Florida: TurningPoint to manage prior authorization process for musculoskeletal surgical procedures

For dates of services on or after May 1, 2025, TurningPoint Healthcare Solutions, LLC (TurningPoint) will manage prior authorization requests for inpatient and outpatient musculoskeletal surgical procedures. This applies to members who reside in Florida and have fully insured or ASO UnitedHealthcare commercial plans. Note, we aren’t adding any new prior authorization requirements.

TurningPoint will review prior authorization requests using UnitedHealthcare clinical policies. Clinical reviews are conducted by appropriately licensed subspecialty medical professionals.

Plans this doesn’t apply to

• Commercial plans of members who reside in the U.S. Virgin Islands
• Optum Care®
• Surest®
• UMR™
• UnitedHealthcare Individual Exchange plans (also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans)
• WellMed®

What you need to do

For dates of service on or after May 1, 2025, providers performing these procedures should use the TurningPoint portal to submit prior authorization requests. To submit a request, please first register for access.

If you need assistance or would like to submit your request another way, please contact TurningPoint at:

• Phone: 904-895-4007
• Fax: 904-544-8025

You may begin submitting prior authorization requests to TurningPoint on April 1, 2025, for dates of services on or after May 1, 2025. If you have requests for dates of service before May 1, 2025, please continue to submit them to UnitedHealthcare.

It is the responsibility of the ordering physician to obtain prior authorization. For more information, please see our frequently asked questions.

Training opportunities

TurningPoint is offering trainings that cover overviews of their program, how to use the portal, and additional tools for success. Register for a training.

Questions?

If you have questions, please contact TurningPoint using their portal, or by phone or fax.