UnitedHealthcare Community Plan
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Bulletins

 

For important announcements from the Texas Health and Human Services Commission, please go to the Provider Information tab.

 

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

Alerts

Click on the arrow above to view current alerts. 

New Way to Refer for Behavioral Health Needs (PDF 722.54 KB) - 7.20.2017

Important Enrollment Information for Care Providers Ordering, Prescribing or Referring for Our Members (PDF 747.59 KB) - 7.11.2017

Hospice Service Coordination in Nursing Facilies - 6.29.2017

Eligibility MESAV Now Available for Nursing Facilities on Link (PDF 58.71 KB) - 6.26.2017

Claim Reconsideration Process Now Available for Clinical Review (PDF 431.5 KB) - 6.22.2017

Update to THSteps Therapeutic Dental Benefits Effective July 1, 2017 - 6.19.2017

CHIP Providers Need to be TX Medicaid Enrolled by Dec.31, 2017 (PDF 53.77 KB) - 6.15.2017

LTSS Providers Need to Enroll in Medicaid by July 1, 2017 (PDF 69.83 KB) - 6.8.2017

A STAR Kids Letter: LTSS Authorizations Extended No Later than June 30, 2017 (PDF 61.32 KB) - 6.6.2017

Prior Authorization Changes for PT, OT and ST Starting July 1, 2017 (PDF 43.6 KB) - 5.26.2017 - UPDATED

RUG Score Available for Nursing Facilities (PDF 84 KB) - 5.25.2017

Required Taxonomy Billing Deadline Extended to Sept. 1 (PDF 56.1 KB) - 5.16.2017

Texas Health Steps Vaccine Administration Claims Error Resolved (PDF 80.82 KB) - 5.9.2017

Home Health Plan of Care Required for All New Home Health Services Requests (PDF 40.55 KB) - 4.9.2017

Home Health Skilled Nursing Claims Recoupment (PDF 121.75 KB) - 3.29.2017

STAR Kids Prior Authorization Notification (PDF 73.67 KB) - 1.10.2017 Updated 3.22.2017

Incorrect Payment of STAR Kids Home Health Claims (PDF 41.54 KB) - 03.10.2017

Required Taxonomy Billing Effective May 1, 2017 (PDF 51.75 KB) - 02.06.2017 

Help Members Get Free Transportation by Enrolling Your Service Location with Medicaid (PDF 750.01 KB) - 02.06.2017

 

Alerts Archives

Click on the arrow above to view the alerts archive. 

 

Claims Reprocessing for Incorrectly Paid “Z23 Encounter for Immunizations” Claims (PDF 29.49 KB) - 12.15.2016

Nursing Facility and Home Health Skilled Nursing Claims Alert (PDF 282.82 KB) - 11.8.2016

Outpatient Therapy Prior Authorization Change (PDF 733.49 KB) - 10.7.2016 (updated 10.10.2016)

New Reporting Requirements for Breaches in Confidential Information (PDF 367.49 KB) - 10.6.2016

Help Medicaid members get a ride to your office by enrolling your office location with Medicaid (PDF 61.35 KB) - 9.30.2016

Zika Virus: Important Information for UnitedHealthcare Community Plan Care Providers in Texas (PDF 263.05 KB) - 9.20.2016

Claims Processing Guidelines (PDF 41.25 KB) - 8.1.2016 

June 17 Deadline to Continue Serving Medicaid Members (PDF 159.75 KB) - 6.13.2016

Survey for LTSS Providers. Deadline July 29, 2016 (PDF 8.04 KB) - 6.9.2016

Prior Authorizations for Physical, Occupational, and Speech Therapies (PDF 164.88 KB) - 5.31.2016

DME Incontinent Supplies Change in Authorization Effective Sept. 1, 2016 (PDF 38.59 KB) - 5.27.2016

Long-acting reversible contraceptive (LARC)  Toolkit (PDF 711.33 KB) - 7.5.2016

Long-Acting Reversible Contraception Available as a Pharmacy Benefit (PDF 52.17 KB) - Updated 5.4.2016

Specialty Pharmacy Qualifying Medications (PDF 61.58 KB) - 5.4.2016

Value-added Service Home Health Billing Code Change Alert (PDF 50.11 KB) - 4.15.2016

HCBS Provider Self-Assessments Webinar Slated for March 23 (PDF 366.05 KB) - 3.22.2016

