March 01, 2025

March monthly overview

Network News is published twice a month. See updates below.

March 1 publication

Medical policy updates
Medical policy updates for March 2025 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.

Network News is going monthly
Starting April 1, 2025, you’ll receive only 1 email per month for Network News updates.

June 6: Several documents going paperless
More letters and reconsiderations, pre-/post-service appeals going digital for Kentucky, Washington, D.C., Medicaid.

Updates to specialty pharmacy prior authorization requirements for UnitedHealthcare Community Plan members in Michigan
Effective June 1, 2025, for Michigan Medicaid, we’ll require prior authorization/notification for certain medications.

Coordination of benefits reconsideration review
Email us to review Missouri Medicaid COB reconsiderations.

Full test menu providers available in our Preferred Lab Network
Our Preferred Lab Network offers full test menu providers, Quest Diagnostics and LabCorp, for UHC Community Plan of NJ.

Home health prior authorization review process no longer required
We won’t require prior authorization or concurrent review processes for some Medicare home health services as of April 1.

June 2: Electronic reconsideration and appeal submissions required
Health care professionals must submit Medicaid medical reconsiderations and appeals electronically in FL, NY, OH and RI.

Don’t wait: Submit your saved My Practice Profile changes
Submit saved changes in My Practice Profile within 14 days to avoid losing changes.

How to submit a pre-service appeal
Learn how to submit pre-service appeals electronically.

Ensure uninterrupted patient care: Help your Medicaid patients avoid a lapse in coverage
Remind your Medicaid patients to complete their redetermination packets so they don’t lose coverage.

Improve patient satisfaction through cultural competency
Cultural competency helps build trust in health care and creates a safe environment for multicultural patients. See how.

Arizona: Make demographic updates quickly with online tools
Online tools make it easy to keep your provider demographic information updated.

Verifying benefits and billing guidelines for New Jersey network health care providers
Health care providers contracted with UnitedHealthcare Community Plan of New Jersey should not bill members for covered care or services.

Wisconsin Medicaid: Avoid claim denials for OB antepartum care
OB antepartum claims require a single date for the final visit. See why date ranges are denied.

Wisconsin Medicaid: Claims must match the Max Fee Schedule to avoid denial
See what claims data are required to match the Wisconsin Medicaid Max Fee Schedule Claims to avoid claim denials.

Access HealthCheck to help children access preventive care
View our HealthCheck benefit, which helps children and young adults stay healthy.

Submit the correct CPT codes for pediatric lead screening patients
Review the state-mandated requirements for lead testing for you and your staff.