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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.

 

UnitedHealthcare Community Plan Added to Electronic Payments & Statements (PDF 59.89 KB)

 

Current Bulletins 

Remember to check our website frequently for updates regarding reimbursement policies, provider manuals and bulletins, providing information to our provider network of changes throughout the year.

You’re Invited to a Class on Diabetes (PDF 89.41 KB) - 5.3.2018

Health Current Information Exchange (PDF 40.7 KB) - 4.18.2018

Medication-Assisted Treatment (PDF 49.05 KB) - 4.9.2018 

Health Current – Health Information Exchange

Reminder: NDC Billing Guidelines - 3.7.2018 

AHCCCS Electronic Visit Verification Provider Survey - 3.6.2018 

Secondary Timely Filing and Coordination of Benefits Agreement (PDF 44.69 KB) - 2.12.2018

Reimbursement Reminder for Long Acting Reversible Contraceptives (LARC) (PDF 62.57 KB) - 2.12.2018

Claim Adjustment and Remittance Advice Codes (CARC/RARC) - 2.12.2018

AHCCCS Guidelines Regarding the Use of Social Determinants (PDF 92.23 KB) - 2.9.2018

Incontinence Supplier Change for Adult Long Term Care Members - Effective Feb. 1, 2018 (PDF 732.91 KB) - 1.23.2018

You’re Invited to a Class on Medications ( 43.03 KB) - 1.19.2018

AHCCCS Re-Enrollment Reminder (PDF 36.47 KB) - 1.19.2018 

Indian Health Service (HIS), Tribally Operated 638 Programs, and Urban Indian Health Programs in Arizona - 1.18.2018

Revenue Codes Requiring Procedure Codes Reimbursement Policy Clarification For Care Providers at Facilities and Hospitals (PDF 65.36 KB) - 12.22.2017

Laboratory Services Update (PDF 61.01 KB) - 12.20.2017 

New Therapy Codes (PDF 21.76 KB) - 12.1.2017

AHCCCS Managed Care Providers 2017 Provider Survey (PDF 38.88 KB) - 11.30.2017
AHCCCS is conducting a survey to determine its contracted Managed Care Organizations' (MCO's) performance and responsiveness to its providers.

Claims Routing Issue for Children’s Rehabilitative Services (PDF 21.97 KB) - 10.13.2017

Dental and Occupational Therapy Benefit Changes - Effective Oct. 1, 2017 (PDF 42.16 KB) - 10.9.2017

Introduction to Link: Care providers can use Link to verify eligibility, check claims status, submit reconsiderations electronically and submit/review prior authorization requests. Go to UHCprovider.com/Link to learn more. - 8.9.2017 

Interactive Voice Response Resource (PDF 22.34 KB) - 8.8.2017

Secondary Claim Timely Filing Guidelines (PDF 32.02 KB) - 8.8.2017

Electronic Payments & Statements (EPS) Changes - Effective Aug. 1, 2017 (PDF 70.42 KB) - 7.10.2017 

Submitting Corrected Claims Electronically (PDF 54.01 KB) - 6.2.2017

CEU Credit – Establishing Effective Communication with Patients with Intellectual Disabilities Part 1 (PDF 845.89 KB) - 5.16.2017

Autism Spectrum Disorder (ASD) Diagnosis and Treatment Resources (PDF 56.76 KB) - 5.19.2017

Reminder: Billing for CPT Code 96110 (PDF 81.08 KB) - 4.8.2017 | Updated 11.27.2017

New Fax Number for EPSDT Forms and Missed Appointments (PDF 51.81 KB) - 4.7.2017 

Retirement of Moderate Sedation, Physical Medicine and Rehabilitation: Supervised Modalities Policies; and Changes to Procedure to Modifier and IMRT Policies ‒ Effective May and June 2017 (PDF 184.12 KB) - 3.21.2017

2017 Therapy Code Changes (PDF 41.65 KB) - 3.15.2017 

Billing Reminder for Home Health Codes G0299 and G0300 (PDF 34.36 KB) - 3.13.2017

New Required Information for FQHC Rendering Care Providers (PDF 54.98 KB) - 3.13.2017 

Arizona Opioid Prescribing Guidelines

Safe and Effective Opioid Prescribing While Managing Acute and Chronic Pain (PDF 3.01 MB) - 2.15.2017

Maricopa Health Plan Member Transition Letter to Providers (PDF 38.24 KB) - 02.10.2017

