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.

 

Provider Alerts

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

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)

UnitedHealthcare Removes Co-pays for BadgerCare Plus Members (PDF 126.95 KB)

Retrospective Claims Review Begins Feb. 1 (PDF 53.6 KB)

Ambulatory Coding Claims Review Audit Begins Feb. 1 (PDF 48.93 KB)

 

2015

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)

UnitedHealthcare Community Plan of Wisconsin to Reimburse for Certain Vision Claims - May 22, 2015 (PDF 87.11 KB)

Claim Audit Change Creates Faster Provider Payments - May 18, 2015 (PDF 171.89 KB)

New Technical Claim Denials Process - April 20, 2015 (PDF 19.5 KB)

Reduced Reimbursement for Certain Services - April 1, 2015 (PDF 90.97 KB)

Appeal Requests for Primary Payment when we are the Secondary Insurer - April 1, 2015 (PDF 164.22 KB)

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

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

Enhanced Reimbursements for Health Professional Shortage Areas - March 27 2015 (PDF 157.75 KB)

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

Important Claims Notices for Network Providers Feb. 2015 (PDF 19.64 KB)

UnitedHealthcare Community Plan Medical Policy Update Bulletin

UnitedHealthcare Responds to Ebola Concerns (PDF 80.08 KB)


2014

Enhanced HIPAA Claim Edits Planned for March 2015 (PDF 173.48 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 (PDF 192.84 KB) - Nov. 15, 2014
New Reimbursement Policies and Changes to Existing Reimbursement Policy for UnitedHealthcare Community Plan Dual Special Needs Plan (PDF 192.25 KB) - Nov. 15, 2014
Reimbursement Policy Changes - Aug. 23, 2014 and New Reimbursement Policies (PDF 195.28 KB) - Sept. 1, 2014
Changes to Existing Reimbursement Policies (PDF 233.14 KB) - Aug. 1, 2014
Provider Preventable Conditions: Health Care Acquired Conditions and Present on Admission Policy Update (PDF 24.65 KB) - Feb. 11, 2014
Changes to Existing Reimbursement Policy (PDF 128.24 KB) - May 17, 2014
Sleep Study FAQ (PDF 135.24 KB) - May 15, 2014
Sleep Study Worksheet (PDF 192.95 KB) - May 15, 2014
Enhanced HIPAA Edits to be applied to Claim Submissions
Changes to Existing Reimbursement Policies (PDF 154.89 KB) - Feb. 15, 2014

2013
Ocular Screening Medical Policy Cancellation Notice (PDF 23.85 KB) - Dec. 1, 2013
New Medical Policy and Changes to Reimbursement Policies (PDF 174.08 KB) - Nov. 16, 2013
UnitedHealthCareOnline Training Sessions (PDF 234.12 KB) - Oct. 29, 2013
Readmission Policy Reminder (PDF 112.8 KB) - Oct. 7, 2013
Provider Appeals (PDF 18.53 KB) - Oct. 1, 2013
Readmission Policy (F7001) Review FAQ (PDF 248.2 KB) - Sep. 30, 2013
New and Changed Reimbursement Policies (PDF 135.2 KB) - Sep. 14, 2013
Routine Medical Vision Services Letter (PDF 167.09 KB) - July 29, 2013
Provider Appeals Address Change  (PDF 22.06 KB)- July 22, 2013
HEDIS 2013 Data Collection  (PDF 31.1 KB) - 2013
HEDIS 2013 FAQ (PDF 65.11 KB) - 2013
Hepatitis Policy Update (PDF 33.68 KB) - May 25, 2013
New and Changed Reimbursement Policies  (PDF 60.18 KB)- May 2013 

 

2012  
Prohibition of Claims Payment Beyond the Borders of the U.S. (PDF 41.21 KB) - Jan. 17, 2012
Important Change to Durable Medical Equipment Providers Network  (PDF 104.59 KB) - Feb. 1, 2013

2011
Bright Futures™ — Our New Standard for Well-Child Care (PDF 26.63 KB) - Oct. 24, 2011
Secure Fax Alert for Medical Prior Authorization Requests (PDF 20.52 KB) - Oct. 12, 2011
New Policies (PDF 48.01 KB) - Aug. 14, 2011
Online Password Change  (PDF 19 KB) - July 15, 2011
Provider Alert: Orencia (abatacept) Reimbursement Policy Change  (PDF 31.26 KB) - May 15, 2011
Acknowledgement of Receipt of Hysterectomy Information (English, Español, Hmong) (PDF 1.26 MB) - April 2011

 

Credentialing

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