Effective May 1, 2023, when processing claims for patients with UnitedHealthcare Dual Special Needs Plans (D-SNP), we will coordinate benefits for Medicare-covered services in accordance with Alabama Medicaid coordination of benefits (COB) methodology.
We will continue to reimburse Medicare-covered services using the fee-for-service (FFS) Medicare Fee Schedules, less applicable Medicare member cost-share amounts. Benefits then will be coordinated using the lesser-of methodology using the Alabama Medicaid Fee Schedules to determine any further reimbursement.
No change is required when submitting claims for patients with Medicare and Medicaid coverage. Please continue to use the same process for claim submissions.