Transportation Vendor Change for Long Term Care Members (PDF 51.89 KB) - 02.10.2017

Transportation Vendor Change for Members Transitioned to UnitedHeathcare Community Plan (PDF 51.89 KB) - 02.10.2017

Therapy Providers Roster Changes Notice (PDF 111.94 KB) - 2.01.2017

KidsCare Overview (PDF 116.25 KB) - 12.20.2016

Revision to Behavioral Health Covered Services Guide Regarding T1016 Unit Billing Guidelines (PDF 179.93 KB) - 12.20.2016

KidsCare Information (PDF 116.25 KB)

Podiatry Benefit Changes Frequently Asked Questions - Effective 10/01/16 (PDF 158.63 KB)

Change in Coverage for Dental Benefits for ALTCS Members Who Are 21 Years and Older (PDF 33.44 KB) - 10.12.2016

Payment Responsibility for Behavioral or Physical Health Services (PDF 96.67 KB) - Information about submission of services that can help determine if services are considered behavioral health or physical health.

AHCCCS EHR Incentive Program – IMPORTANT DEADLINE (PDF 147.84 KB)

Podiatry Benefit Changes and ALTCS Dental Benefit Changes Notice - 2016 (PDF 40.81 KB)

Cardiology Prior Authorization CPT Code Crosswalk – 2016 (PDF 100.06 KB)

Prior Authorization Cardiology FAQs – 2016 (PDF 88.98 KB)

Prior Authorization Radiology FAQs – 2016 (PDF 66.38 KB)

UHCCP 2016 Radiology Prior Authorization CPT Code Crosswalk (PDF 118.77 KB)

Optum Trauma Informed Care and Services Education Series (PDF 177.57 KB)

New Policy-Evaluation and Management Reimbursement Policy (PDF 123.16 KB)  

Emergency Room Discharge Instructions for Suspect Measles Patients provided by the Arizona Department of Health Services (PDF 224.81 KB)

Inpatient Discharge Instructions for Suspect Measles Patients provided by the Arizona Department of Health Services (PDF 224.1 KB)

English downloadable poster provided by the Arizona Department of Health Services:  Think it might be Measles (PDF 20.85 KB)

Spanish downloadable poster provided by the Arizona Department of Health Services:  Think it might be Measles (PDF 52.32 KB)

DME and Wheelchair Vendor Changes for CRS Members – Effective June 1, 2016 (PDF 47.39 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 282.09 KB)   

Zika & Pregnancy Information for Providers from ADHS (PDF 94.59 KB)

Home Health Reminder for Dual Special Needs Plan (PDF 153.35 KB)

Reminder: Drug Billing Changes for Injectable Medication (PDF 150.38 KB)

HCBS Client Obligation Provider Notification Process Update (PDF 67.91 KB)

Home Health / Hospice Billing Changes effective 2016 (PDF 17.92 KB)

Enhanced Corrected Claim Processing (PDF 253.26 KB) - Information regarding the corrected claims processing improvement.

Denial Trend Bulletin (PDF 28.08 KB) - Information regarding the top denials identified by UnitedHealthcare Community Plan and resources for resolution.

LINK Training and Education

Obstetrical (OB) Billing Guidelines : Updated OB Billing Guidelines (PDF 99.13 KB)

B-Bundled Codes and Age/Gender Reimbursement Policy Reminder (PDF 23.04 KB)

Change in Coverage for Orthotic Devices for Members Who Are 21 Years and Older (PDF 54.68 KB)

Changes to Blood Lead Screening - Required blood lead screening for children less than six years of age is now based on the child’s risk as determined by either the member’s residential zip code, or presence of other known risk-factors.
Changes to Blood Lead Screening – Facts (PDF 120.62 KB)
Questionnaire – A parent’s to help determine if your child has been exposed to lead (PDF 469.02 KB)
Provider Lead Screening Guide (PDF 1.85 MB)
2014 High Risk Lead Poisoning Zip Codes (PDF 229.54 KB)

AHCCCS Notices Regarding Behavioral Health Benefit Changes for Medicare and AHCCCS Medicaid Members – effective 10/01/15 - AHCCCS provided documents regarding the Behavioral Health changes effective 10/01/15 that affect members enrolled in both AHCCCS Medicaid and Medicare benefits.
Contractor Responsibilities (PDF 372.81 KB)
Frequently Asked Questions for AHCCCS Members (PDF 83.68 KB)
Frequently Asked Questions for Providers (PDF 89.08 KB)

