January 09, 2015
Area(s) of Interest: Payor Issues and Reimbursement Practice Management
The 30-day window for physicians in San Diego and Sacramento counties wishing to opt out of United Healthcare’s new Medi-Cal managed care network, called United Healthcare Community Plan, is rapidly approaching.
Affected physicians in these two counties were notified by United Healthcare in December that they are being automatically opted into the Community Plan and rates and terms were included with the notice. Physicians do, however, have the option to opt out of the Community Plan product without affecting their underlying United Healthcare commercial contract. To do so, physicians must notify United Healthcare of their decision to opt out within 30 days of receipt of the notice. Notices were mailed beginning December 12, so in order to meet the deadline, physicians interested in opting out must do so very soon.
The opt out notice should be sent via certified mail, with return receipt, to:
1311 W. President George Bush Highway, Suite 100
Richardson, TX 75080-1152
As always, physicians are encouraged to carefully review all proposed amendments to payor contracts. Physicians do not have to accept substandard contracts that are not beneficial to their practice.
Physicians with questions or those who didn’t receive a notice but want to confirm whether or not they are affected can contact United Healthcare's Debra Pearson at (661) 944-5236.