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Latest UnitedHealthcare Provider News

May 2018: Further Updates on Smart Edits in the EDI Worfklow

Last Modified | 06.19.2019

In the April 2018 Network Bulletin, we shared with you that UnitedHealthcare has a new capability in the EDI workflow, known as Smart Edits, which autodetects claims with potential errors and delivers feedback within 24 hours of submission.

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06/01/2019 – UnitedHealthcare Commercial Medical Policy Update Bulletin: June 2019

Last Modified | 06.13.2019

This bulletin provides complete details on recently approved, revised, and/or retired UnitedHealthcare Commercial Medical Policies, Medical Benefit Drug Policies, Coverage Determination Guidelines (CDG), Utilization Review Guidelines (URG), and/or Quality of Care Guidelines (QOCG).

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“Always Therapy” Code Reimbursement Error for UnitedHealthcare Community Plan Claims

Last Modified | 06.07.2019

On May 21, 2019, it was discovered a claim edit was incorrectly loaded into our system. As a result, UnitedHealthcare Community Plan claims that included “Always Therapy” codes with and without the GN, GO or GP modifiers were denied for claims submitted on or after May 19, 2019.

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