November 09, 2015
Area(s) of Interest: Commercial Payors Payor Issues and Reimbursement Professional Development & Education
As announced earlier this year, United Healthcare (UHC) will begin offering products through Covered California, the California health benefit exchange, in 2016. In April, UHC notified 19,000 of its commercially contracted physician practices of their inclusion in the newly created UHC Core product line designated as its Covered California provider network.
In 2016, UHC will only offer exchange coverage in the five regions of California where fewer than three exchange health plans are currently offered, including:
- Region 1: Northern counties (Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Nevada, Plumas, Shasta, Sierra, Siskiyou, Sutter, Tehama, Trinity, Tuolumne and Yuba)
- Region 9: Central Coast (Santa Cruz, San Benito, Monterey)
- Region 11: Central Valley (Fresno, Kings, Madera)
- Region 12: Central Coast (San Luis Obispo, Santa Barbara and Ventura counties)
- Region 13: Eastern region (Inyo, Mono)
UHC will be sending a welcome packet to Core participating physicians and is offering a number of one-hour webinars aimed at providing more information about the United Healthcare Core for the Health Insurance Marketplace product. The welcome packet will be sent out mid-November, but practices can register to attend a webinar now. Topics included are health plan overview, eligibility and benefits details, how to verify participation status, and prior authorization requirements.
To register for one of the webinars, visit www.UnitedHealthcareOnline.com > Tools & Resources > Products & Services > 2016 Health Plans Training. Physicians who are unsure about their participation in the Core plan network can contact UHC Network Management at (866) 574-6088.