UHCD Ideas

Request intake portal for the UnitedHealthcare Digital product team

Add Referral Language to Disclaimers on M&R

Referrals from your PCP

Your PCP can handle most routine health care needs. If you need to see a network specialist or other network provider, you may need to get a referral from your PCP. Your PCP will make a referral based on your health situation. They may or may not refer you to a particular specialist in this directory who you want to see. Generally, your PCP will provide follow-up care, as needed. Please see the Evidence of Coverage for information about access to specialists.This directory provides a list of skilled nursing facilities for all networks. Contact your PCP for a referral to a network skilled nursing facility. The "network providers" listed in this directory have agreed to provide you with your health care coverage. However, some services may require a referral. If you have been going to one network provider, you are not required to continue going to that same provider. Check your Evidence of Coverage to make sure your plan includes additional benefits or that you've signed up for optional supplemental riders before making appointments for dental, vision or hearing services.

  • Guest
  • Aug 1 2017
  • Planned
Priority Important
Estimated Cost ($ Dollars)
Business Problem

Existing requirement for 2017 and also included in the new 2018 Provider Model Directory guidance (see paragraph 2)

 

Business Value

Meet regulatory requirements

Business Risk

CMS CAP potential

Date Required By 2017-09-01
Who would be willing to pay for it?
Regulatory Yes
Regulatory Date 2017-01-01
Client Commitment Comments
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