October monthly overview

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

October 1 publication

Medical policy updates
Medical policy updates for October 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.

Jan. 1: Electronic reconsideration submissions required
Health care professionals must submit Medicaid claim reconsideration submissions electronically in Arizona.

New radiation therapy requirements for Rocky Mountain Health Plans
On Jan. 1, some UnitedHealthcare requirements and criteria will apply to Rocky Mountain Health Plans.

Dec. 1: Electronic reconsideration and appeal submissions required
Health care professionals must submit Medicaid medical reconsiderations and appeals electronically in Louisiana and Pennsylvania.

Minnesota Medicaid: Your claims may be denied if you’re not enrolled before Oct. 1
See how to avoid claim denials if you’re contracted with a Medicaid MCO or have recently billed as an MCO network provider.

Missouri Medicaid: New state communications portal now available
UnitedHealthcare Community Plan and Missouri partner to launch portal, enhancing Medicaid communication.

New Jersey: Complete survey to avoid credentialing denials
New Jersey care providers are required to complete survey forms to avoid denied credentialing applications.

New York Medicaid: Update your data in My Practice Profile or CAQH
Help patients and other health care professionals find your practice faster by updating your demographic data.

New 2025 Individual Exchange plans and prior authorization information
On Jan. 1, 2025, we'll launch Individual Exchange plans in 4 new states. Learn more.

2025 Medicare Advantage service area changes
On Jan. 1, 2025, we’re making changes to some UnitedHealthcare® Medicare Advantage service areas.

Medicare: Part B step therapy prior authorization requirements
For dates of service starting Jan. 1, 2025, prior authorization is required for Part B Step Therapy Program medications.

Register certain tests for phase 3 of the DEX Z-Codes
Starting Oct. 1, you can register tests that are in scope for phase 3 of the DEX Z-Codes®.

Highlight cultural competencies on your My Practice Profile
Help patients make informed care decisions by updating your practice profile.

Want to save up to $7 and 17 minutes per transaction?
Learn how and when to contact us and use our digital tools for maximum efficiency.

Starting Nov. 1, you’ll begin seeing Surest plan documents in the portal as a member’s plan renews; they’ll no longer be mailed.

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