialties. A summary of the methodology and frequently asked questions about the program are included with the UHC mailing to physicians.

Included with the UHC mailing to physicians are important links and resources to obtain additional information on the program. Physician reports can be accessed through a specific link provided in the letter  https://ereports.uhc.com/ReportCard  but you must have your user name and password provided in the letter from UHC to access your specific report. Other resources available from UHC on the program are available online at www.UnitedHealthcareOnline.com  >Clinician Resources >UnitedHealth Premium >UnitedHealth Premium Designation. UHC is also offering an interactive online UnitedHealth Premium Designation course through their website.