Georgia: Review key referral and billing protocols
AI Summary
UnitedHealthcare Georgia commercial plans now require providers to use Member Advance Notice forms before providing non-covered services and mandates that only 9amHealth providers can prescribe weight-loss medications for Georgia State Health Benefit Plan members in HMO/HDHP plans (excluding diabetic GLP-1s). Out-of-network referrals must be limited to emergency situations only.
Action Required
Immediately: Front desk staff must obtain Member Advance Notice forms before providing any non-covered services to Georgia UHC commercial members to prevent balance billing issues. By Feb 1, 2026: Stop accepting weight-loss medication prescriptions from non-9amHealth providers for Georgia SHBP HMO/HDHP members - direct these members to join9am.com/shbp or 888-870-9542. Providers must refer to in-network providers except in emergencies and follow nonparticipating provider guidelines for any out-of-network referrals.
Plan Types
Commercial
States
GA
Specialties
all-specialties