FAQ's
What is the House Calls program?
Through this program, health care practitioners make in-home clinical visits with members to evaluate their health conditions. The program is designed to educate and help our members be proactive about their health. This visit is meant to support the care the member receives from their primary care provider. It does not replace their regular PCP visits or the annual wellness exam. There is no additional cost for this program to our members
What Article is KM1004126 (there is 2)
Situational Guidelines - One Breath - Advocate
& Situational Guidelines - Index
DispatchHealth
KM1226006
How many years are there in a millennium?
1000
Part D Expedited Appeal
A request to expedite an appeal in situations when the member or the member's physician/prescriber believes that waiting the standard time frame may jeopardize the member's life, health, or ability to regain maximum function. (A review of a benefit already provided to a member cannot be expedited.)
What are Mental Health Virtual Visits?
A mental health virtual visit is a covered optional treatment modality that uses HIPAA-compliant audio/video technology to deliver mental health services, information and education at a distance in real time. Scheduled online appointments with a mental health provider take place via a secured Internet-based connection. Mental health clinicians evaluate as well as treat general mental health conditions, such as depression and anxiety. Services include evaluation, therapy and medication management.
What is Article KM1225807
State Assistance Locator
Genesys Dialer - Index
KM1122931
Which is heavier? A pound of feathers or a pound of rocks?
Neither
Part C Expedited Appeal
A member or physician may request to expedite an appeal if the member/physician believes that waiting for a decision under the standard time frame may jeopardize the member's life, health, or ability to regain maximum function. (A request for payment of a service already provided to a member cannot be expedited). Expedited appeals include fast track appeals that missed the Quality Improvement Organization (QIO) deadline.
Who is March Vision Care?
March Vision Care is a vision care plan that manages and administers vision care programs for health plans such as UnitedHealthcare. Currently it serves more than 6 million Medicaid, Medicare and MMP members in 24 states plus the District of Columbia.
What is Article KM1006563
Network Advocates - Index
Preventive Services - Index
KM1006920
In Avengers Infinity War, the Avengers must defeat the powerful
7 Day Limit
An opioid drug used for the treatment of acute pain may be limited to a 7 day supply for members with no recent history of opioid use. This limit is intended to minimize long-term opioid use. For members who are new to the plan, and have a recent history of using opioids, the limit may be overridden by having the pharmacy contact the plan
If a commitment needs to be extended, what is the process?
If a change to a scheduled commitment time is necessary, an outreach to the member should be made before changing the commitment time in Maestro.
What is Article KM1013257
FirstLine Benefits - Index
Fraud Waste Abuse - Index
KM1169503
A farmer has 17 sheep and all but nine die, how many are left?
9
Sensitive Member Information
Member Sensitive Information is information which directly indicates the member may have a sensitive health condition.
This information should NOT be provided to any callers, unless specifically listed in the What can be Discussed After the Caller has been Authenticated section of the caller type.
Examples include Diagnosis Codes, CPT codes, provider names, or any other information that would indicate one of the following conditions:
How does the NPPO Medicare Advantage Plan work if I use an out-of-network provider?
When you go out of the network for care, the UnitedHealthcare Medicare Advantage PPO plan pays providers Medicare Allowed amounts, and you pay the same cost-share amount out of pocket as if you had stayed in the network.
What is Article KM1267135 and read the Alert section
06.24.21 Invalid Address Triggers and Discrepancy
Situational Guidelines - Index
KM1004126
What is the full name of the school Harry Potter attended?
Hogwarts School of Witch Craft and Wizardry
Crossover
The act of Medicare sending a claim to secondary insurance once they have processed their responsibility of the claim.