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Pennsylvania | Spring 2020

For the latest on COVID-19, visit the Centers for Disease Control at CDC.gov.

For UnitedHealthcare benefits information and resources related to COVID-19, visit UHCprovider.com/covid19. We encourage you to view the latest COVID-19 information at the Pennsylvania Department of Human Services providers site.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33682 Practice Matters: PA – Spring 2020 Provider Services Center: 877-842-3210

Important information for health care professionals and facilities

Policy, drug and Protocol changes contained herein are effective and enforceable as of the dates indicated, pending notice from UnitedHealthcare to the contrary. Changes to these effective dates or updates to our business practices and policies as a result of COVID-19 will prevail and be posted on our care provider website as quickly as possible. As with any public health issue, we are working with and following guidance and protocols issued by federal, state, and local health authorities.

We understand that it’s a confusing time. Right now, you need all the resources and information you can get. We’re working to keep you updated so you can focus on keeping Pennsylvania residents healthy and safe.

First and Foremost, Thank You.As the people on the front lines of COVID-19, we appreciate your efforts to fight this virus. To all health care professionals who are caring for sick patients and working around the clock to help find solutions — thank you for all you’re doing.

Find the Up-To-Date Information You NeedWe’ll be regularly updating the National UHCprovider.com page with our actions on updating state-specific guidance at your state-specific UHCprovider.com page. We also suggest that you check your state’s COVID-19 site for the latest news and regulations.

To Help Manage Your Business

• Acceleration of Claim Payments• Extension of Timely Filing Limits• CARES Act Information• Provisional Credentialing• Requirements to Practice in a New Location• Changes to Prior Authorization Requirements• Updates on Delayed Programs and Policies

On our sites, you’ll find information:

As You Work With Patients

• Expanded Telehealth Access and Reimbursement• Telehealth Coding Guide• Member Cost-Share Waivers• Assistance with Patient Discharge Planning• Easier Access to DME and Supplies• Suspension of HouseCalls and Optum at Home

Practice Matters: PA – Spring 2020 Provider Services Center: 877-842-3210

Important information for health care professionals and facilities

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In This Issue...• UnitedHealthcare Clinical Programs and Resources

• Providing Hepatitis C Treatment

• Special Needs Unit Reminder

• Language Services

• DSNP Reminder

• Medical Assistance Transportation Program

• Spirometry Testing Standards for Members with COPD

• Let’s Get the Lead Out

• Cultural Competency

• Long-Acting Reversible Contraceptives

• Adult Annual Dental Visit

• Tobacco Treatment Resources

• Helping Members in Pennsylvania Get to Their Appointments

• New Educational Resources for the 2020 UnitedHealthcare Dual Complete® Plan

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33681 Practice Matters: PA – Spring 2020 Provider Services Center: 877-842-3210 1

Important information for health care professionals and facilities

UnitedHealthcare Clinical Programs and Resources UnitedHealthcare Community Plan has a variety of programs and resources to assist you with providing care that helps members live healthier lives. Here are a few resource examples you can connect members with:

• Diabetes Prevention Program: Helps members reduce weight and increase physical activity —decreasing their risk for diabetes — through a series of lifestyle meetings with a health coach (Pittsburgh only, more locations to be added later this year).

• Healthy First Steps: Provides support to members as they navigate through their pregnancy and the first 60 days postpartum.

• NurseLine: Allows members to talk by phone with registered nurses trained to provide resources and other information.

• Smoking Cessation: Gives members up to 70 visits of tobacco cessation counseling per year and coverage for products and medication to help members quit tobacco.

To learn more about programs and resources available, go to UHCprovider.com/PAcommunityplan > Bulletins and Newsletters > Guide to UnitedHealthcare Community Plan of Pennsylvania Clinical Programs.

Providing Hepatitis C TreatmentThe American Association for the Study of Liver recommends that sustained virologic response (SVR)bloodwork is drawn 12 weeks after a prescription treatment is completed (after last dose is taken). UnitedHealthcare Community Plan of Pennsylvania is required to report results to our state partners regarding hepatitis C treatment results for members who receive Mayvret, Vosevi, Ledipasvir/Sofosbuvir and Sofosbuvir/Velpatasir.

Care providers have up to one year, post-treatment, to submit results to the UnitedHealthcare Community Plan of Pennsylvania Special Needs Unit by faxing 877-215-9811. Care providers should perform outreach to members who have not been compliant with lab draws. If you have any questions, call the Special Needs Unit at 877-844-8844.

Special Needs Unit ReminderThe UnitedHealthcare Special Needs Unit offers services for members who have unique needs due to ongoing physical, developmental, emotional or behavioral conditions. The unit educates and helps UnitedHealthcare Community Plan members:

• Find a doctor or dentist.• Identify and connect with community and

state resources.• Connect with behavioral health providers and

case management.• Access the transportation benefit.• Understand and coordinate their other benefits.

