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Maintaining up-to-date provider directories is necessary as CMS can fine insurers with outdated directories. [21] As a condition of participation, UnitedHealthcare requires that providers notify them of changes, but also has a Professional Verification Outreach program to proactively request information from providers. [19]
UnitedHealthcare (UHC) is an insurance and managed care company with four main divisions: UnitedHealthcare Employer and Individual – provides health benefit plans and services for large national employers and individuals. UnitedHealthcare Medicare and Retirement – provides health and well-being services to individuals age 65 and older. [80]
Optum serves employers, government agencies, health plans, life science companies, care providers and individuals and families offering products in data and analytics, pharmacy care services, health care operations and delivery, population health management and advisory services. [7]
In 2011, eligibility expanded to include employees of the Department of State and the U.S. Agency for International Development and the network provider changed to UnitedHealthcare (UHC), which is one of the largest network providers and facilities in the FEHB market. [4]
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In December 2005, the company was acquired by UnitedHealth Group. [7] At that time, the company had 705,000 Medicare enrollees. [8] The company continued to market health plans under the PacifiCare and SecureHorizons names until 2011, when it changed to the UnitedHealthcare name. [9]
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A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). The NPI has replaced the Unique Physician Identification Number (UPIN) as the required identifier for Medicare services, and is used by other payers ...