This supplement is for participating physicians, care providers, facilities and ancillary providers, and delegated accountable care organizations (ACOs) capitated for certain UnitedHealthcare products.
All health care professionals who are contracted with UnitedHealthcare must attest to the accuracy of their demographic information every 120 days to meet your contract requirements and regulatory guidelines.
UnitedHealthcare maintains a Quality Improvement (QI) program to improve our members’ and providers’ health care experience. The following are the most important activities in our QI 2020 program for UnitedHealthcare commercial plans.
We monitor sanction activity from state medical boards, CMS, OIG and other regulatory bodies. If we find a care provider has a sanction that results in loss of license or material restriction, we terminate them from our network.
Checking the member’s eligibility and benefits before rendering services helps ensure that you submit the claim to the correct payer, collect correct copayments, determine if a referral is required and reduce denials for non-coverage.