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

Payment Policy Notifications

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

New Policy-Evaluation and Management Reimbursement Policy (PDF 123.17 KB)

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)

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)

Changes to Existing Reimbursement Policy and Update to New Reimbursement Policy-Effective Nov. 15, 2014
(PDF 192.84 KB)
New Reimbursement Policies and Changes to Existing Reimbursement Policy for UnitedHealthcare Community Plan Dual Special Needs Plan - Effective Nov. 15, 2014 (PDF 192.25 KB)

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)

Provider Preventable Conditions: Health Care Acquired Conditions and Present on Admission Policy Update (PDF 24.65 KB)

Changes to Existing Reimbursement Policy (PDF 128.24 KB) – Effective May 17, 2014

Changes to Existing Reimbursement Policies (PDF 155.68 KB) - Effective February 15, 2014

New Medical Policy and Changes to Reimbursement Policies (PDF 174.08 KB)  - Effective November 16, 2013

New and Changed Reimbursement Policies - Effective May 2013 (PDF 60.18 KB)

Important New Reimbursement Policy - Vaccines for Children (PDF 43.89 KB) - Effective 5/18/2013

New and Changed Reimbursement Policies (PDF 135.2 KB) - Effective Sept. 14, 2013

Provider Notification for November Payment Policy Updates/Changes - Nov. 1, 2012   (PDF 205.73 KB)

Date Sent Description
1/25/2013 Synagis Program 5 Doses (PDF 51.26 KB)
08/21/2012 Synagis Program (PDF 52.46 KB)
7/12/2012 SOS Claim Reconsideration Form (PDF 148.51 KB)
7/3/2012 Provider Sanction Notice (PDF 50.36 KB)
7/2/2012 SOS Facility Edit Reminder (PDF 38.79 KB)
5/24/2012 Elimination of Observation Authorization Requirement (PDF 38.59 KB)
5/4/2012 SOS Adult Chiropractic Benefit Reinstatement (PDF 35.44 KB)
2/24/2012 SOS Grant Program Preview (PDF 36.45 KB)
1/12/2012 Rebranding Announcement (PDF 458.23 KB)
11/18/2011 Bright Futures™ — Our New Standard for Well-Child Care (PDF 26.67 KB)
10/27/2011 Pharmacy Update Annual Notice (PDF 51.69 KB)
10/27/2011 NDC Reporting (PDF 177.91 KB)
09/01/2011 Deadline for HIPPA Secure Fax Confirmation - Effective September 6, 2011 (PDF 62.25 KB)
08/31/2011 HIPAA Intake Prior Authorization Reminder (PDF 384.58 KB)
07/01/2011 New Policies Effective Aug. 14, 2011 (PDF 43.98 KB)
06/10/2011 Prior Authorization Form, Fax Back Instructions, and Tool Free Fax (PDF 167.54 KB)
06/09/2011 Enhancements to DME Authorization Process (PDF 217.57 KB)
06/02/2011 Newborn Take Backs from the State (PDF 119.05 KB)
12/17/2010 Personal Care Plus/UnitedHealthcare Dual Complete 2011 Updates (PDF 133.36 KB)
11/05/2010 Implementing E-Prescribing (PDF 54.97 KB)
10/29/2010 Flu Shots 2010 (PDF 123.43 KB)
10/15/2010 Lab Service Update (PDF 86.93 KB)
10/14/2010 Reinstatement of Podiatry Benefits (PDF 42.02 KB)
10/01/2010 MIChild Announcement (PDF 365.02 KB)
09/28/2010 NDC Billing Alert (PDF 46.47 KB)
09/27/2010 OB Billing Reminder (PDF 74.62 KB)
08/16/2010 Point-of-Care Hemoglobin and Lead Testing (PDF 84.53 KB)
06/28/2010 Fraud, Waste and Abuse (PDF 131.81 KB)
06/17/2010 GLHP Partners for Electronic Claims Submission (PDF 44.07 KB)
04/10/2010 Postpartum Incentive Announcement (PDF 51.4 KB)
10/27/2009 Member Rights and Responsibility (PDF 38.87 KB)
09/28/2009 PCP Roster Information in OSCR (PDF 41.51 KB)
09/28/2009 Toll Free Numbers for Fax Lines (PDF 41.43 KB)

New Policies Effective Aug. 14, 2011 (PDF 43.98 KB) 
2011 Disease Management Information for Providers (PDF 122.34 KB)
H1N1 Update  (PDF 11.69 KB)
HEDIS 2010 Frequently Asked Questions  (PDF 42.26 KB)
HEDIS 2010 Data Collection  (PDF 52.26 KB)
2010 Fraud, Waste and Abuse Training Materials  (PDF 542.39 KB)
Healthy First Steps  (PDF 65.05 KB)
Cost-Share Grace Period for Dual SNP Members FAQ  (PDF 320.18 KB)
Reimbursement Policy Update  (PDF 13.16 KB)
2009 Fraud, Waste and Abuse Training Materials (PDF 794.7 KB)