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.

Credentialing Update: contact the National Credentialing Center at 1-877-842-3210 – Feb. 28, 2012

UnitedHealthcare Community Plan Medical Policy Update Bulletin

 

Bulletins

Billing Guidance from the Ohio Department of Medicaid Regarding ICD-10 Implementation (PDF 63.79 KB)
Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 139.15 KB)
Enhanced HIPAA Claim Edits Planned for March 2015 (PDF 173.48 KB)
Bright Futures™ — Our New Standard for Well-Child Care? (PDF 26.63 KB)
Enhanced HIPAA Edits to be applied to Claim Submissions
FAQ for Sleep Test Optimization Program (PDF 126.02 KB)
Frequently Asked Questions: How to Handle Cost-sharing for UnitedHealthcare Dual Eligible Patients (PDF 61.15 KB)
HEDIS® 2012 Data Collection for UnitedHealthcare and Affiliated Commercial, Medicare and Medicaid Plans Notification - Jan. 26, 2012 (PDF 62.42 KB)
HEDIS 2012 Frequently Asked Questions - Jan. 26, 2012 (PDF 64.85 KB)
Maternity Admission Notification Update - January 2012 (PDF 27.15 KB)
Occular Screening Medical Policy Cancellation Notice (PDF 23.96 KB)
ODM Guidance Document for Nursing Facilities regarding Patient Liability (PDF 88.5 KB)
Online Password Change (PDF 19 KB)
Plans Notification - Jan. 26, 2012 (PDF 62.42 KB)
Prohibition of Claims Payment Beyond the Borders of the U.S. - Jan. 17, 2012 (PDF 41.21 KB)
Provider Alert: Orencia (abatacept) Reimbursement Policy Change (PDF 31.26 KB)
Provider Notification for November Payment Policy Updates/Changes - Nov. 1, 2012 (PDF 205.73 KB)
Provider Preventable Conditions: Health Care Acquired Conditions and Present on Admission Policy Update (PDF 24.65 KB)
Readmission Policy FAQ (PDF 248.2 KB)
Readmission Policy Reminder (PDF 119.6 KB)
Secure Fax Alert for Medical Prior Authorization Requests - Oct. 12, 2011 (PDF 20.52 KB) (PDF 20.52 KB)
Synagis Program 5 Doses (PDF 51.26 KB)
Synagis Program / Authorization and Product Delivery - Posted October (PDF 52.46 KB)
FAQ – Cost Sharing for Dual Eligible Patients (PDF 39.5 KB)
UnitedHealthcare Sequestration Implementation (PDF 93.07 KB)
United Healthcare Supports National Elder Abuse Awareness Day (PDF 33.22 KB)

UnitedHealthcare Responds to Ebola Concerns (PDF 80.08 KB)

Community Plan Medical Policy update - June 2015 (PDF 743.36 KB)

 

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  (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)

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)

Changes to Existing Reimbursement Policy – Effective May 17, 2014 (PDF 148.09 KB)

New Drug Policy and Changes to Existing Reimbursement Policies - Effective February 15, 2014 (PDF 160.18 KB)

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

(PDF 148.09 KB)New and Changed Reimbursement Policies  - Effective Sept. 14, 2013
(PDF 135.2 KB)
New and Changing Reimbursement Policies - Effictive May 18, 2013 (PDF 56.18 KB)

New Vaccines for Children Policy - Effective May 18, 2013 (PDF 43.89 KB)

Changes to Reimbursement Policies – Effective Feb. 12, 2012 (PDF 45.12 KB)

New Policies Effective Aug. 14, 2011 (PDF 65.09 KB)