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CAA and Transparency Rule

2021 United HealthCare Services, Inc. All Rights and Transparency RuleProvision Highlights GuideNovember 3, 2021 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth information is intended to provide general information on CAA and Transparency In Coverage rule and does not constitute medical, legal or tax advice nor does it constitute a binding obligation of UnitedHealthcare with respect to any matter discussed herein. Please note, inaddition to federal law, states may have additional or differing requirements. Please contact your UnitedHealthcare account representative for additional details.

Under the new regulations, a provider may, in advance, secure the patient’s consent to be balance billed. However, the provider would need to disclose information regarding the fact that they are out-of-network and the member would have to agree in writing. This variation to the rule would not apply in an emergency

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