Please select the state where you practice.

Bulletins & Payment Policy Notifications

 

See the bulletins below to stay up-to-date on news, policy changes, and other issues important to your practice.

 

Credentialing Updates

Contact the National Credentialing Center at 1-877-842-3210.

 

Medical Policy Update Bulletin 

UnitedHealthcare Community Plan Medical Policy Update Bulletin

 

Current Bulletins  

FL Provider Announcement Peer to Peer (PDF 39.29 KB) - Posted 08.08.2017

EAPG Payment Methodology Implementation for Hospitals and Ambulatory Surgical Centers (PDF 124.39 KB) - Posted 07.25.2017

New Enhanced Enrollment and Claims Payment System External Frequently Asked Questions (PDF 78.96 KB) - Posted 06.29.2017

Summary of Changes - New Enrollment and Claims Payment System, Effective June 1, 2017 (PDF 105.37 KB) - Posted 06.23.2017

New Enhanced Enrollment and Claims Payment System Frequently Asked Questions (PDF 79.09 KB) - Posted 05.25.2017

New Auto Crossover Claim Submission Process: COBA (PDF 170.69 KB) - Posted 05.08.2017

New Enrollment and Claims Payment System Summary of Changes (PDF 105.31 KB) - Posted 4.26.2017 

Facility Billing Policy Update Reporting an ICD-10 Manifestation Code as a Primary/Principal Diagnosis - Effective July 1, 2016 (PDF 130.9 KB)

New Intensity-Modulated Radiation Therapy (IMRT) Reimbursement Policy - Effective July 1, 2016 (PDF 122.63 KB)

Changes to the Obstetrical Services and Supply Policies - Effective May 21, 2016 and Changes to the Inappropriate Primary Diagnosis Codes Policy and Implementation of the New Diabetic Testing Strips and Lancets Policy - Effective June 1, 2016 (PDF 204.94 KB)

REVISED: Adjunct Professional Services Policy - Frequently Asked Questions (PDF 394.63 KB)

Adjunct Professional Services Policy-Frequently Asked Questions (PDF 394.61 KB)

Claims Processing Change for Eight Professional Reimbursement Policies - Effective May 21, 2016 (PDF 145.71 KB)

New Place of Service (POS) 19 and Revision to POS 22-Effective January 1, 2016 and Telemedicine Policy Changes-Effective February 13, 2016 (PDF 177.42 KB)

Reporting Obstetrical Procedure Codes with Date Spans (PDF 140.03 KB)

2015 

Revision to Time Span Codes Policy - Effective Fourth Quarter 2015 (PDF 120.08 KB)

Reimbursement and Drug Policy Update for ICD-10 (PDF 183.43 KB)

2015 Quarter 3 & 4 Updates: Subsequent Revision Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 136.23 KB)

Procedure to Place of Service and Laboratory Services Reimbursement Policy Updates-Effective August 22, 2015 (PDF 191.37 KB)

Reimbursement Policy Clarification for the Maximum Frequency Per Day Policy and Revision Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 139.15 KB)

Changes to Existing Reimbursement Policies-Effective May 2015 (PDF 206.2 KB)

REVISED: New “X” Modifiers and Impact to UnitedHealthcare Community Plan Reimbursement Policies (PDF 380.73 KB)

New “X” Modifiers and Impact to UnitedHealthcare Community Plan Reimbursement Policies (PDF 376.83 KB)

Physical Medicine & Rehabilitation: Multiple Therapy Reduction Policy Reminder (PDF 24.38 KB)

New Reimbursement Policies and Changes to Existing Reimbursement Policies-Effective Feb. 14, 2015 and Mar. 1, 2015 (PDF 211.02 KB)

Payment Policy Notifications

Revenue Codes Requiring Procedure Codes Reimbursement Policy Clarification for Care Providers at Facilities and Hospitals (PDF 66 KB) - 11.29.2017 

Reimbursement Change for Image Guidance Code 77014 (PDF 66 KB) - 11.29.2017

Ambulance Reimbursement Policy Coding Guidelines Reminder and Policy Changes for 2018 (PDF 57.68 KB) - Date Posted 10.26.2017

New Add-On Codes Facility Policy - Effective Feb. 1, 2018 (PDF 54.38 KB) - Date Posted 10.20.2017 

Drug Testing Reimbursement Policy Update - Effective Jan. 1, 2018 (PDF 68.64 KB) - Date Posted 10.5.2017

