The UnitedHealthcare Care Insights Code Program

UnitedHealthcare (UHC) has partnered with Vim to improve practices’ access to data and streamline workflows by using Vim’s Care Insights application at the point of care.

With Care Insights, providers can view key quality measures, identify care gaps, and take action directly within their EHR. This integration links the codes surfaced in Care Insights to UnitedHealthcare’s Medical Condition Assessment Incentive Program.

UHC's Medical Condition Assessment Incentive Program (MCAIP)

UnitedHealthcare’s Medical Condition Assessment Incentive Program (MCAIP) supports providers in assessing and documenting suspected medical conditions for Medicare Advantage patients. Through Vim, these conditions (shown as diagnosis gaps) surface directly in the EHR workflow, enabling care teams to review, document, and close them before, during, or after the patient visit. This streamlined process ensures documentation flows back to UnitedHealthcare, helping providers meet MCAIP requirements with less administrative effort.

Program components: 

• MCAIP Assessment Bonus:
  If eligible, providers will receive $25 per assessment when a comprehensive assessment is completed and a compliant medical record is returned within 60 days of the exam.
• Fully Assessed Bonus:
  If eligible, providers will receive a $150 bonus per member when all suspected medical conditions are assessed during a comprehensive visit and a complete, compliant medical record is submitted.
• Medical Condition Assessment Superior Bonus:
  Providers who meet performance thresholds during the MCAIP term may earn an additional bonus ranging from $100–$200 per valid assessment, based on the percentage of MCAIP members assessed and performance point criteria.

Please note: The information on this page is provided by Vim for educational and informational purposes only. Vim is not affiliated with or responsible for administering any UnitedHealthcare incentive programs and does not manage, calculate, or distribute payments associated with them. All incentives and bonuses are offered directly by UnitedHealthcare in accordance with their program guidelines.

Workflow Integration

• Before the Visit: Open Vim Care Insights to review gaps and prepare for the encounter. Any insights that cannot be actioned can be dismissed with feedback sent back to UnitedHealthcare.

• During the Visit: Address gaps in real time, document findings, and capture ICD-10 and CPT-II codes directly in the encounter.

• After the Visit: Submit a claim. Vim updates UnitedHealthcare on actions taken in Care Insights.

Responding to UnitedHealthcare Insights through Care Insights

Care Insights may surface gaps from UnitedHealthcare. Providers can respond directly within Vim by selecting:

1. Agree - Confirms an insight is being acknowledged and addressed appropriately. If any additional documentation is needed in the EHR, it should be handled by the user.
2. Agree & Select - Confirms an insight is being acknowledged, addressed, and coded appropriately with ICD or CPT codes. If any additional documentation is needed in the EHR, it should be handled by the user.
3. Dismiss – Records a dismissal reason for feedback when an insight cannot be actioned.

Questions and Support

For questions about UnitedHealthcare program incentives, contact your UnitedHealthcare Network representative. Learn more here.