For more information about the Special Needs Unit, go to UHCprovider.com/PAcommunityplan > Provider Administrative Manual and Guides > Pennsylvania > View the UnitedHealthcare Community Plan of Pennsylvania Care Provider Manual. Call the Special Needs Unit at 877-844-8844 toconnect a UnitedHealthcare Community Plan member with these services.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33682 Practice Matters: PA – Spring 2020 Provider Services Center: 877-842-3210 2

Important information for health care professionals and facilities

Language ServicesUnitedHealthcare Community Plan of Pennsylvania helps you find language services for your patients who are our members. Services are available by phone and in person for members who are deaf, hard of hearing or have language barriers.

How to Access Interpreter Services

In-Person By PhonePreview Languages Unlimited, LLC for American Sign Language, telephonic and on-site interpretation at languagesunlimited.com or call 800-864-0372.

Open an account with LanguageLine Solutions® at languageline.com or call 800-752-6096, option 4.

Get a quote for Accredited Language Services (ALS) International professional translation services in more than 200 languages at accreditedlanguage.com or call 800-322-0284.

Dial 711 to use Hamilton Relay in Pennsylvania at hamiltonrelay.com/state_711_relay or call:

• TTY: 800-654-5984

• Voice: 800-654-5988

• Speech-to-Speech: 844-308-9292

• Spanish: 844-308-9291

Using LanguageLine

To find out how LanguageLine works, go to languageline.com > Client Services. Once you’re ready to use the interpreter service, follow these instructions.

To Conferencing in a Limited English Speaking Patient:

• Call the LanguageLine number you used when you signed up for a LanguageLine account.

• Request the language your caller speaks through our simple interactive voice response system.

• When the interpreter is connected, explain the situation.

• Conference in your patient.

To Make a Call to a Limited English Speaking Patient:

• Call LanguageLine at 800-752-6096.• Request the language your client speaks through

our simple interactive voice response system.• When the interpreter is connected, call your patient

or the interpreter can place the call for you.

If You’re Face-to-Face with a Limited English Speaking Patient:

• Call LanguageLine at 800-752-6096.• Request the language your client speaks through

our simple interactive voice response system.• When the interpreter is connected, use the

LanguageLine phone, speakerphone or pass your handset back and forth.

If you have questions, please contact Provider Services at 800-600-9007.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33683 Practice Matters: PA – Spring 2020 Provider Services Center: 877-842-3210 3

Important information for health care professionals and facilities

DSNP Reminder Reminder About Your Participation with UnitedHealthcare’s Dual Special Needs Plan (DSNP)

Community HealthChoices (CHC) participation does not affect your DSNP participation with UnitedHealthcare. If a participant has chosen a Medicare option through a different company, the CHC-MCO is still responsible for coordinating with the participant’s Medicare plan and providers. The participant’s Medicare will not change unless the participant decides to change it. For additional information, please refer to the Community HealthChoices Medicare Questions and Answers issued on May 1, 2018, and revised on Dec. 2, 2019, at healthchoices.pa.gov/cs/groups/webcontent/documents/document/c_274784.pdf.

Medical Assistance Transportation ProgramThe Medical Assistance Transportation Program, also known as MATP, provides transportation to medical appointments for Medical Assistance recipients who don’t have transportation available to them. The individual’s county of residence will provide the type of transportation that is the least expensive while still meeting their needs. A one-time MATP application must be completed and signed.

The MATP provider will give members information about how to schedule transportation, use the local program and about their rights. If a member needs assistance or is a minor, there are provisions for accompanying riders. The resources are usually either a bus pass or shared ride depending on medical needs. To learn more, contact your county office. Each county’s phone numbers can be found at matp.pa.gov/CountyContact.aspx.

Spirometry Testing Standards for Members with COPD The Global Initiative for Chronic Obstructive Lung Disease (GOLD®) standards/guidelines should be followed when managing members with COPD. These guidelines state that yearly spirometry testing is recommended to assess and monitor members with a COPD diagnosis. Use of spirometry testing in the assessment and diagnosis of COPD is a HEDIS® measure that tracks adults, age 40 and older, who have a new diagnosis of chronic obstructive pulmonary disease (COPD) or newly active COPD and received spirometry testing to confirm the diagnosis.

More information is available at UHCprovider.com > Search Clinical Guidelines > PA > COPD and goldcopd.org.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Let’s Get the Lead Out Every child is at risk for lead exposure. The Early Periodic Screening, Diagnosis and Treatment (EPSDT) and the Bright Futures program requires providers to test children on Medical Assistance at ages 1 and 2. Screening tools don’t close care opportunity alerts for blood lead level (BLL) screenings in children. In 2020, UnitedHealthcare will provide an additional incentive to providers that perform BLL screenings on children ages 2 and younger. Just remember 2 x 2 — two BLL screenings by age 2.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33684 Practice Matters: PA – Spring 2020 Provider Services Center: 877-842-3210 4

Important information for health care professionals and facilities

Cultural Competency Are you culturally competent? To effectively deliver health care services that meet the social, cultural and linguistic needs of individuals with diverse backgrounds, there is a need for cultural awareness and sensitivity.

