Feb. 1: Reconsideration and appeal submissions going digital-only
Seven states affected
Beginning Feb. 1, 2024, you’ll be required to submit claim reconsiderations and medical pre- and post-service appeals electronically. This change affects most* network health care professionals (primary and ancillary) and facilities that provide services to UnitedHealthcare Community Plan (Medicaid) plan members in the following states:
If you use an outside vendor, such as a revenue cycle management company, please ensure they’re aware of the following changes and digital workflow options.
Application Programming Interface (API): API is a fully electronic digital solution that allows you to automate administrative transactions. This is a great alternative to Document Library for organizations with medium-to-high claim volume that have the technical resources to program API or the ability to outsource implementation.