Prior Authorization Fax Number Change (PDF 42.01 KB) - 3.9.2016

Medicaid Reenrollment Deadline: Action May Be Required - 3.9.2016

LTSS ACEP Payment Delay Resolved (PDF 64.97 KB) - 2.4.2016

Non-Emergency Transportation Prior Authorization Alert (PDF 262.71 KB) - 1.11.2016

Attendant Rate Increase (PDF 132.06 KB) - 11.4.2015

Community Based Alternative Provider Claims Alert (PDF 62.59 KB) - 10.29.2015

Methylin Authorization Notice (PDF 20.68 KB) - 10.5.2015

TMHP Mandatory Medicaid Reenrollment Workshops Scheduled - 8.19.2015

DADS LTSS Reenrollment Information: Action Required (PDF 22.78 KB) - 8.18.2015

Re-enroll your Texas Medicaid ID: Action Required (PDF 193.08 KB) - 8.18.2015

NDC Unit of Measure Billing Requirement (PDF 62.17 KB) - 7.23.2015

Providers Need to Re-enroll to serve Texas Medicaid Members (PDF 70.34 KB) -7.21.2015

New Prior Authorization Form for all Texas (PDF 65.55 KB) - 7.14.2015

Femoroacetabular Impingement Syndrome Prior Authorization Changes (PDF 61.54 KB) - 6.19.2015

OB/GYN Rate Change (PDF 60.56 KB) - 5.18.2015

HHSC MMP Member Enrollment Rights (PDF 34.91 KB) - 5.7.2015

Medicaid Re-enrollment:  An important message from HHSC (PDF 62.23 KB) - 5.1.2015

UnitedHealthcare Connected (Medicare-Medicaid Program) Town Hall and Webinar Flyer (PDF 121.09 KB) - 4.30.2015

Sinuplasty Required Prior Authorizations (PDF 167.49 KB) - 4.21.2015

UnitedHealthcare Connected (MMP) Authorization Alert (PDF 199.02 KB) - 4.14.2015

NDC Drug Vendor Program Crosswalk (PDF 61.88 KB) - 3.18.2015

MRSAs IDD Authorizations Extended (PDF 65.67 KB) - 4.1.2015

Enhanced HIPAA Claim Edits Planned for March 2015 (PDF 173.48 KB)

Electronic Visit Verification

Click on the arrow above to view Electronic Visit Verification, Electronic Visit Verification Archives, Forms, HHS Alerts & Notifications, Training, and Your Plan Compliance.

Revised Form: H1002 Provider Electronic Visit Verification Vendor System Selection - 2.15.2017
Telephone Service Types Approved for EVV Use - 02.08.2017
Reminder on Required EVV System Data Elements - 02.08.2017
2017 Electronic Visit Verification (EVV) Training (PDF 327.4 KB) - 1.20.2017 
Reason Code News - 11.18.2016
Complete List of Reason Codes - 11.18.2016
Medicaid Electronic Visit Verification (EVV) Small Alternative Device Agreement and Order - 7.28.2016
Medicaid EVV Small Alternative Device Agreement (Spanish) - 11.3.2016
HHSC EVV Provider Compliance Plan Notification (PDF 93.25 KB) - posted 6.1.2016
About The HHSC EVV Provider Compliance Plan Notification (PDF 415.27 KB) - posted 6.1.2016
Provider Compliance Plan for UnitedHealthcare Community Plan EVV (PDF 1.22 MB) - posted 5.27.2016
Community First Choice Providers EVV Training (PDF 36.99 KB) - posted 1.26.2016
EVV Compliance Manditory April 2016 (PDF 97.15 KB) - posted 12.24.2015
Frequently Asked Questions - Former CM2000 Users (PDF 374.68 KB) - posted 11.2.2015
Incorrect or Missing Data Elements Required (PDF 135.2 KB) - posted 11.2.2015
EVV Change Final!! (PDF 95.49 KB) - posted 11.2.2015
EVV Manditory Reminder (PDF 63.94 KB) - posted 10.30.2015
EVV Vendor Selection (PDF 30.99 KB) - posted 10.30.2015
CM2000 Contract End (PDF 106.74 KB) - posted 10.2.2015
EVV Delay in Imposing Compliance Penalties (PDF 38.91 KB) - posted 9.1.2015
Suspension of Visit Maintenance Requirement (PDF 187.32 KB) - posted 8.4.2015
Attend an HHSC EVV Training (PDF 214.03 KB) - posted 6.19.2015


