The referrals feature on the UnitedHealthcare Provider Portal can help you submit new referral requests, find if a referral is needed and the status of existing referral requests, plus get confirmation details for your submitted referrals.
NexusACO Referral Requirements Quick Reference Guide
The UnitedHealthcare NexusACO benefit plans offer UnitedHealthcare commercial members a tailored network of accountable care organization (ACO) care providers. In areas where UnitedHealthcare NexusACO doesn’t have a featured ACO, UnitedHealth Premium® Program designated providers will be included as participating Tier 1 care providers.
Designated Diagnostic Provider (DDP)
UnitedHealthcare is launching a new benefit design for outpatient diagnostic lab services to help drive patient transparency and manage the cost of healthcare. Outpatient diagnostic lab services will be covered for commercial members at the lowest cost shared when delivered by a Designated Diagnostic Provider.
Skilled Nursing Facilities
These resources are especially tuned to skilled nursing facilities, including brochures for patient education, support for billing and reimbursement, and a special focus on Medicare Advantage and the UnitedHealthcare Passport Service.
EDI 278I: Prior Authorization and Notification Inquiry
Use the Prior Authorization and Notification Inquiry (278I) transaction to check the status of previously submitted authorizations and notifications. Electronic authorization and notification inquiries can be submitted in real-time or in batches and you will receive a unique inquiry ID for confirmation of submission.