Tag: #reimbursement #UHC

Posted in #reimbursement, #unitedhealthcare, Prior Authorization Insurance Carrier Updates, Training

Musculoskeletal surgical services prior auth change for FL UHC plans

Posted on by KR2Medical Billing

This authorization process change affects FL ASO and fully insured plan types.

Please note that after any DOS 5/1/2025, Turning Point Healthcare Solutions LLC will take over the authorization process for musculoskeletal surgical procedures.

Starting April 21st 2025 the providers should start to contact the TurningPoint to request an authorization.

Please contact Turning Point Healthcare via phone/fax: 904-895-4007/904-544-8025 or sign up on their portal: https://www.myturningpoint-healthcare.com/

This change does not apply to the following plan types:

Commercial plans of members who reside in the U.S. Virgin Islands
Optum Care®
Surest®
UMR™
UnitedHealthcare Individual Exchange plans (also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans)
WellMed®

Do you find this type of content useful? Follow mt blog for more!

Posted in #reimbursement, #unitedhealthcare, Payer Updates, Training, Updates

UHC Minnesota Community Plan: non-emergency transport

Posted on by KR2Medical Billing

Effective immediately, UHC is going to process claims and payment for all non-emergency transportation services for Community Health Plans of Minnesota.

The following HCPCS codes are affected:

HCPCS code A0428: Ambulance service, basic life support, non-emergency transport

HCPCS code A0130: Non-emergency transportation: wheelchair van

This change applies to the following plans:

  • UnitedHealthcare® Families and Children Medical Assistance (PMAP)
  • MinnesotaCare
  • Minnesota Senior Health Options (MSHO)
  • Minnesota Senior Care Plus (MSC+)
  • Special Needs Basic Care (SNBC) plans

Providers please submit your claims directly to the UHC  Community Plan instead of submitting them to MTM Inc.

Any previousely unpaid claims that were submitted to MTM Inc. on DOS 7/1/22 and thereafter can be resubmitted to UHC Community HealthPlan directly Oct 1,2024. Timely filling will be waived for these 2 particular codes.

Submitting claims:

Using UHC EDI or UHC portal.

For any further questions, providers can chat with UHC 7 a.m.–7 p.m. CT, Monday–Friday from the UnitedHealthcare Provider Portal.open_in_new For additional contact information, visit UHC Contact us page.

Find this type of content useful? Follow my blog for the latest news in healthcare. #medicalbilling #medicalcoding #reimbursement #UHC