Managed Care Notification Requirements
Important: On July 1, 2010, changes were made to the Plan’s notification requirements. You must comply with these requirements to receive the highest level of coverage.
The Managed Care Program for the UniCare State Indemnity Plan includes notification requirements, utilization management, medical case management
and Quality Centers and Designated Hospitals for Transplants.
The Plan's Managed Care Program reviews clinical information and determines the medical necessity and
appropriateness of certain health care services based on Plan coverage. This process ensures that benefits are used appropriately and lets you know in advance what services will be covered.
The process is initiated when you or someone on your behalf notifies the Andover Service Center at (800) 442-9300 of a hospital
admission or health care service listed in the notification requirements section. Different notification requirements
apply, depending on the plan in which you are enrolled.
Who Is Responsible for These Notification Requirements?
If you are enrolled in the UniCare State Indemnity Plan, you are responsible for complying with the
Plan's notification requirements. If you fail to notify the Andover Service Center at (800) 442-9300 within the
required time frames, your benefits may be reduced or denied.
View notification requirements for non-Medicare members (including Basic, PLUS and Community Choice Plan members)
View notification requirements for Medicare Extension Plan members
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