You do not need to take any action during this transition. Some of your patients may be GEHA members in 2022. 1, 2022, GEHA members in California will now access the Select Plus network of providers if enrolled in the Standard Option, High Option or High Deductible Health Plans (HDHPs). 1, 2022, Government Employees Health Association (GEHA) members in the following states will now access the Choice Plus care provider network* if enrolled in the standard option, high option or high deductible health (HDHP) plans:Īdditionally, effective Jan. ** For more information on a specific member's benefit coverage, please call the customer service number on the back of the member ID card or refer to the Administrative Guide.īy clicking "I Agree," you agree to be bound by the terms and conditions expressed herein, in addition to our Site Use Agreement.Effective Jan. *CPT® is a registered trademark of the American Medical Association. Unauthorized copying, use and distribution of this information are strictly prohibited. View services requiring prior authorization. UnitedHealthcare Reimbursement Policies do not include notations regarding prior authorization requirements. Physicians and other healthcare professionals can sign up for regular distributions for policy or regulatory changes directly from CMS and/or your local carrier. UnitedHealthcare encourages physicians and other healthcare professionals to keep current with any CMS policy changes and/or billing requirements by referring to the CMS or your local carrier website regularly. UnitedHealthcare regularly updates its Reimbursement Policies to comply with changes in CMS policy and other standard coding guidelines. However, the information presented in the Reimbursement Policies is accurate and current as of the date of their publication. UnitedHealthcare may modify Reimbursement Policies at any time by publishing a new version of the Reimbursement Policies on this website. Finally, the Reimbursement Policies may not be implemented exactly the same way on the different electronic claims processing systems used by UnitedHealthcare due to programming or other constraints however, UnitedHealthcare strives to minimize these variations. These factors may include, but are not limited to: legislative mandates, the physician or other provider contracts, and/or the member specific benefit plan documents**. Other factors affecting reimbursement may supplement, modify or, in some cases, supersede the Reimbursement Policies. Further, the Reimbursement Policies do not address all issues related to reimbursement for health care services provided to UnitedHealthcare members. Accordingly, UnitedHealthcare may use reasonable discretion in interpreting and applying the Reimbursement Policies to health care services provided in a particular case. Reimbursement Policies are intended to serve only as a general resource for the services described and are not intended to address every aspect of a reimbursement situation. Coding methodology, industry-standard reimbursement logic, regulatory requirements, benefits design and other factors are considered in developing Reimbursement Policies. The Reimbursement Policies apply to all health care services billed on CMS 1500 forms and, when specified, to those billed on UB04 forms (CMS 1450). References to CPT® or other sources are for definitional purposes only and do not imply any right to reimbursement. The Reimbursement Policies use Current Procedural Terminology (CPT®*), Centers for Medicare and Medicaid Services (CMS), or other coding guidelines. The Reimbursement Policies are intended to ensure that you are reimbursed based on the code or codes that correctly describe the health care services provided. You are responsible for submission of accurate claims. The UnitedHealthcare Medicare Advantage Reimbursement Policies ("Reimbursement Policies") are applicable to UnitedHealthcare Medicare Advantage Plans offered by UnitedHealthcare and its affiliates. Please read the terms and conditions below carefully.
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