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Provider Reimbursement Policies

Get updates to UniCare’s reimbursement policies and view complete policies. Claims submitted in a CMS-1500 format will be subject to the editing rules.

McKesson's ClaimsXten™ Rules – may be implemented from time to time to reflect the addition of:

Check updates and claims editing rules administered by ClaimsXten™:

Get an overview of ClaimsXten™ Rules.

Reimbursement Policies – View UniCare’s complete reimbursement policies.

Claims must be submitted in accordance with the reporting guidelines and instructions contained in the American Medical Association (AMA) CPT Manual, CPT® Assistant, and HCPCS publications. Providers are responsible for accurately reporting the medical, surgical, diagnostic and therapeutic services rendered to a member with the correct CPT and/or HCPCS codes, and for appending the applicable modifiers, when appropriate.

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For self-funded plans, claims are administered by UniCare Life & Health Insurance Company. © 2000-2019 UniCare.