National Drug Code Requirements for UnitedHealthcare Community Plan Professional Claims Frequently Asked Questions (PDF 149.76 KB) - Date Posted 8.22.2017

Reimbursement Change for Prolonged Services Policy (PDF 67.01 KB) - Date Posted 8.18.2017

Claim Reprocessing for Rebundling Code 96160 (PDF 48.51 KB) - Date Posted 7.27.2017

Revision to the Intrauterine Device (IUD) Supply Policy (PDF 52.8 KB) - Date Posted 7.12.2017

UnitedHealthcare Community Plan Bilateral Procedures and Maximum Frequency Per Day Policies – Effective Nov. 11, 2017 (PDF 49.38 KB) - Date Posted 6.28.2017

Two Place-of-Service (POS) Codes Added to Facility POS Code List in Two Policies (PDF 54.97 KB) - Date Posted 6.23.2017

New Drug Testing Reimbursement Policy Effective Sept. 1, 2017 (PDF 120.5 KB) - Date Posted 5.31.2017

UnitedHealthcare Community Plan Medicare Claims Processing System Is Being Upgraded – Effective May 20, 2017 (PDF 39.84 KB) - Date Posted 4.9.2017

Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy – Acupuncturist Update (PDF 216.94 KB) - Date Posted 4.07.2017

Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy – Acupuncturist Update (PDF 216.66 KB) - Date Posted 3.31.2017

Retirement of Moderate Sedation and Physical Medicine and Rehabilitation: Supervised Modalities Policies, and Changes to Procedure to Modifier and IMRT Policies - Effective May and June 2017 (PDF 202.22 KB) - Date Posted 3.2.2017

New National Drug Code Requirement Policy – Effective May 1, 2017 (PDF 48.38 KB)  - Date Posted 12.21.2016

Coding Reminder: How to Report Multiple Surgeons for One Operative Session (PDF 737.06 KB) - Date Posted 10.27.2016

Policy Change for the Multiple Procedure Payment Reduction of Diagnostic Imaging Services - Effective Jan. 1, 2017 (PDF 732.87 KB) - Date Posted 10.27.2016

Revision to Maximum Frequency per Day and Bilateral Procedures Policies for Procedure Codes with Bilateral Surgery Indicator of “2” - Effective Feb. 12, 2017  (PDF 110.97 KB)- Date Posted 10.27.2016

Revision to Lupron Policy-Effective January 1, 2017 (PDF 203.22 KB)

New Facility Reimbursement Policy-Appropriate Patient Status for Type of Bill Policy-Effective December 1, 2016 (PDF 180.99 KB) - Date Posted 8.11.2016

Implementation of the new Clinical Laboratory Improvement Amendments Identification Requirements Policy and the Replacement Codes Policy-Effective August 1 and November 1, 2016. Changes to the Non-Covered Codes, Ambulance, and Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policies-Effective in November and December 2016 (PDF 202.15 KB) - Date Posted - 7.29.2016

Phase Two Implementation Delay for Supply Reimbursement Policy (PDF 139.5 KB)

Changes to the CCI Editing, DME, Incontinence Supply, Lab Services, and T Status Codes Policies -Effective August 20, 2016 and Implementation of the new Consultation Services Policy-Effective September 1, 2016 (PDF 282.07 KB)

Facility Billing Policy Update Reporting an ICD-10 Manifestation Code as a Primary/Principal Diagnosis - Effective July 1, 2016 (PDF 130.9 KB)

New Intensity-Modulated Radiation Therapy (IMRT) Reimbursement Policy - Effective July 1, 2016 (PDF 122.63 KB)

Changes to the Obstetrical Services and Supply Policies - Effective May 21, 2016 and Changes to the Inappropriate Primary Diagnosis Codes Policy and Implementation of the New Diabetic Testing Strips and Lancets Policy - Effective June 1, 2016 (PDF 204.94 KB)

REVISED: Adjunct Professional Services Policy - Frequently Asked Questions (PDF 394.63 KB)

Adjunct Professional Services Policy-Frequently Asked Questions (PDF 394.61 KB)

Claims Processing Change for Eight Professional Reimbursement Policies - Effective May 21, 2016 (PDF 145.71 KB)

New Place of Service (POS) 19 and Revision to POS 22-Effective January 1, 2016 and Telemedicine Policy Changes-Effective February 13, 2016 (PDF 177.42 KB)

