June 01, 2023

June monthly overview

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

June 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for June 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

Arizona Medicaid appeals going paperless Sept. 8
Starting Sept. 8, we won’t mail appeal decision letters to most AZ Medicaid network health care professionals/facilities.

Digital documents coming to Mississippi Medicaid
On Sept. 8, some medical claim-related documents for MS Medicaid health care professionals/facilities are going digital.

Refer patients to Oxford Preferred Lab Network
Oxford Preferred Lab network for large groups in New York goes live in July.

Digital updates

Medicaid claim letters are going paperless
Starting Sept. 8, 2023, Medicaid claim letters won’t be mailed in multiple states.

You can submit pre-service appeals digitally
Network and out-of-network health care professionals can now submit medical pre-service appeals electronically.

Program and policy updates

Important UnitedHealthcare Medicare Advantage post-acute care requirements
Facilities providing post-acute inpatient services for UnitedHealthcare® Medicare Advantage members are required to obtain prior authorization before members can be admitted to a post-acute care facility.

Updates to the clinical pharmacist-led medication optimization program
This pharmacist-led program evaluates medication therapy for indication, effectiveness, safety and adherence.

UnitedHealthcare Shared Services members can access our network 
UnitedHealthcare Shared Services plan members have access to our network. Learn more.

Join us for a Surest live webinar and Q&A 
Attend a live webinar to get all the information you need about working with Surest benefit plans.

June 22 publication

State news

Florida Medicaid: Claim and AHCA data must match
Your claims must have the correct identifiers per AHCA requirements, or they will be denied. See what you need to do.

New Mexico provider grievance plan for UnitedHealthcare commercial plans
All New Mexico providers serving UnitedHealthcare commercial plan members have the right to file a grievance. Learn more.

Revenue code update for STAR Kids respite care 
Effective July 1, the Texas HHSC will update the revenue code to 663 for STAR Kids respite care for MDCP.

Help us recognize excellent attendant care 
We’re accepting nominations for the UnitedHealthcare REACH award, which recognizes attendants for their hard work.

Transition to Cardinal Care Medicaid program
UnitedHealthcare Community Plan of Virginia will complete its transition to Cardinal Care later in 2023.

Tools and training

Digital solutions that can save you time, money
Explore 2 digital solutions that can help your practice save time and money.

Complete Special Needs Plan MOC training
Complete the CMS mandated training for SNPs and out-of-network providers who routinely see SNP members by Dec. 31.

Updates to the Claims Detail page
You can now view more documents you submitted in the portal in the Related Documents section of the Claims Detail page.

Miscellaneous news

Updated requirements for gastroenterology services
Beginning June 1, 2023, only prior notifications are needed for gastroenterology endoscopy services.

More claim letters going digital on July 14
Starting July 14, we will no longer mail claim letters to most medical network health care professionals and facilities for UnitedHealthcare® Medicare Advantage plans.

Prospero and Landmark combine to create one home-based care program
Between Jan. 1 and July 30, 2023, Prospero Health is merging with Landmark Health.


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