June monthly overview
Network News is published twice a month. See updates below.
June 1 publication
Policy and protocol updates
Medical policy updates
Medical policy updates for June 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
Colorado: No referrals required with HMO Open Access
As of Jan. 1, 2024, all of our Medicare HMO H0609 plans no longer require referrals.
Sept. 1: Electronic reconsideration and appeal submissions required
Health care professionals must submit Medicaid medical reconsiderations and appeal submissions electronically in MN and VA.
New Jersey: Do your patients need to renew their Medicaid coverage?
Your NJ FamilyCare (Medicaid) patients may need to renew their coverage. If not, they could lose their eligibility.
New Jersey Medicaid: Claims reminder for nutritionist services
Are your claims for nutritionist services being denied? See how to check the maximum frequency allowed per CPT® code.
North Carolina Medicaid: EP modifier requirement for EPSDT services
Avoid denied claims for Early and Periodic Screening Diagnostic Treatment services by properly using the EP modifier.
Texas Medicaid: 25 in-person meetings coming to you soon
UnitedHealthcare Community Plan of Texas is hosting several town hall meetings regarding service area expansion.
Sept. 13: Several documents going paperless
VCP statements, and overpayment and claim letters going digital for Virginia Medicaid members.
Prior authorization updates
Surest plans: Change to oncology prior authorization process
As of July 1, 2024, prior authorization requests for Surest plans and Surest Flex plans must be submitted using Optum CGP.
UHC Provider Portal changes
Updates required: Portal access methods are changing
To enhance data security, UnitedHealthcare Provider Portal and specialty portal users will be required to make One Healthcare ID sign-in and recovery updates by summer 2024.
Now available: New and enhanced claim submission process features
We’ve updated our claims section to make it easier for you to understand where in the process a claim may be.
Plan and policy news
RMHP Individual Exchange plans to align with hospital reference lab protocol
Effective Sept. 1, UnitedHealthcare Hospital Reference Lab Protocol will apply to RMHP Individual Exchange plans.
View claims submission information for APWUHP High Option members using the UnitedHealthcare network
Starting Jan. 1, 2024, American Postal Works Union Health Plan High Option members will use the UnitedHealthcare network.
LCD Guidance for Skin Substitutes
Medicare does not have an NCD for non-porcine based skin substitutes. View our Medicare Advantage Coverage Summary.
June 20 publication
State news
Florida Medicaid: HearUSA to begin serving MMA members in July
Medicaid members in Florida can use HearUSA for their hearing needs, beginning in July. Learn more.
Help ease the strain of rising medication costs
With prescription costs on the rise, explore strategies you can use to help patients manage their medication expenses.
Review health care provider grievance rights for New Mexico commercial plan
The NM supplement document details how to handle a grievance.
North Carolina Medicaid: Avoid denied DMEPOS claims
Learn why invoices are essential when submitting claims for durable medical equipment, prosthetics, orthotics and supplies.
Ohio Medicaid: Time to revalidate your Medicaid agreement
Read about the revalidation requirements for Ohio Medicaid Provider Agreements.
Ohio Medicaid: Balance billing is not permitted
See what steps you can take to stay compliant with balance billing regulations.
Nominate a deserving attendant for the UnitedHealthcare REACH Award in Texas
Nominate an attendant for the UnitedHealthcare REACH Award by Aug. 31, 2024.
Washington Medicaid: Enhanced utilization management support
Learn about new support available to providers caring for Washington members on ITA treatment plans.
EZ Claim Pay availability updates
EZ Claim Pay available in additional states, starting July 1
Starting July 1, 2024, we’re expanding EZ Claim Pay access to even more states. See if your state is included.
Provider directory reminder
Avoid directory removal: Verify your demographic data
We may remove unattested data from the UnitedHealthcare Provider Directory if we can’t verify your information.
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