Reporting Obstetrical Procedure Codes with Date Spans (PDF 140.03 KB)

2015 

Revision to Time Span Codes Policy - Effective Fourth Quarter 2015 (PDF 120.08 KB)

Reimbursement and Drug Policy Update for ICD-10 (PDF 183.43 KB)

2015 Quarter 3 & 4 Updates: Subsequent Revision Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 136.23 KB)

Procedure to Place of Service and Laboratory Services Reimbursement Policy Updates-Effective August 22, 2015 (PDF 191.37 KB)

Reimbursement Policy Clarification for the Maximum Frequency Per Day Policy and Revision Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 139.15 KB)

Changes to Existing Reimbursement Policies-Effective May 2015 (PDF 206.2 KB)

REVISED: New “X” Modifiers and Impact to UnitedHealthcare Community Plan Reimbursement Policies (PDF 380.73 KB)

New “X” Modifiers and Impact to UnitedHealthcare Community Plan Reimbursement Policies (PDF 376.83 KB)

Physical Medicine & Rehabilitation: Multiple Therapy Reduction Policy Reminder (PDF 24.38 KB)

New Reimbursement Policies and Changes to Existing Reimbursement Policies-Effective Feb. 14, 2015 and Mar. 1, 2015 (PDF 211.02 KB)

2014 

Changes to Existing Reimbursement Policies ‒ Effective Aug. 1, 2014 (PDF 233.28 KB)

Reimbursement Policy Changes-Effective Aug. 23, 2014 and New Reimbursement Policies-Effective Sept. 1, 2014 (PDF 195.28 KB)

New Reimbursement Policies ‒ Effective August 4, 2014 (PDF 159.2 KB)

Changes to Existing Reimbursement Policies (PDF 148.08 KB) - Effective May 17, 2014

Readmission Policy - November 2011 (PDF 372.51 KB)

 

Automated Overpayment Adjustment Process - PRA Enhancement (Posted 11/2011)  (PDF 42.14 KB)
Service Pending Reference Number Process Change - Oct. 1, 2011  (PDF 33.99 KB)
H1N1 Update  (PDF 13.17 KB)
Baby Be Well Notice  (PDF 236.93 KB)
New Member ID Cards Notice  (PDF 52.37 KB)
Dual-Eligible Special Needs Plans Important Information for Providers  (PDF 25.57 KB)
Atypical antipsychotics use in preschoolers  (PDF 28.65 KB)
Healthy First Steps OB Referral  (PDF 29.58 KB)
HEDIS 2010 Data Collection  (PDF 52.26 KB)
Ancillary Network Transition Notice  (PDF 7.39 KB)
United Healthcare of Florida  (PDF 82.57 KB)
Update on Therapy Guidelines  (PDF 7.32 KB)
Enhancement to Provider Services  (PDF 7.35 KB)
Medicaid Provider Number and NPI Notice  (PDF 48.61 KB)
HEDIS 2010 Frequently Asked Questions  (PDF 42.26 KB)
Domestic Violence and Drug Screening  (PDF 38.21 KB)
Notice Regarding Orlando Health Hospitals  (PDF 160 KB)
National Healthy First Steps Program Update  (PDF 18.45 KB)
Baby Be Well Appointments  (PDF 236.93 KB)
Cost-Share Grace Period for Dual SNP Members Frequently Asked Questions  (PDF 320.18 KB)
Recommended Immunization Schedules for Persons Aged 0–18 Years  (PDF 257.65 KB)
Vaccines for Children Program (VFC) Program Reminder  (PDF 11.16 KB)
Children and Teens Immunization Schedule  (PDF 317.05 KB)
Screening Questionnaire for Child and Teen Immunization (Español)  (PDF 344.4 KB)
Screening Questionnaire for Child and Teen Immunization (English)  (PDF 315.59 KB)
2010 Recommended Immunizations for Babies  (PDF 365.04 KB)
Important Information About 17 Alpha-Hydroxyprogesterone Caproate (17P) Injection (PDF 62.53 KB)
Automated Overpayment Adjustment Process
(PDF 22.01 KB) - PRA Enhancement (Posted 11/2011)
NDC Billing Alert Fall 2010 Bulletin (PDF 21.72 KB)

Frequently Asked Questions: How to Handle Cost-sharing for UnitedHealthcare Dual Eligible Patients (PDF 61.15 KB)