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UNITEDHEALTHCARE PROVIDER PORTAL

The UnitedHealthcare Provider Portal has more than 40 tools that allow you to
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ELIGIBILITY AND BENEFITS

Verify member eligibility, determine benefits, view care plans and get a digital
copy of the member ID card.


PRIOR AUTHORIZATION AND NOTIFICATION

Check prior authorization and notification requirements, submit requests, upload
medical notes, check status and update cases.


CLAIMS AND PAYMENTS

Submit claims, look up fee schedules, check status, view payment information,
and submit reconsideration and appeal requests.


REFERRALS

Check referral requirements, submit requests, review referral history and
monitor the number of remaining visits.

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GO DIGITAL!

 * less paper
 * more automation
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All designed to support faster payments.

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NETWORK NEWS

Find the latest announcements, updates and reminders – prior authorization
requirements, policy and protocol changes, reimbursement updates and other
important information to guide how your practice works with UnitedHealthcare and
our members.

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NO SURPRISES ACT OPEN NEGOTIATIONS

Learn more about the requirements of the No Surprises Act of 2020 and the
out-of-network claims covered under the Act. Step-by-step instructions guide you
through submitting a negotiation request through the UnitedHealthcare Provider
Portal.

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NEWS

October 28, 2022


NEW YORK MEDICAID: CHANGES TO PRACTITIONER DISPENSING BILLING PROCESS



Effective Sept. 1, 2022, Medicaid Managed Care plans will deny payment to
pharmacies not enrolled as a pharmacy provider for FFS Medicaid.

Read Full Update

October 28, 2022


MEDICARE: PART B STEP THERAPY PRIOR AUTHORIZATION REQUIREMENTS



For dates of service starting Jan. 1, 2023, prior authorization is required for
Part B step therapy program medications.

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October 28, 2022


SPECIALTY MEDICAL INJECTABLE DRUG PROGRAM UPDATES: NOVEMBER 2022



Specialty Medical Drug Program updates for UnitedHealthcare Commercial,
Community Plan, Medicare Advantage, and Value & Balance Exchange plans for
November 2022.

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October 28, 2022


MEDICAL POLICY UPDATES: NOVEMBER 2022



Medical policy updates for November 2022 for the following plans: Medicare,
Medicaid, Exchanges, and Commercial.

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October 28, 2022


REIMBURSEMENT POLICY UPDATE BULLETINS: NOVEMBER 2022



You can review the details on November's reimbursement policy updates through
the commercial, Medicare, Medicaid and Exchange plan bulletins.

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October 28, 2022


RECONSIDERATION AND APPEAL SUBMISSIONS GOING DIGITAL



Starting in February 2023, reconsiderations and appeals for Commercial and
Medicare plans must be submitted electronically.

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