Of the 22,524 practitioners in UnitedHealthcare Community Plan of Pennsylvania, only 3,337 (14.8%) attested to participating in cultural competency training on My Practice Profile. It is unknown if this represents an accurate number of practitioners trained in culturally sensitive care or if it’s due to underreporting. Please update your Practice Profile on the Provider Portal to attest to completion of cultural competency training through UnitedHealthcare or any other resource such as your employer or office. As a reminder, your Practice Profile should be updated quarterly.

How do I update and attest to my data using My Practice Profile?

• If you’re an authorized user, follow these steps. – Sign in to Link by clicking on the Link button in the top right corner of UHCprovider.com.

– Select the My Practice Profile tile on your Link dashboard.

– Select Corporate name, tax ID number and click Go.

– If the data we have is correct, click Attest. – If the data we have is incorrect:○ Update your data and select Save Changes.○ Review your changes by selecting Submit

Changes, then click Attest

Resources for cultural competency are available through UHCprovider.com where continuing education units can also be earned:

• UHC On Air “Cultural Competency and the American with Disabilities Act”

• Optum On Demand “Advancing Health Equity” educational series at optumhealtheducation.com/wellness/advancing-health-equity

Long-Acting Reversible Contraceptives Long-acting reversible contraceptives (LARCs) provide long-lasting pregnancy prevention and are ideal for many patients. LARCs are up to 20 times more effective than other forms of reversible birth control. LARCs eliminate the possibility of user error that can make other methods less effective. Reinforce that no contraceptive device prevents sexually transmitted diseases (STDs).

Adult Annual Dental VisitNew for 2020! Adult Dental Visit is a new quality target that we are focusing on this year. As a provider, including an oral screening is an integral part of the adult physical examination. A referral to a dental professional for an annual dental visit can help ensure that the patient’s oral health needs are addressed. The direct correlation between physical and dental health exists. To find dental providers for members, go to UHCprovider.com and click on the “Find Dr.” icon at the top of the page. From there, you can find a dental professional by state, network or location.

Practice Matters: TX - Summer 2013 Customer Service Center: 888-362-33685 Practice Matters: PA – Spring 2020 Provider Services Center: 877-842-3210 5

Important information for health care professionals and facilities

Tobacco Treatment ResourcesThe Centers for Disease Control and Prevention has several clinical resources, current evidence, and clinical guidelines for treating tobacco use and dependence. You will also find usable tools to guide your practice and help you integrate tobacco treatment into routine clinical care. Please visit cdc.gov > Healthy Living > Smoking & Tobacco for more information.

Helping Members in Pennsylvania Get to Their AppointmentsThe UnitedHealthcare Dual Complete® plan transportation benefit can assist your patients in getting to their health care appointments. For the 2020 plan year, Pennsylvania members are eligible for 48 one-way rides per year. Members can request rides up to 50 miles one way to approved locations and back home again.

Transportation coverage may include rides to:

• Appointments with doctors• Appointments with dentists• A pharmacy to pick up prescriptions

It’s Easy to Set Up a RideNon-emergency transportation services are provided by our service partner, LogistiCare. Rides should be scheduled three business days in advance of the desired pick-up time. Urgent transportations requests are available 24/7. Members or care providers can call LogistiCare at 866-418-9812, 8 a.m. to 5 p.m. local time, Monday through Friday.

Visit UHCProvider.com/PADSNP > 2020 Plan > 2020 UnitedHealthcare Dual Complete Plan Benefit Flyer to see a full list of benefits in your area.

New Educational Resources for the 2020 UnitedHealthcare Dual Complete® Plan New resources for the 2020 UnitedHealthcare Dual Complete plan are now available on the Pennsylvania UHC On Air channel. These courses include valuable program information and meaningful updates for your office staff. Courses are pre-recorded and available online 24/7.

2020 courses include:

• Dual Special Needs Plans: An Introduction• Dual Special Needs Members: Who Are They?• The UnitedHealthcare Dual Complete Plan

in Pennsylvania

Simply sign into Link with your Optum ID and begin watching.

Visit UHCProvider.com/PADSNP to learn more about the Dual Special Needs plans offered in your area.

practicemattersPractice Matters is a quarterly publication for physicians and other health care professionals and facilities in the UnitedHealthcare network.

Pennsylvania

CPT® is a registered trademark of the American Medical Association.PCA-1-20-00498-C&S-WENB_PA_03052020© 2020 United HealthCare Services, Inc.

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