One or more of the following symptoms indicate the deterioration of kidney function: 1  Itching. 2  Nausea, vomiting and loss of appetite. 3  Swollen ankles. 4  Tiredness and fatigue. 5  Muscle cramps. 6  Change in urine volume, (there can be an increase or decrease in the amount of urine passed daily) 7  Shortness of breath. 8  Sleep disturbance.
Reference Pricing. With reference-based pricing, employers set a pricing cap on the maximum amount that they will cover for certain medical services that have wide cost variations, such as knee and hip replacement surgery.
United Healthcare Community Plan currently utilizes the following Level of Care Guidelines (LOCGs) to conduct medical necessity reviews of requests for services as they apply to available Behavioral Health benefits. ASAM PPC-2R criteria are currently utilized for all Substance Abuse services.