New Jersey Medicaid: Consent Form Now Mandatory for Sterilization Claims
Effective immediately, the UnitedHealthcare Community Plan of New Jersey has implemented a new requirement in compliance with state Medicaid guidelines for sterilization procedures. All healthcare providers submitting claims for sterilization procedures—including hospitals, operating physicians, anesthesiologists, and clinics—must attach a fully completed Consent Form-7473-M ED 3-81 to their claims. Failure to comply will result in denied payments.
The consent form is to be attached to support each sterilization procedure to ensure that such has been authorized and consented to by the patient, with federal and state requirements. It must be followed for paper and electronic claim submissions.
Providers who mail paper claims must have the completed form actually attached to their documentation. For electronic submissions, providers must follow the protocols of their respective clearing houses to attach the consent form to the claim file.
Providers should be aware that when partial forms are submitted or the form is missing, it can cause delays or denials of payments which may impact the time to reimbursement of services. UnitedHealthcare therefore advises all providers to familiarize themselves with these procedures as a way of not facing the interruptions.
UnitedHealthcare 24/7 further assistance through Provider Portal includes real-time options that are available in chat, and providers may contact Provider Services toll-free at 888-362-3368, Monday through Friday, 8 a.m. through 6 p.m. Eastern Time, for business hours. More detailed information can be found on the UnitedHealthcare page.
