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UHCprovider.com Home UHCprovider.com

Details: UnitedHealthcare's home for Care Provider information with 24/7 access to Link self-service tools, medical policies, news bulletins, and great resources to support administrative tasks including eligibility, claims and prior authorizations.

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Patient Health and Safety UHCprovider.com

Details: Patient health and safety is an essential and vital component of quality health care. We are one of many stakeholders that supports industry standards to help ensure patient care is safely delivered. We offer physicians and other health care professionals information and tools to help support this important goal.

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Eligibility and Benefits UHCprovider.com

Details: Obtaining it from our Eligibility and Benefits tool gives you detailed benefit information beyond what can be found on the traditional member ID card. For example, you can find the member’s copay, coinsurance and deductible amounts as well as the accumulated deductible. Learn …

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Access and New User Registration UHCprovider.com

Details: Step 2: Connect your One Healthcare ID to your organization’s Tax ID. Administrators and Standard Users – During the user registration process, you’ll need to answer a few questions and follow the instructions to select a primary administrator who will assign you the appropriate role and access. You’ll receive an email when your access is approved and can begin using the portal.

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Resource Library UHCprovider.com

Details: The UnitedHealthcare Provider Portal is your gateway to our self-service tools. The portal can quickly provide the comprehensive information you may need for most UnitedHealthcare benefit plans – without the extra step of calling for information.

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UnitedHealthcare Provider Portal UHCprovider.com

Details: Information and resources for our online self-service tools on the UnitedHealthcare provider portal. On the portal you can get member eligibility, benefits, claims and referral information for multiple UnitedHealthcare plans, all in one location.

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News UHCprovider.com

Details: 05.17.2021 - UHCprovider.com behavioral health resources - Online resources to help PCPs screen patients for behavioral health conditions. 05.17.2021 - API: Improve efficiency and reduce cost with real-time data exchange - Application Programming Interfaces allow for a free, secure and efficient way to seamlessly exchange data.

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UnitedHealthcare Community Plan of New York Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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Testing, Treatment, Coding & Reimbursement UHCprovider.com

Details: UnitedHealthcare is updating testing guidelines, coding and reimbursement information for the COVID-19 health emergency, based on guidance from the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), state and federal governments and other health agencies. Check back often for updates.

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Behavioral Health UHCprovider.com

Details: Behavioral Health Toolkit for Medical Providers; Buprenorphine Medication Assisted Treatment (BMAT) Project ECHO (Extension for Community Healthcare Outcomes) Information and Training - Project ECHO will link specialist teams at an academic “hub” with primary care clinicians in local communities – the “spokes” of the model.Together, you’ll participate in weekly teleECHO™ clinics

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UnitedHealthcare Community Plan of Virginia Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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UnitedHealthcare Community Plan of Texas Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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Telehealth Services UHCprovider.com

Details: We will adjudicate benefits in accordance with the member’s health plan. Medicaid Providers: UnitedHealthcare will reimburse out-of-network providers for COVID-19 testing-related visits and COVID-19 related treatment or services according to the rates outlined in the Medicaid Fee Schedule.

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Reports and Quality Programs UHCprovider.com

Details: UnitedHealthcare’s disciplined approach to payment reform leverages years of experience with incentive-based contracting models.One component of this overall strategy is the Hospital Performance-Based Compensation (HPBC) program, which provides an incentive to hospitals for quality and efficiency improvements in the delivery of health care affecting the overall health of UnitedHealthcare

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Details: Identify resources to support administrative tasks including eligibility, claims and prior authorizations as well as specific medical policy documents and news information.

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Individual Health Record™ (IHR) UHCprovider.com

Details: The right data informs the right decisions. IHR works in partnership with your Electronic Medical Records (EMR) and existing population health tools to consolidate and securely store an individual’s health story into one comprehensive digital record, even if your patients see other providers.

