Training

Reminder on Special Needs Plan Model of Care Training 

The Centers for Medicare & Medicaid Services (CMS) requires Special Needs Plans (SNPs) to provide initial and annual Model of Care (MOC) training to all network providers contracted to see SNP members and all out-of-network providers seen by SNP members routinely. UnitedHealthcare offers the SNP MOC training as a pre-recorded session that takes about 10 minutes to complete. Please complete the annual training module. 

SNPs are responsible for conducting their own MOC training, which means you may be asked to complete multiple trainings by different health plans. 

The training includes information about the different types of  SNPs tailored to individual needs. You’re considered a SNP  care provider if you see UnitedHealthcare plan members who have benefits under a Medicare Advantage SNP. 

Please complete this year’s training by Oct. 1, 2020: 

• To complete the training, click here.

Resources

• Special Needs Plan Model of Care Training Overview
• Special Needs Plan Model of Care Training Frequently Asked Questions

In this 30-minute session you’ll learn how to register for Link, use the Link Security tool for user ID and password management, and join multiple Tax IDs to one account. This is most relevant for larger provider organizations and revenue management cycle/billing companies.

Need help now? Go to our Link Self-Service Tools page for tutorials and quick reference guides.

The OptumHealth™ Education website provides access to on-demand webcasts, information on upcoming conferences and registration for other educational programs.

• Introduction to Electronic Data Interchange (EDI): Introduction to the basics of EDI as an electronic solution to exchange and obtain information with us. Learn how it may help you increase productivity and reduce expenses.
  
  
  • What is EDI
  • EDI Connectivity

• Enhancements to EDI Transactions: Improvements to 270/271 eligibility and benefits and 276/277 claims status transactions will enable you to be more productive using EDI.
  
  
  • Enhancements to 270/271 Eligibility and Benefits Transactions
  • Get Better Results with 270/271 Eligibility and Benefits Transactions
  • Enhancements to 276/277 Claims Status Transactions 
    
    
• EDI Optimization: Learn how EDI can simplify common operational processes and maximize productivity and savings.
  
• EDI Optimization Training: Registration is not available at this time. Registration will be opened up after the training revisions are completed.
  

Need help now? Go to our EDI section for more information and resources.

A 30-minute introduction to the EPS/Optum Pay website. Learn how to view payments, search remittances and print electronic remittance advices.

Need help now? Visit the EPS/Optum Pay page for more information and resources.

This training discusses why cultural competency and the Americans with Disabilities Act (ADA) requirements are important to care providers, including information on:

Impact of these requirements on care providers

• Cultural competency overview
• Americans with Disabilities Act (ADA) overview
• The provider's role in complying with these requirements

This training is available through UHC On Air. 

UnitedHealthcare Community Plan Initial Health Assessment Requirements

Per California Department of Health Care Services (DHCS) Policy Letter 08-003, the Initial Health Assessment (IHA) is a comprehensive assessment that is completed during the member’s initial encounter(s) with a select or assigned primary care physician (PCP), appropriate medical specialist, or non-physician medical provider (Nurse Practitioner, Certified Nurse Midwives, Physician Assistants and Primary Care Providers in training) and must be documented in the member’s medical record.

The IHA enables the members PCP to assess and manage the acute, chronic and preventive health needs of the member. The IHA must be completed and documented in medical record within 120 calendar days of the member’s enrollment to UnitedHealthcare Community Plan.

• Initial Health Assessment Care Provider Training
  

Need Help?

If you have questions, please email the Quality Department at UHCCSCAQualityDepartment_DL@ds.uhc.com.

This 30-minute session reviews how to submit a CMS 1500 Professional Claim using the Claim Submission tool on Link.

This 30-minute session reviews how to access documents and reports in Document Vault and how to enroll in Paperless Delivery Options, so you can reduce mail.

An introduction to Link, your gateway to UnitedHealthcare’s online tools. This 60-minute session introduces two of Link’s most-used tools:

• eligibilityLink for checking member eligibility and reviewing detailed benefits information.
• claimsLink lets you check claim status and submit claim reconsideration requests.

Need help now? Go to our eligiblityLink and claimsLink pages for tutorials and quick reference guides.

In this 30-minute session you’ll learn how to register for Link, use the Link Security tool for user ID and password management, and join multiple Tax IDs to one account. This is most relevant for larger provider organizations and revenue management cycle/billing companies.

Need help now? Go to our Link Self-Service Tools page for tutorials and quick reference guides.

This 30-minute session reviews the features on the My Practice Profile tool, which lets authorized users view and update the demographic information UnitedHealthcare members see for your practice ‒ including office address, hours, phone, email, contracted plans and more.

Need help now? Go to our My Practice Profile page for more information and resources.

Prior Authorization and Notification Tools on Link

In this 30-minute session, you’ll learn how to submit prior authorization/notification requests, view requests submitted by others, check status and update requests as needed through the Prior Authorization and Notification Tool in Link. You will also learn how to find prior authorization/notification requirements.  

Need help now? Go to our Prior Authorization and Notification section for more information and resources.

This short, on-demand session reviews the process of submitting a referral online and checking the status of an existing referral. To access the training presentation, please use your Link credentials to sign in to the on-demand session.

We offer two ways to access training for new care providers and their staff:

• Access the interactive self-paced course whenever it’s convenient for you
• Register for one of our instructor led-sessions

With both options, you’ll learn about important tools and resources available as you begin doing business with us.

Per California Department of Health Care Services (DHCS) Policy Letter 18-006, federal law requires care providers to screen children younger than 21 who are enrolled in Medi-Cal for autism spectrum disorder. This requirement is part of the Center for Medicare & Medicaid Services (CMS) Early and Periodic Screening, Diagnostic and Treatment (EPSDT) guidelines.

When screening children for autism spectrum disorder, we recommend administering the Ages and Stages Autism Screening Questionnaire – Third Edition (ASQ®-3). You can request a hard copy of the ASQ-3 by emailing uhccscaqualitydepartment_dl@ds.uhc.com. 

• Screening Requirements for Autism Spectrum Disorder

Care Provider Instructions

Review the Timely Access to Care Standards and share them with your staff.

Timely Access to Care Standards

The California Department of Managed Health Care requires that appointment requests are completed within specific timeframes. Following these standards guarantees that patients have timely access to care.

Annual Monitoring

We want to make sure our care providers are following the timely access to care standards. Each year, we ask certain care providers to complete a Patient Access and Availability Study. UnitedHealthcare Community Plan of California closely monitors grievance reports to identify access and availability issues. Issues will be tracked and, if a trend is identified, it may result in an Improvement Action Plan.

2018 Provider Appointment Availability Survey Results 

Review the 2018 Provider Appointment Availability Survey Results and share with your staff. If you have any questions regarding the results, please email the Quality Department at uhccscaqualitydepartmentdl@ds.uhc.com. 

Need Help?

If you have questions, please email the Quality Department at uhccscaqualitydepartmentdl@ds.uhc.com.