In 2015, UnitedHealthCare will launch Lock In Your Doc to encourage members to establish an ongoing relationship with their primary care physician (PCP).
If you are a PCP, the program requires you to only provide services to members assigned to you or your medical group/tax ID number (TIN). Starting August 1, 2015, UnitedHealthCare Community Plan may not pay for services rendered by a care provider not assigned to that member.
To help you prepare for the program, we will add a new PCP assignment explanation code to the provider remittance advice (PRA) starting Jan. 1, 2015. The new code will help you identify which members you provide services to who are not assigned to you or your medical group/TIN: Services not provided by network/primary care provider (242). Covered only when performed by the primary treating physician or the designee (N450).
Please be sure to check the member’s UnitedHealthCare Community Plan member ID card or visit UHCCommunityPlan.com to view your PCP roster and confirm your are the assigned PCP before providing services. Members can request to change their PCP assignment by calling 800-690-1606.
If you have any questions please contact your Physician Advocate at uhc_tn_outreach@uhc.com or call 800-690-1606.