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UnitedHealthcare Oxford
Administrative PolicyREQUESTS FOR NETWORK EXCEPTIONS
Policy Number: ADMINISTRATIVE 247.3 T2Effective Date: August 1, 2017Table of Contents
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What is requests for in-network exceptions?
Requests for in-network exceptions are formal requests made by individuals or organizations to deviate from the usual in-network coverage rules and receive coverage for out-of-network healthcare services.
Who is required to file requests for in-network exceptions?
Requests for in-network exceptions can be filed by any individual or organization who wants to receive coverage for out-of-network healthcare services instead of using the designated in-network providers.
How to fill out requests for in-network exceptions?
To fill out a request for in-network exceptions, the individual or organization needs to provide their personal information, details of the requested out-of-network healthcare services, reasons for the exception, and any supporting documentation.
What is the purpose of requests for in-network exceptions?
The purpose of requests for in-network exceptions is to allow individuals or organizations to receive coverage for out-of-network healthcare services in exceptional circumstances where using in-network providers is not feasible or appropriate.
What information must be reported on requests for in-network exceptions?
Requests for in-network exceptions must include personal information such as name, contact details, and insurance policy number. Additionally, details of the requested out-of-network healthcare services, reasons for the exception, and any supporting documentation must also be reported.
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