Electronic Visit Verification Archives

EVV Data Integrity (PDF 89.78 KB) - posted 6.4.2015
EVV Compliance Plan Updated (PDF 407.1 KB) - posted 5.19.2015
EVV for Community First Choice (PDF 103.9 KB) - posted 6.4.2015
EVV Postponed for Private Duty Nurses (PDF 105.03 KB) - posted 5.18.2015
EVV 21 Day Extended (PDF 24.35 KB) - posted 5.1.2015
EVV HHSC Implementation Additional Dates (PDF 41.97 KB) - posted 4.14.2015
EVV HHSC Reason Codes Webinar - April 15, 2015 (PDF 21.34 KB) - posted 4.13.2015
EVV HHSC Reason Codes (PDF 154.01 KB) - posted 4.13.2015
EVV HHSC Reason Code Power Point (PPTX 360.1 KB) - posted 4.13.2015
EVV HHSC Announcement - Accectable Telephone Devices (PDF 51.82 KB) - updated 4.13.2015
EVV Fixed Visit Verification Device Santrax (PDF 17.26 KB) - posted 3.25.2015
EVV Provider Implementation Dates 3.6.2015 (PDF 108.22 KB) -  posted 3.18.15
EVV Sandata Notification Update 3.12.2015 (PDF 58.96 KB) -  posted 3.18.15
EVV Provider Alternative Device Notification 3.2015 (PDF 37.63 KB) - posted 3.18.15
EVV Small Device Agreement and Order Form: English (PDF 527.37 KB) - 3.18.15
EVV Small Device Agreement and Order Form: Spanish (PDF 484.52 KB) - 3.18.15
EVV Update: Start date extended (PDF 29.49 KB)
EVV Update: Provider Selection by Feb 10. Default Selection
(PDF 44.41 KB)
Updated EVV Announcement
(PDF 45.37 KB)
Medicaid Provider Notification: Statewide Implementation of Electronic Visit Verification
(PDF 42.62 KB)
Electronic Visit Verification Initiative
(PDF 72.42 KB)


Forms

Medicaid Electronic Visit Verification (EVV) Small Alternative Device Agreement and Order - posted 7.28.2016
Medicaid EVV Small Alternative Device Agreement (Spanish) - posted 11.3.2016
Revised Form: H1002 Provider Electronic Visit Verification Vendor System Selection - posted 1.26.2016


HHS Alerts and Resources

Change to Reason Code 305: Malfunctioning Small Alternative Device or Invalid Small Alternative Device Value - Verified Services Were Delivered - posted 7.10.2017
Reason Code News - posted 11.18.2016
HHSC EVV Provider Compliance Plan Notification (PDF 93.25 KB) - posted 6.1.2016
EVV Compliance Manditory April 2016 (PDF 97.15 KB) - posted 12.24.2015
Incorrect or Missing Data Elements Required (PDF 135.2 KB) - posted 11.2.2015
EVV Change Final (PDF 95.49 KB) - posted 11.2.2015
EVV Mandatory Reminder (PDF 63.94 KB) - posted 10.30.2015
EVV Vendor Selection (PDF 30.99 KB) - posted 10.30.2015
CM2000 Contract End (PDF 106.74 KB) - posted 10.2.2015
EVV Delay in Imposing Compliance Penalties (PDF 38.91 KB) - posted 9.1.2015
Suspension of Visit Maintenance Requirement (PDF 187.32 KB) - posted 8.4.2015
Attend an HHSC EVV Training (PDF 214.03 KB) - posted 6.19.2015
EVV for Community First Choice (PDF 103.9 KB) - updated 6.4.2015
EVV Postponed for Private Duty Nurses (PDF 105.03 KB) - posted 5.18.2015
EVV 21 Day Extended (PDF 24.35 KB) - posted 5.1.2015
EVV HHSC Implementation Additional Dates (PDF 41.97 KB) - posted 4.14.2015
EVV HHSC Reason Codes Webinar - April 15, 2015 (PDF 21.34 KB) - posted 4.13.2015
EVV HHSC Announcemen - Accectable Telephone Devices (PDF 51.82 KB) - updated 4.13.2015
 

Training

Complete List of Reason Codes - posted 11.18.2016
Community First Choice Providers EVV Training (PDF 36.99 KB) - posted 1.26.2016
Frequently Asked Questions - Former CM2000 Users (PDF 374.68 KB) - posted 11.2.2015
EVV Brochure (PDF 815.79 KB) - 5.26.2017


Your Plan Compliance

Provider Compliance Plan for UnitedHealthcare Community Plan EVV (PDF 1.22 MB) - Posted 03.15.2017
About The HHSC EVV Provider Compliance Plan Notification (PDF 415.27 KB) - Posted 06.01.2016

Payment Policy Notifications

Click on the arrow above to view payment policy alerts. 

