July monthly overview
Network News is published twice a month. See updates below.
July 1 publication
Policy and protocol updates
Medical policy updates
Medical policy updates for July 2024 for the following plans: Medicare, Medicaid, Exchanges and commercial.
Reimbursement policy updates
See the latest updates for reimbursement policies.
Specialty Medical Injectable Drug program updates
See the latest updates to requirements for Specialty Medical Injectable Drugs for UnitedHealthcare members.
Pharmacy and clinical updates
Access upcoming new or revised clinical programs and implementation dates for UnitedHealthcare plans.
State news
Massachusetts Medicaid: Use appropriate billing codes for faster DME claims processing
Correct billing code information for UnitedHealthcare Community Plan of Massachusetts plan members.
Michigan: Prior authorization updates for provider administered medications
Starting Oct. 1, 2024, we’ll require prior authorization for some provider administered medications in Michigan.
Nebraska Medicaid: Explore training sessions to stay up to date on topics important to you
Explore available training to help you stay up to date on topics that are important to your practice.
Home health and private duty nursing services prior authorization process
Home health and private duty nursing service prior authorization requests are assessed based on medical necessity and more.
Virgin Islands: Benefit update for certain Medicare Advantage plan members
Effective June 1, 2024, clinical laboratory services will no longer apply to a member’s annual deductible. Learn more.
Prior authorization updates
New prior authorization requirements for CGMs
As of Sept. 1, we’re making updates to continuous glucose monitor coverage for UnitedHealthcare Medicare Advantage plans.
Improvements to prior authorization process for sacral nerve stimulation for urinary and fecal indications
Starting Oct. 1, we’re improving the prior authorization process for SNS for urinary and fecal indications.
Updates to oncology and hematology prior authorization codes for many plans
Starting Oct. 1, 2024, we’ll require prior authorization for diagnosis of oncologic or hematologic conditions.
New online utilization management requirement
You will be required to submit utilization management requests online for patients delegated to Optum Health Networks.
July 2024 Preferred Lab Network updates
July 2024 Preferred Lab Network list is now available
View the Preferred Lab Network lists for UnitedHealthcare coverage plans, which have been updated as of July 2024.
Update your My Practice Profile
Add your merchant ID in My Practice Profile
Help ensure seamless payments with your unique merchant ID for the UnitedHealthcare Care Cash program.
Federal audit outreach for commercial plans
Annual federal audit of commercial plans
UnitedHealthcare commercial plan providers may be selected to provide documentation for the HHS annual RADV audit program.
MOC training for special needs plans
Complete special needs plan MOC training by Dec. 31
Complete the CMS mandated training for SNPs and out-of-network providers who routinely see SNP members by Dec. 31.
July 18 publication
State news
Trellus Elevate: Empower your patients with personalized IBD support
Your New York and Connecticut IBD patients can enroll in Trellus Elevate™ until Sept. 1.
NPI number and taxonomy codes required Aug. 1, 2024
New York Medicaid health care professionals will need to submit an NPI number and taxonomy code with claims.
Oklahoma: Stay in our network, file all claims
Oklahoma requires us to remove health care professionals with no recent claims on file from our network.
Texas Medicaid: Help avoid service delays
To help limit delays, include required medical necessity documentation when submitting prior authorization requests.
Surest plan updates
Join us for a webinar on how to complete key Surest tasks in the UnitedHealthcare Provider Portal
In this session, we'll discuss the basics of the Surest™ plan and how to navigate the UnitedHealthcare Provider Portal to complete key tasks.
Training and resources
The road to health equity through technology
Take our free CME Driving Health Equity Through Technology and Service Innovation course.
EZ Claim Pay availability updates
EZ Claim Pay: More of your patients may now be eligible for this Part B deductible payment option
As of July 1, 2024, we’ve expanded the availability of EZ Claim Pay, a service for some AARP® Medicare Supplement Plan G insured members.
Announcements
Explore trauma-informed care treatments for chronic diseases
Take our free CME course to incorporate the principles of trauma-informed care into your practice.
Your opinion matters to us
You have the power to help us make changes. Share your thoughts in our quick Network News email survey.
Sept. 1, 2024, Prescription Drug List Updates
Access the latest Prescription Drug List and pharmacy benefit updates for UnitedHealthcare commercial plans.
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