![]() Finally, this policy may not be implemented in exactly the same way on the different electronic claim processing systems used by UnitedHealthcare Community Plan due to programming or other constraints however, UnitedHealthcare Community Plan strives to minimize these variations. Further, the policy does not cover all issues related to reimbursement for services rendered to UnitedHealthcare Community Plan enrollees as legislative mandates, the physician or other provider contract documents, the enrollee’s benefit coverage documents, and the Physician Manual all may supplement or, in some cases, supercede this policy. Accordingly, UnitedHealthcare Community Plan may use reasonable discretion interpreting and applying this policy to services being delivered in a particular case. This information is intended to serve only as a general reference resource regarding UnitedHealthcare Community Plan’s reimbursement policy for the services described and is 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 policy. This reimbursement policy applies to all professionals who deliver health care services. References to CPT or other sources are for definitional purposes only and do not imply any right to reimbursement. This and other UnitedHealthcare Community Plan reimbursement policies may use CPT, CMS or other coding methodologies from time to time. This reimbursement policy is intended to ensure that you are reimbursed based on the code that correctly describes the procedure performed. You are responsible for submission of accurate claims requests. ![]() Please note that where a specific conflict between a provision of a contract between UnitedHealthcare Community Plan and an applicable state program a provider contracts or state/federal regulations, such contract/regulation will supersede these reimbursement policies. ![]() The UnitedHealthcare Community Plan Reimbursement policies are generally based on national reimbursement determinations, along with state government program reimbursement policies and requirements. Important Note about Reimbursement PolicesĪll provider notification regarding UnitedHealthcare Community Plan reimbursement and medical policies will be posted on this website. Please read the terms and conditions below carefully. ![]()
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