April 01, 2024

April monthly overview

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

April 1 publication

Policy and protocol updates

Medical policy updates
Medical policy updates for April 2024 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: Continuous glucose monitors added to pharmacy benefit
As of April 1, 2024, CGM devices and supplies have been added to the pharmacy benefit. Learn more.

Minnesota Medicaid: Billing change for non-emergent transportation
Some non-emergent transportation codes should now be submitted to UnitedHealthcare Community Plan instead of MTM, Inc.

New Jersey: You can help your patients keep their Medicaid coverage
Your NJ FamilyCare (Medicaid) patients may need to renew their coverage.

New York: Begin referring patients to in-network home infusion providers
On July 1, we’ll limit home infusion benefits to in-network providers.

Billable limits for dental procedures in an ambulatory surgery center
As a reminder, NYS Medicaid changed billable limits for dental surgery services rendered in ASC settings for some members.

UnitedHealthcare Provider Portal security updates

Don’t get locked out of the UHC Provider Portal: Verify your phone number by April 1
Soon, UnitedHealthcare Provider Portal users will be required to update their One Healthcare ID authentication sign-in and recovery options to retain their portal access.

Change Healthcare update
We’re working diligently to support providers. Sign in to the UnitedHealthcare Provider Portal to learn more.

Reimbursement and regulatory updates

Attest to mental and developmental disability accommodations
Meet the new mental and developmental disability accommodation requirements by updating your My Practice Profile.

UnitedHealthcare Student Resources claims submission and payment updates
Important claims submission and payment updates for UnitedHealthcare Student Resources providers.

2024 UnitedHealthcare OPG Exhibit reimbursement updates
The Outpatient Procedure Grouper Exhibit will be updated on July 1, 2024.

2024 United Hero kit

The 2024 Hero Kit is now available
Order your free Hero Kit to receive a variety of resources designed to help you achieve high patient experience scores.

April 18 publication

State news

Important AHCCCS Medical Policy Manual 510 revisions
Policy updates to help you better coordinate care for UnitedHealthcare Community Plan of Arizona members.

Arizona: Required health care workforce survey opens April 16 
Complete the 2024 AZ Healthcare Workforce Goals and Metrics Assessment online starting April 16.

Mississippi Medicaid managed care provider training workshops
The Division of Medicaid will offer free training to provide information related to Medicaid and managed care programs.

Earn $150 for obstetrical risk assessment form
You can earn an additional $150 for completing the obstetrical risk assessment form for each of your pregnant patients.

North Carolina: Get accurate rates for non-routine infant care
Learn when notification is required after rendering non-routine care to infants and how noncompliance can affect your rate.

Virginia Medicaid: Complete the OBRAF to receive a $100 bonus 
Earn a $100 bonus for completing the Obstetrical Risk Assessment Form within 10 days of the member’s visit.

Digital updates

Change Healthcare update
We’re working diligently to support providers. Sign in to the UnitedHealthcare Provider Portal to see the latest news and updates. 

May 1: Electronic reconsideration and appeal submissions required
Starting May 1, 2024, you’ll be required to submit claim reconsiderations and medical pre- and post-service appeals electronically. 

Your Community Plan medical claim letters are going paperless soon
Starting May 3, 2024, we’ll no longer mail claim letters to most medical network health care professionals and facilities for UnitedHealthcare Community Plans (Medicaid) in Florida and Massachusetts.

Resources and training

CommunityCare Portal can help save you time
The CommunityCare Portal allows you to get an overview of a patient’s total health, complete redeterminations and more.

April is Minority Health Month
This Minority Health Month, show your support by attesting to our new cultural competency categories.

Program and process reminders

EZ Claim Pay available in additional states, starting April 1
Starting April 1, 2024, we’re expanding the availability of EZ Claim Pay, a service for some AARP® Medicare Supplement Plan G insured members.

Two-step claims reconsiderations and appeals process reminder
We follow a 2-step claims reconsiderations and appeals process for commercial and Medicare members.


Help your patients get the kidney care they need

Please help ensure that your patients with diabetes and hypertension complete recommended kidney health screenings this year.

Get details Help your patients get the kidney care they need

Learn how EDI can help improve your Surest experience

Join our webinar to discuss how Electronic Data Interchange can help you boost efficiencies and achieve cost savings.

Sign up now Learn how EDI can help improve your Surest experience

May 1, 2024, Prescription Drug List Updates

Access the latest Prescription Drug List and pharmacy benefit updates for UnitedHealthcare commercial plans.

View the list May 1, 2024, Prescription Drug List Updates

Simplify prior authorizations with our updated crosswalk

Make it easier to determine next steps and reduce claim rework with our enhanced Prior Authorization Crosswalk.

Get started Simplify prior authorizations with our updated crosswalk


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