December monthly overview
Network News is published twice a month. See updates below.
December 1 publication
Policy and protocol updates
Medical policy updates
Medical policy updates for December 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.
State news
Arizona Medicaid: Understanding claims-based member assignments and capitated payments
When members are assigned to a PCP, our system automatically updates the information based on current claims data.
Arizona: Comply with state-mandated appointment availability standards
AHCCCS health plans are required to ensure that members can see medical professionals in a timely manner.
Rocky Mountain Health Plans to align with UnitedHealthcare clinical requirements
Effective March 1, 2025, specific UnitedHealthcare clinical requirements and criteria will apply to RMHP plans. Learn more.
Digital enhancements
Dig deeper into 10 new reasons to skip the phone
Get more details about our latest digital tools and portal enhancements.
Plan and policy updates
2025 Medicare Advantage plan updates
Get important information for UnitedHealthcare Medicare Advantage plans, including D-SNP, in your area.
Medical record documentation update for Surgery of the Hip and Surgery of the Knee
Some total joint replacement procedures will have additional documentation requirements as of Nov. 1. Learn more.
Updated 2025-2027 credentialing plan effective in March
UnitedHealthcare credentialing plan updates for 2025–2027 go into effect in March.
New changes: Close FUH gaps using qualified billing and diagnostic codes
Starting Jan. 1, you can help close FUH gaps using qualified billing and diagnostic codes.
Review the UnitedHealthcare Medicare Part D drug cost and formulary changes
On Jan. 1, several changes to the UnitedHealthcare Medicare Part D drug costs and formulary will go into effect.
Preferred Lab Network application
Apply to be included in our 2025 Preferred Lab Network
Learn about the application process for the UnitedHealthcare Preferred Lab Network and the benefits of being included.
December 19 publication
State news
Jan. 1: Electronic reconsideration submissions required
Health care professionals must submit Medicaid claim reconsideration submissions electronically in Arizona.
Kentucky Medicaid: More UnitedHealthcare members may be coming to your practice
Many Kentucky Medicaid members will be transitioning to UnitedHealthcare on Jan. 1, 2025.
Nebraska Medicaid: Explore training sessions to stay up to date on topics important to you
See information on upcoming training and stay up to date on topics that are important to your practice.
Nebraska: Centralized credentialing available soon
UnitedHealthcare Community Plan of Nebraska will soon offer centralized credentialing processing.
Review Texas Medicaid and Healthcare Partnership CPW program changes
On Dec. 1, we won’t require prior authorizations for the Texas Medicaid and Healthcare Partnership Children and Pregnant Women program services.
Gain continuing education credits and discover top UTI strategies for your patients
This activity is provided by Optum Health Education and United Healthcare, Community Health Plan of Texas.
Plan and program updates
Register certain tests for phase 4 of the DEX Z-Codes
Starting Jan. 1, 2025, you can register tests that are in scope for phase 4 of the DEX Z-Codes®.
Explore preferred covered alternatives for recently discontinued AstraZeneca products
AstraZeneca has announced the discontinuation of Bydureon BCise and Byetta. Review preferred covered alternatives.
2025 UnitedHealthcare UCard updates
Review upcoming updates to the UnitedHealthcare UCard for Medicare Advantage patients.
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