In sum, the renewal of the Gold Card program is good news for providers! Be sure to keep your practice up to date so that you can benefit from it or seek billing help that can help you do so. At TNT, we keep track of updates like these so your practice doesn’t miss a beat. By staying ahead of requirements, we help you protect revenue and focus on patient care.
Final Thoughts
Prior authorizations are one of the biggest sources of denials and delayed payments. For infusion centers, specialty clinics, and other practices with high-cost treatments, this change can mean:
- More consistent cash flow
- Reduced staff time spent on administrative back-and-forth
- Better patient experience with fewer interruptions to care
Why It Matters for Billing
It’s October, which means new billing updates just came through! Here’s what providers need to know:
As of October 1, 2025, UnitedHealthcare’s National Gold Card Program is entering its second year. The Gold Card program is designed for providers who consistently follow evidence-based guidelines. If you qualify, many services that normally require prior authorization are moved to an advanced notification model instead – this means fewer interruptions, fewer denied claims, and more predictable reimbursement, which is a big deal for practices of all sizes and specialties!
1. Renewal for Year Two: Providers who met UHC’s criteria will remain in the program.
- What to Do: Check eligibility by confirming whether your providers are included via the UHC portal.
- What to Do: Stay proactive in both billing and compliance. Even with fewer authorizations required, accurate documentation is still key to keeping claims clean.
- What to Do: Update workflows by making sure your billing and clinical teams know which services no longer need prior authorization.