December monthly overview

Network News is published twice a month. See updates below.

December 1 publication

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.

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.

Dig deeper into 10 new reasons to skip the phone
Get more details about our latest digital tools and portal enhancements.

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.

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.

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