Letter from the Administrator
Medicare Advantage change effective January 1 (SNF/NF)
UnitedHealthcare has issued a bulletin outlining a reimbursement policy change effective January 1 that will require skilled nursing facilities providing post-acute inpatient services to request prior authorization and receive a determination before UnitedHealthcare Medicare Plan Advantage plan members can be admitted. UnitedHealthcare may deny claims if one of their members is admitted to your facility without an approved authorization request.
Prior authorization can be requested using UnitedHealthcare’s online Prior Authorization and Notification Tool. After completing the tool questionnaire, you will receive a reference number to track the status of your request. The reference number is not a determination of coverage nor a guarantee of payment.
If you are unable to use the online tool, call UnitedHealthcare at 877.842.3210
New MCO coming to Iowa in July (Medicaid providers)
Iowa Total Care is Iowa’s newest Managed Care Organization (MCO) and will begin serving the Medicaid population effective July 1, 2019. As a subsidiary of Centene, Iowa Total Care has over 30 years of experience with Medicaid and partnering with providers in the delivery of quality care.
For those providers interested in contracting with Iowa Total Care, now is the time to start working with them to ensure their members can be accepted starting in July.