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Reimbursement Policies - River Valley Entities Supplement, 2018 UnitedHealthcare Administrative Guide

Claim payment is subject to reimbursement policies. Find these policies on > Commercial Policies > Reimbursement Policies for Commercial. These tools are not available to River Valley members.

Changes to these policies are announced in the Network Bulletin available on

Coding edits may also effect reimbursements. We apply coding edits based primarily on the National Correct Coding Initiative (NCCI) edits developed by the Centers for Medicare and Medicaid Services (CMS) as well as the CMS’ Outpatient Code Editor (OCE). You can find NCCI and OCE edits on > Medicare > Coding > National Correct Coding Initiative Edits.