Use the daily Payment Summary report to complement existing payment and remittance information. For claim-level reconciliation, continue to use the appropriate remittance advice, provider remittance ...

To maintain Medicaid eligibility, members may be required to: Complete at least 80 hours per month of qualifying work, education, training or volunteer activities Renew Medicaid coverage every 6 ...

The New York State Department of Health has updated its provider revalidation process following CMS approval of its improvement plan. What you need to know. As part of the plan, N ...

Operational measures such as call center metrics, complaints, etc. Healthcare Effectiveness Data and Information Set (HEDIS) measures Consumer Assessment of Healthcare Providers and Systems (CAHPS) ...

UnitedHealthcare Community Plan providers in Florida may receive secret shopper calls or on-site visits through the Florida Agency for Health Care Administration’s (AHCA) Enhanced Provider Network ...

Beginning Jan. 1, 2027, we’re making prescription drug list (PDL) updates for UnitedHealthcare Individual Exchange plans, also referred to as UnitedHealthcare Individual and Family ACA Marketplace ...

To comply with CMS and/or American Medical Association procedure code updates, effective Jan. 1, 2027, prior authorization will be needed for the following HCPCS code when administered in outpatient ...

For patients with autism, ADHD and other neurological differences, inclusive care starts with adapting the care experience to meet individual neurodivergent needs. This Disability Awareness Month, we ...

Over the past few years, we’ve shared and implemented our plans to transition to digital transactions. This helps ensure you get the answers you need more quickly. As part of that effort, as of Dec. 1 ...

Our digital solutions offer you the fastest way to find plan information, manage tasks, check statuses and decisions — all without calling.