Practice Matters
A Member’s Right to Culturally Competent Care
UnitedHealthcare Community Plan’s members have a right to receive care that is culturally appropriate and respects their cultural and ethnic background and origins.
Access and Availability Standards
UnitedHealthcare Community Plan has appointment availability requirements for primary care providers (PCPs) and specialists.
Benefit enhancements for New Jersey dual special needs plan (DSNP)
The UnitedHealthcare Dual Complete® plan is available for individuals who qualify for both Medicare and Medicaid.
Case Managers Help Members With Complex Needs
The UnitedHealthcare Community Plan Case Management program is a holistic approach to care for members with complex needs, especially those with chronic conditions. The goal is to provide our community members with the resources necessary to maintain the highest functional status possible.
Early Elective Delivery Reimbursement Changes
Early Elective Delivery Reimbursement Changes, Effective July 1, 2020
Managing Medication for People With Asthma
Help achieve better health care outcomes for Children and adults with asthma.
Measures for Respiratory Conditions
UnitedHealthcare would like to emphasize to care providers the appropriate use of antibiotics in children and adults with upper respiratory tract infections.
New Disease Management Program in New Jersey for End-Stage Renal Disease
UnitedHealthcare Dual Complete® One offers new disease management program in New Jersey for end-stage renal disease
Office-Based Addictions Treatment
Office-based addictions treatment (OBAT) is the use of medications in combination with navigator services to coordinate counseling and behavioral therapies to treat both substance use disorder (SUD) and opioid use disorder (OUD).
Perinatal Risk Assessment Form Requirements
Effective June 1, 2020, New Jersey began enforcing new data reporting requirements as condition of Medicaid payment for prenatal care
Providers Must Obtain Hospital Privileges
Participating UnitedHealthcare Community Plan of New Jersey providers must obtain hospital privileges at a participating New Jersey hospital
Referral Reminder: Out-of-Network Labs
Refer all members to in-network labs to help avoid any possible claim denials.
Tips to help improve the patient office visit experience
We believe members who have positive experiences are more likely to follow medical advice and treatment plans from their care provider.
Understanding Early and Periodic Screening, Diagnostic and Treatment Requirements
Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services are an important part of preventive care for children.
UnitedHealthcare Dual Complete®: New Jersey Members Matched With a Navigator
The UnitedHealthcare Dual Complete® plan will now pair our members with a Navigator. This is a go-to-person that provides support and helps them every step of the way on their health journey in New Jersey.
Updated (PCM) Medical Care Coordination: Private Duty Nursing Policy
To view the updated policy, visit UHCprovider.com.