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PROVIDER REFERRALS




REFERRALS


REFERRALS


REFERRALS


UNITEDHEALTHCARE PROVIDER PORTAL TOOLS

The referrals feature on the UnitedHealthcare Provider Portal can help you
submit new referral requests, find if a referral is needed and the status of
existing referral requests, plus get confirmation details for your submitted
referrals.

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REFERRALS

Use the tool for these plans: commercial, community, Individual Exchange Benefit
marketed as Individual and Family Plans, Medicare and Oxford (for members with a
numeric group number).

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UNITEDHEALTHCARE OXFORD PLANS

For UnitedHealthcare Oxford plans with alphanumeric Group Numbers


UNITEDHEALTHCARE WEST PLANS

For UnitedHealthcare West plans simply contact your patient's primary care
physician.




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ADMINISTRATIVE GUIDES


FREQUENTLY SEARCHED

Charter, Navigate and Navigate Now Referral Requirement Quick Reference
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UnitedHealthcare® Charter, Navigate and NavigateNOW benefit plans offer
UnitedHealthcare commercial members a customized, more-focused network of
healthcare professionals. Some plans require referrals.

Important Concepts in Integration: Coordination of Care
Members may receive services from more than one practitioner. Coordination of
Care among practitioners is a best practice, as well as a vital contribution to
integrating a member’s physical and behavioral health needs.  

Home Health and SNF High-Performing Provider Initiative Lists
High-Performing Skilled Nursing Facility and Home Health Provider Initiative
Lists

Designated Diagnostic Provider (DDP)
UnitedHealthcare is launching a new benefit design for outpatient diagnostic lab
services to help drive patient transparency and manage the cost of healthcare.
Outpatient diagnostic lab services will be covered for commercial members at the
lowest cost shared when delivered by a Designated Diagnostic Provider.

Skilled Nursing Facilities
These resources are especially tuned to skilled nursing facilities, including
brochures for patient education, support for billing and reimbursement, and a
special focus on Medicare Advantage and the UnitedHealthcare Passport Service.

EDI 278I: Prior Authorization and Notification Inquiry
Use the Prior Authorization and Notification Inquiry (278I) transaction to check
the status of previously submitted authorizations and notifications. Electronic
authorization and notification inquiries can be submitted in real-time or in
batches and you will receive a unique inquiry ID for confirmation of submission.

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