July 01, 2023

July monthly overview

Network News is published twice a month. See updates below.

July 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for July 2023 for the following plans: Medicare, Medicaid, Exchanges and commercial.

Reimbursement policy updates
See the latest updates for reimbursement policies. 

Specialty Medical Injectable Drug program updates
See the latest updates to requirements for Specialty Medical Injectable Drugs for UnitedHealthcare members. 

Pharmacy and clinical updates
Access upcoming new or revised clinical programs and implementation dates for UnitedHealthcare plans.

State news

American Rescue Plan Act provider payment
Expect a one-time payment for certain services provided from July 1, 2021, to June 30, 2022.

Minnesota: Submit your rates for outpatient services
The Minnesota DHS sets payment rates each year for outpatient services. Here’s how to help ensure you’re paid correctly.

Verify practice technology use
Help us learn more about your practice and the technology you use.

Enroll to receive your enhanced LTSS rate
Learn how to earn attendant compensation rate enhancement payments as a long-term services and supports provider in Texas.

Some payment documents going paperless Oct. 6
Starting Oct. 6, 2023, we’ll no longer mail some payment documents to Wisconsin Medicaid health plans.

Prior authorization changes

Ohio Medicaid: Radiofrequency ultrasound guidance procedure updates 
Starting Aug. 1, we'll require prior authorization for radiofrequency guidance procedure codes for some plans.

New home health prior authorization process 
Starting Oct. 1, you’ll need to request prior authorization from naviHealth for home health visits after the SOC visit.

Tools and resources

Tools to help make credentialing faster and easier
New solutions, Onboard Pro and chat support, make credentialing faster and more efficient.

The Preferred Lab Network roster is available
View the list of Preferred Lab Network providers as of July 1.

July 20 publication

State news

Hawaii Medicaid: HOKU registration required
You must register with HOKU by Dec. 31 to serve QUEST. See how.

New Jersey: Help your patients retain their Medicaid coverage 
Please remind your patients to act quickly if they receive a NJ FamilyCare renewal notice.

North Carolina Medicaid billing update 
How to bill inpatient delivery charges with non-covered sterilization.

Prior authorization and code changes

New oncology prior authorization codes
Starting Oct. 1, we’ll require prior authorization for HCPCS code J1449. Learn which plans and states are affected.

Expanded DEX Z-codes for molecular tests
Additional CPT codes now available to register for Z-Codes for Medicare Advantage members.

Digital updates

Prescription Drug List updates for Sept. 1
We’ve updated the Prescription Drug List for commercial plans, effective Sept. 1, 2023. See what’s changing.

More claim letters are going paperless Aug. 4
Beginning Aug. 4, 2023, we will no longer mail claim letters to most medical network health care professionals and facilities for UnitedHealthcare commercial plans.

Want more flexible communication preferences?
Transfer PAA role, opt out of notification emails and assign other users editing access to Document Delivery Settings.

Submit unsolicited EDI 275 claim attachments
Five clearinghouses will begin to accept Electronic Data Interchange (EDI) unsolicited 275 claim attachments throughout 2023.

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