Celebrating National Nurses Day on May 6

Through these difficult times, nurses continue to support and guide those in need. Thank you today and every day for making a difference.

Celebrating National Nurses Day on May 6

Through these difficult times, nurses continue to support and guide those in need. Thank you today and every day for making a difference.

Celebrating National Nurses Day on May 6

Through these difficult times, nurses continue to support and guide those in need. Thank you today and every day for making a difference.

UnitedHealthcare Provider Portal

The UnitedHealthcare Provider Portal has more than 40 tools that allow you to take action on claims and get the answers you need quickly. It’s available 24/7 – and at no cost to you. All without having to pick up the phone.

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Eligibility and Benefits

Verify member eligibility, determine benefits, view care plans and get a digital copy of the member ID card.

Prior Authorization and Notification

Check prior authorization and notification requirements, submit requests, upload medical notes, check status and update cases.

Claims and Payments

Submit claims, look up fee schedules, check status, view payment information, and submit reconsideration and appeal requests.

Referrals

Check referral requirements, submit requests, review referral history and monitor the number of remaining visits.

COVID-19 resources

Access resources, information and tools to help you provide care to patients and support your practice during the public health emergency. You’ll find details on federal, state and health plan requirements, claim and billing guidelines for COVID-19 testing, treatment and vaccines, and any temporary provisions in effect. The site is updated as new information becomes available.

News

Pennsylvania Medicaid: Billing updates for personal care services

The Pennsylvania Department of Human Services has updated its billing requirements for personal care services that are verified using an electronic visit verification (EVV) system. For dates of service starting May 1, 2022, health care professionals administering personal care services to UnitedHealthcare Community Plan members in their home must use HCPCS code T1019 when submitting claims and requesting prior authorization.

Louisiana Medicaid: Policy updates from the Louisiana Department of Health

The Louisiana Department of Health has shared policy updates regarding COVID-19 monoclonal treatment, cardiovascular services and cochlear implants.

Electronic payments required for claim payments starting June 1

Effective June 1, 2022, in accordance with your contractual agreement that you do business with us electronically, UnitedHealthcare is no longer sending paper checks for claim payments. This change supports our continued efforts to accelerate payments to your practice by moving to digital transactions.

Medicaid: Charging patients for non-covered services

The Centers for Medicare & Medicaid (CMS) requires all Medicare members, including Dual Eligible Special Needs Plan (D-SNP) members, to know costs prior to receiving non-covered services. Request a prior authorization if you know or have reason to believe that a service for a Medicare Advantage member may not be covered.

Central/Southeast/Northeast regions: Prior authorization and clinical decision letters are going paperless

Starting May 20, 2022, UnitedHealthcare will no longer mail prior authorization and clinical letters to network providers and facilities in AL, AR, CT, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI, MO, MS, NC, ND, NE, NH, NJ, NY, OH, OK, PA, RI, SC, SD, TN, TX, VA, VT, WI and WV.

Coverage changes for prenatal ultrasounds

Starting July 1, 2022, there’s a new obstetrical ultrasound medical policy for UnitedHealthcare Individual Exchange plan members.

Network News

Find the latest announcements, updates and reminders – prior authorization requirements, policy and protocol changes, reimbursement updates and other important information to guide how your practice works with UnitedHealthcare and our members.

Read the news

No Surprises Act open negotiations

Learn more about the requirements of the No Surprises Act of 2020 and the out-of-network claims covered under the Act. Step-by-step instructions guide you through submitting a negotiation request through the UnitedHealthcare Provider Portal.

Review the process