Verifying eligibility and benefits - Chapter 4, 2021 UnitedHealthcare Administrative Guide

Check the member’s eligibility and benefits before providing care. Health plans and coverage can change within a single enrollment year due to changes in qualifications and Medicaid subsidies.

When checking eligibility, be sure you:

  1. Verify your network participation in the member’s health plan using the online care provider portal.
  2. Confirm whether the member is in the grace period.
  3. Know the member’s financial liabilities at the time of service.