2017 

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

New Drug Testing Reimbursement Policy Effective Sep. 1, 2017 (PDF 50.01 KB) - Date Posted 6.08.2017

Policy Change for the Multiple Procedure Payment Reduction of Diagnostic Imaging Services (PDF 351.3 KB) - Date Posted 4.26.2017

Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy – Acupuncturist Update (PDF 216.94 KB) - Date Posted 4.11.2017

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 48.37 KB) - Date Posted 1.25.2017                         

2016

Coding Reminder: How to Report Multiple Surgeons For One Operative Session (PDF 366 KB) - Date Posted 11.29.2016                      

Maximum Frequency per Day and Bilateral Procedures  (PDF 110.98 KB) - Date Posted 11.16.2016

Revision to Lupron Policy-Effective January 1, 2017 (PDF 203.22 KB) - Date Posted 9.19.2016

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 207.51 KB) - 8.3.2016  


New Policy-Evaluation and Management Reimbursement Policy
(PDF 123.41 KB) - 6.23.2016

Phase Two Implementation Delay for Supply Reimbursement Policy (PDF 140.16 KB) - 6.7.2016   

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 282.09 KB) - 5.5.2016 

Facility Billing Policy Update: Reporting an ICD-10 Manifestation Code as a Primary/Principal Diagnosis - Effective July 1, 2016 (PDF 130.9 KB) - 3.29.2016

Adjunct Professional Services Policy-Frequently Asked Questions (PDF 394.35 KB) - 3.7.2016

New Intensity-Modulated Radiation Therapy (IMRT) Reimbursement Policy-Effective July 1, 2016 (PDF 124.56 KB) - 3.1.2016

Claims Processing Change for Eight Professional Reimbursement Policies -Effective May 21, 2016 (PDF 146.62 KB) - 2.17.2016

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 206.33 KB) - 2.17.2016

Changes to Existing Reimbursement Policies-Effective January 1, 2016 and 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 November 14, 2015
(PDF 120.33 KB) - 8.6.2015

Reimbursement and Drug Policy Update for ICD-10 (PDF 183.38 KB) - 7.6.2015

2015 Quarter 3 & 4 Updates: Subsequent Revision Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 136.23 KB) - 5.27.2015

Procedure to Place of Service and Laboratory Services Reimbursement Policy Updates -Effective August 22, 2015 (PDF 191.23 KB) - 5.12.2015

Reimbursement Policy Clarification for the Maximum Frequency Per Day Policy and Revision Delay for the Radiology Multiple Imaging Reduction and Multiple Procedure Policies (PDF 139.17 KB) - 2.5.2015

New Reimbursement Policies an Changes to Existing Reimbursement Policies-Effective May 16, 2015 (PDF 210.73 KB)

New “X” Modifiers and Impact to UnitedHealthcare Community Plan Reimbursement Policies (PDF 380.15 KB)


2014 and Prior


Changes to Existing Reimbursement Policy and Update to New Reimbursement Policy-Effective Nov. 15, 2014
(PDF 191.17 KB)

Changes to Existing Reimbursement Policies-Effective Sep. 1, 2014 (PDF 232.62 KB)

Reimbursement Policy Changes-Effective Aug. 31, 2014 and New Reimbursement Policies-Effective Sep. 1, 2014 (PDF 195.72 KB)

Changes to Exisiting Reimbursement Policies (PDF 148.56 KB) - May 17, 2014

Changes to Reimbursement Policies (PDF 169.77 KB) - Effective November 16, 2013
Readmission Policy (F7001) FAQ (PDF 251.03 KB)
Readmission Policy Reminder (PDF 113.71 KB)    
New and Changed Reimbursement Policies (PDF 135.5 KB) - Effective Sept 14, 2013
New Payment Policies (PDF 178.82 KB) - Effective November 2012 
Changes to Payment Policies  (PDF 102.73 KB)- Effective November 2012  
New and Changed Reimbursement Policies  (PDF 60.18 KB)- Effective May 2013