EPSDT Forms and Periodicity Schedules Age 0-21 Years (PDF 204.27 KB) - All members 0-21 years of age should have an Early and Periodic Screening Diagnosis and Treatment (EPSDT) form completed at each Well Child Visit

Billing and Payment Process Change for FQHCs and RHCs (PDF 56.71 KB)

EPSDT Bundling Update  (PDF 61.17 KB)

New interactive web site to help people easily locate a clinic that provides free or low cost primary, family planning, mental and dental health services to people without health insurance. Resources for Low-Cost or No-Cost Clinics in Arizona

Circumcision Reminder Bulletin (PDF 38.84 KB)

Community Plan Secondary Claims Processing Issue (PDF 47.34 KB) - UHCCP has identified an issue with processing electronically submitted secondary claims.

Minimum Subcontractor  Provisions Update for Long Term Care Network (PDF 19.51 KB)

Added Coverage for Incontinence Briefs for ALTCS Members (PDF 15.11 KB)

Diabetic Supplier Change - Effective 01/01/15 (PDF 63.24 KB)

Updated EPSDT Tracking Forms, Developmental Screenings, and Fluoride Varnish (PDF 43.57 KB) : EPSDT Tracking Forms are now available for use at well-child/well-care visits for patients 0-21 years of age. Developmental Screening and Fluoride Varnish are enhanced services now available for patients at specified EPSDT visits when PCPs complete the required training and certification. 

Information on how to submit website improvements and other suggestions (PDF 59.09 KB)

Ebola Virus Disease (EVD) Evaluation Algorithm Provided by the Maricopa County Department of Public Health (PDF 199.32 KB)

Ebola Virus Disease (EVD) Web Resources for Healthcare Providers Provided by the Maricopa County Department of Public Health (PDF 198 KB)

AHCCCS Changes and DRG Payment Methodology Notice (PDF 41.86 KB)

Reminder - UB-04 NPI for Attending or Referring Providers (PDF 50.55 KB)

UnitedHealthcare Community Plan Bilateral Procedures and Maximum Frequency Per Day Policies – Effective Nov. 11, 2017 (PDF 49.39 KB) - 8.17.2017

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

Revision to the Intrauterine Device (IUD) Supply Policy (PDF 52.81 KB) - 7.14.2017

Two Place-of-Service (POS) Codes Added to Facility POS Code List in Two Policies (PDF 54.98 KB) - 7.5.2017

New Drug Testing Reimbursement Policy Effective Sep. 1, 2017 (PDF 50 KB) - 6.19.2017

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) - 4.28.2017

Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy – Acupuncturist Update (PDF 216.94 KB) - 4.10.2017

UnitedHealthcare Community Plan Medicare Claims Processing System Is Being Upgraded – Effective May 20, 2017 (PDF 39.84 KB) - 4.6.2017

Washington Publishing Company Claim Adjustment Reason Code (CARC) and Remittance Advice Remark Code (RARC) Listings - 3.6.2017

New National Drug Code Requirement Policy - Effective May 1, 2017 (PDF 48.38 KB) - 1.31.2017 

Coding Reminder: How to Report Multiple Surgeons for One Operative Session (PDF 366.47 KB)  Date Posted 12.01.2016 

Policy Change for the Multiple Procedure Payment Reduction of Diagnostic Imaging Services - Effective January 1, 2017 (PDF 352.93 KB)  Date Posted 12.01.2016 

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

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)

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

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

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

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

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)

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

Changes to Existing Reimbursement Policy and Update to New Reimbursement Policy-Effective Nov. 15, 2014 (PDF 192.62 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 Nov. 1, 2014
(PDF 233.18 KB)

Reimbursement Policies Changes - Effective Aug. 23, 2014 and New Reimbursement Policies-Effective Sept. 1, 2014
(PDF 195.03 KB)

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

Occular Screening Medical Policy Cancellation Notice (PDF 23.96 KB)

New Reimbursement & Drug Policies and Changes to Existing Reimbursement Policies (PDF 161.4 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  (PDF 135.2 KB)- Effective Sept. 14, 2013

Provider Preventable Conditions/Healthcare Acquired Conditions Policy  (PDF 31.67 KB)
Information regarding the withholding payments for HCAC's and other PCP's - October 2012

Global Days Policy Reminder  (PDF 41.96 KB)
Reference for policy R0005, effective Aug. 10, 2012

 

Other Announcements

Fax Notification Form for Missed Appointments (PDF 39.82 KB)