Maryland: Reminder to submit referrals with IFP claims
AI Summary
UnitedHealthcare Maryland providers must now submit referrals with all evaluation and management (E&M) and specialty service claims for Individual and Family Plan members. Starting December 2025, electronic claims will receive automated alerts within 24 hours if referrals are missing, with 5 days to correct before denial.
Action Required
Immediately: Billing team must ensure all E&M and specialty service claims for UnitedHealthcare Individual and Family Plan members include referrals before submission. Update billing workflows to verify referral attachment for electronic claims. Monitor for Smart Edit mnemonic uATCMDREF alerts within 24 hours and submit missing referrals within 5 calendar days to avoid denials. For paper claims, verify referrals before mailing as no alerts will be provided. Claims denied for missing referrals require appeals process in Maryland.
Plan Types
Exchange
States
MD
Specialties
all-specialties