The
Empire Plan provides a paid-in-full benefit for the administration of an allergy
injection, including the cost of the serum, when billed by a participating provider. But,
what happens when the serum is dispensed by one participating physician and is
administered by another participating physician or, in some cases, by the patient or the
patient’s family? As of January 1, 2002, the “take-away” serum will be paid
in full under the Participating Provider Program.
Before
this change, benefits for the “take-away” serum were provided under the Basic
Medical portion of the Plan subject to the annual deductible and paid at 80% up to the
Reasonable and Customary Charge. No payment would be made until the patient had met his or
her annual deductible.
For
more information, please call United HealthCare at 1-800-942-4640.