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UnitedHealthcare Community Plan of Mississippi Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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UnitedHealthcare Community Plan of Kansas Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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UnitedHealthcare Community Plan of Tennessee Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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Virginia Commercial Health Plans UHCprovider.com

Details: A health savings account (HSA) may be available to pay for qualifying medical expenses, including the annual deductible. The UnitedHealthcare Motion™ program provides a financial reward (in the form of a reimbursement for out-of pocket medical expenses or an HSA deposit) for meeting daily activity goals. The UnitedHealthcare Motion program is

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Details: Behavioral Health Facility Credentialing Application: Short - UnitedHealthcare Community Plan of Washington LAST MODIFIED 01.06.2021 Acceptance into the UnitedHealthcare care provider network is contingent upon the applicant Facility meeting our credentialingstandards and subject to review and approval by the Credentialing Committee.

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Claims and Payments UnitedHealthcare Community Plan of

Details: A formal claim dispute/appeal is a comprehensive review of the disputed claim (s), and may involve a review of additional administrative or medical records by a clinician or other personnel. UnitedHealthcare Community Plan generally completes the review within 30 calendar days. However, depending on the nature of the review, a decision may take

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Behavioral Health Resources UHCprovider.com

Details: Behavioral Health Referrals. To refer a member to a United Behavioral Health network practitioner for assessment and/or treatment, call United Behavioral Health at the number on the back of their UnitedHealthcare member identification (ID) card. Behavioral Health Members in the Medical Practice Office Setting. Antidepressant Medication Management

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UnitedHealthcare Community Plan of Kentucky Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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Details: Mental Health (17) Nephrology (17) Neurology (17) Neurosurgery, Orthopedics and Spine (NOS) (18) Obstetrics and Gynecology (ObGyn) (24) Oncology and Cancer (33) Ophthalmology (17) Pediatrics (22) Pharmacy and Drugs (82) Physical Medicine and Rehabilitation (19) Plastic Surgery (18) Primary Care Physicians (PCPs) (33) Pulmonology (18) Radiology (20)

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National Minority Health Month UHCprovider.com

Details: To help health care professionals navigate the complexities of cultural competency and reducing health disparities, OptumHealth Education and UnitedHealthcare have created two accredited education activities. These web-based courses are available on-demand and at no cost to providers. Advancing Health Equity series

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UnitedHealthcare Community Plan of Louisiana Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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UnitedHealthcare Connected UHCprovider.com

Details: UnitedHealthcare Connected is dedicated to improving quality and efficiency of care benefits for members through an individualized approach that focuses on seamless coordination of care while simultaneously easing the administrative burden for Ohio Community Plan providers through assistance with higher acuity patients and claims simplification.

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Home Health and Hospice Telehealth Services UHCprovider.com

Details: Benefits will be adjudicated in accordance with the member’s health plan, if applicable. COVID-19 Testing From Feb. 4, 2020 through the national public health emergency period (currently scheduled to end July 19, 2021), UnitedHealthcare is waiving cost sharing for in-network and out-of-network testing and testing-related telehealth visits.

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Contact Us UHCprovider.com

Details: If you suspect another provider or member has committed fraud, waste or abuse, you have a responsibility and a right to report it. Taking action and making a report is an important first step. After your report is made, we will work to detect, correct and prevent fraud, waste, and abuse in …

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Delivering Home Health Services

Details: Delivering Home Health Services Frequently Asked Questions . PCA-1-20-01360-M&R-FAQ_06122020 . Overview . UnitedHealthcare is dedicated to providing innovative health and well-being solutions to help our Medicare Advantage members live healthier lives. One way we do that is …

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UnitedHealthcare Behavioral Health Agency Credentialing

Details: Rural Health Clinic Mental Health Substance Abuse School-based Health Center Mental Health Substance Abuse State Licensed OP Clinic Mental Health Substance Abuse GENERAL / PROFESSIONAL LIABILITY Please attach current certificates for two types of liability insurance information. UnitedHealthcare insurance requirements are as follows:

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Commercial and Medicare Advantage behavioral health

Details: The preventive health website, prevention. liveandworkwell.com, includes: A screening tool to help you decide whether to seek care. Articles about behavioral health conditions and how they are treated. A list of organizations you can contact if you want more information about a condition and its treatment.

