Jan 1, 2020

  • Applicable to all states except NC

Applicable to all states e...
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Provider Responsibilities and Workflows - 2020 UnitedHealthcare Administrative Guide

OneNet care providers follow Chapter 2: Provider Responsibilities and Standards with the noted exceptions:

  • As part of transitions under continuity of customer care, participating care providers should notify current patients accessing them through the OneNet Network of an effective date of termination of their Agreement at least 30 calendar days prior, or as required under applicable laws. OneNet does not maintain participant names and addresses and may not notify participants on your behalf.
  • Additional exceptions related to benefits, eligibility, online tools and health care ID cards are in other parts of this supplement.

Behavioral Health Services

Contact the adjuster if you believe an injured worker or claimant would benefit from mental health/substance use services due to their job-related injury or auto accident. The network includes behavioral health care providers. Follow ODG guidelines and requirements or other evidence-based requirements as defined by each state.

Case Management

Procura clients may use their own internal case management services for injured workers or claimants. You are required to comply with the case management programs used by Procura and its clients. They will follow state-driven requirements or other evidenced-based guidelines. OneNet care providers must work with case managers and follow all applicable state laws, regulations and rules.