Tennessee, Virginia and Wisconsin Medicaid: Appeal decision letters won’t be mailed starting Nov. 4
Beginning Nov. 4, we’ll no longer mail appeal decision letters for most UnitedHealthcare Community Plans to network health care professionals (primary and ancillary) and facilities in Tennessee, Virginia and Wisconsin. Instead, you’ll be able to view them 24/7 through either the UnitedHealthcare Provider Portal or an Application Programming Interface (API) system-to-system data feed.
Note: Appeal decision letters will continue to be mailed to Behavioral Health professionals and facilities and Home and Community Based Services.
Please share the following changes and digital workflow options with those who are affected, including outside vendors such as revenue cycle management companies.
In the menu, select Documents & Reporting > Document Library > Appeals and Disputes folder
Use Advanced Search and search by Member Name, Case ID or Claim No. to help you find what you need. For letters available after June 30, 2022, you can also search by Member ID.
Notifications: When new letters are available in Document Library, an email notification will be sent to the address on file, which is typically the Primary Access Administrator.
Need to notify multiple staff members? Document Library notifications are limited to 1 email address per letter type. If multiple staff members require notification, the Primary Access Administrator can consider using a group email address. See our Paperless Delivery Options for Primary Access Administrator for more information.
View using API: You should consider API if you have significant claims volume and either automate correspondence intake or prefer an option other than looking up individual items in Document Library. Data can be pulled into your practice management system, portal or any application you prefer. API requires technical programming between your organization and UnitedHealthcare.
What’s ahead in paperless
Letters we mail you aren’t the only communications going digital. Looking ahead to 2023, contracted health care professionals and facilities will be required to submit most claims, claim attachments, reconsideration requests and appeal requests electronically. We’ll also begin to introduce digital member ID cards for commercial plans. All transitions will be announced in Network News at least 90 days prior to the change. We encourage you to explore our digital solutions and review your workflows so that your team is prepared. Review the most up-to-date information, exclusions and schedule.