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Medical & Drug Policies and Coverage Determination

Details: Benefit coverage for health services is determined by the member specific benefit plan document, such as a Certificate of Coverage, Schedule of Benefits, or Summary Plan Description, and applicable laws that may require coverage for a specific service. The member specific benefit plan document identifies which services are covered, which are

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UnitedHealthcare Level Funded supplement UHCprovider.com

Details: Health Insurance Marketplace (Exchanges) - Chapter 4, 2021 Administrative Guides Medicare products - Ch.5, 2021 Administrative Guide Referrals - Ch.6, 2021 Administrative Guide

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Healthcare plan identification (ID) cards

Details: Our members receive health care ID cards that include information necessary for you to submit claims, such as the payer ID for electronic claims submission. Information on …

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Virginia Dual Complete® Special Needs Plans UHCprovider.com

Details: Health Maintenance Organization (HMO) plans use a network of contracted local physicians and hospitals to provide member care. Generally, members must use these care providers to receive benefits for covered services, except in emergencies. Some HMO plans do not require referrals for specialty care.

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UnitedHealthcare Community Plan of Ohio Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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UnitedHealthcare Community Plan of Arizona Homepage

Details: Health Insurance Portability and Accountability Act (HIPAA) Information. HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.

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Credentialing/profile reporting requirements

Details: Credentialing program. We credential physicians, health care professionals, and facilities who want to join our network and be listed in our Provider Directory. We recredential at least every 36 months. Our credentialing program helps us maintain and improve the quality of …

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IMC Mental Health EBP Reporting for Behavioral Health

Details: Mental health providers are able to report eligible EBPs after (1) receiving an interactive training by an approved training entity, and (2) documenting their use of EBPs in treatment plans and progress notes. Guidance on how to correctly document the use of EBPs is outlined in the Reporting Guide for Evidence-based Practices (updated annually

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Credentialing Updates UHCprovider.com

Details: Site visit requirements for health care practitioners and facilities will be waived during the COVID-19 national public health emergency period. This is in accordance with Centers for Medicare & Medicaid Services (CMS) guidelines and federal and local restrictions on travel and face-to …

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Medica HealthCare supplement

Details: Medica HealthCare Inc., a wholly-owned subsidiary of UnitedHealthcare, is a Medicare Advantage (MA) health plan. We offer MA plans in 2 Florida counties: Broward and Miami-Dade. Medica participating care providers are subject to both the main guide and this supplement. This supplement controls if it conflicts with information in the main guide.

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Physical Health, Occupational and Speech Therapy

Details: Benefits will be adjudicated in accordance with the member’s health plan, if applicable. COVID-19 Testing From Feb. 4, 2020 through the national public health emergency period (currently scheduled to end July 19, 2021), UnitedHealthcare is waiving cost sharing for in-network and out-of-network testing and testing-related telehealth visits.

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Home Health and SNF High-Performing Provider Initiative

Details: The results of these quality and cost efficiency assessments were used together to identify high-performing home health care providers and skilled nursing facilities in the states below. Note: We will provide updates as this information becomes available in more states.

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Case management and disease management program information

Details: Behavioral health care programs. We work with Optum to provide behavioral health care services for our members. For more information on how to access the behavioral health care programs, you or our members may contact a representative through the phone number listed …

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Kentucky Provider Orientation Webinar UHCprovider.com

Details: As you and your staff begin providing care to new UnitedHealthcare Community Plan of Kentucky members in the Medicaid program, we want to make sure you have the information you need to do business with us. This new Medicaid program is for members currently enrolled in the state’s Medicaid, Children’s Health Insurance Program (CHIP), Aged, Blind or Disabled children and adults …

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Ohio Community Plan Prenatal Risk Assessment form

Details: Prenatal Risk Assessment forms (PRAF) are important for the care and referral of patients. They also help ensure that moms receive the best support for a healthy pregnancy. When you fill out the form, we’re notified of the member’s pregnancy, so we can enroll the mom-to-be in our Maternity Management programs as soon as possible.

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