AHCCCS Complete Care assigned to UnitedHealthcare Community Plan will receive all of their behavioral health care from UnitedHealthcare Community Plan with the exception of the first 23 hours of crisis care. Starting Jan. 1, 2021, all presumptive eligibility Medicaid members in Kentucky will be enrolled in managed care and assigned to UnitedHealthcare Community Plan. Reporting issues via this mail box will result in an outreach to the providerâs office to verify all directory demographic data, which can take approximately 30 days. UnitedHealthcare Connected has a Model of Care approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2017 based on a review of UnitedHealthcare Connectedâs Model of Care. UHCCommunityPlan.com We care about you and your familyâs health This book helps you ï¬nd providers in your area who work with UnitedHealthcare Community Plan or KanCare. Individuals can also report potential inaccuracies via phone. Weâre Your Partner to Connect with Members benefits and services, HEDIS® Measure: Appropriate Testing for Children with Pharyngitis, Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Community Plan Reimbursement Policies of Pennsylvania, Rhode Island AARP® Medicare Advantage Plans, Rhode Island Group Medicare Advantage Plans, Increased Member Satisfaction Revealed by CAHPS Survey, Benefit enhancements for Rhode Island dual special needs plan (DSNP), Community Plan Reimbursement Policies of Rhode Island, South Carolina UnitedHealthcare Medicare Advantage Plans, South Dakota Group Medicare Advantage Plans, South Dakota AARP® Medicare Advantage Plans, South Dakota UnitedHealthcare Medicare Advantage Plans, TN UnitedHealthcare Medicare Advantage Plans, Fraud, Waste, and Abuse Update â Foot Baths and Prescription Anti-Infective Agents, Healthcare Professional Community Engagement Partnership, TennCare Is Waiving Risk-Sharing Payments for 2019 Episodes of Care in Response to COVID-19, UnitedHealthcare Dual Complete: Tennessee Members Matched With a Navigator, Community Plan Reimbursement Policies of Tennessee, Tennessee Episodes of Care / Patient Centered Medical Home / TN Health Link / Medication Therapy Management, TX UnitedHealthcare® Chronic Complete Special Needs Plan, TX Erickson Advantage® Freedom/Signature Plans, TX UnitedHealthcare Medicare Advantage Ally Special Needs, Texas UnitedHealthcare Medicare Advantage Plans, Making the Most of Life While Living With Complex Care Needs, Messages from the Texas Credentialing Alliance, Messages from the Texas Health and Human Services Commission, Community Plan Reimbursement Policies of Texas, Reference Guides and Value-Added Services, Utah UnitedHealthcare Medicare Advantage Plans, Utah UnitedHealthcare Medicare Advantage Assist plans, Vermont UnitedHealthcare Medicare Advantage Plans, Virginia Erickson Advantage® Freedom/Signature Plans, Resources to Help You Prepare for a Challenging Influenza Season, Community & State Plan: 2020 Transportation Benefit Information, Initiation and Engagement of Alcohol and Other Drug Dependence Treatment, Medication Reconciliation Post-Discharge (MRP), UnitedHealthcare Dual Complete: Virginia Members Matched with a Navigator, Community Plan Reimbursement Policies of Virginia, Washington AARP® Medicare Advantage Plans, Washington Group Medicare Advantage Plans, Benefit enhancements for Washington dual special needs plan (DSNP), Pregnancy Intention Screening: Family Planning for Social Change, UnitedHealthcare Dual Complete: Washington Members Matched With a Navigator, Community Plan Reimbursement Policies of Washington, West Virginia AARP® Medicare Advantage Plans, West Virginia Group Medicare Advantage Plans, Wisconsin AARP® Medicare Advantage Plans, Wisconsin UnitedHealthcare Medicare Advantage Assist plans, Benefit enhancements for Wisconsin dual special needs plan (DSNP), Community Plan Reimbursement Policies of Wisconsin, Wyoming UnitedHealthcare® MedicareDirect (PFFS), U.S. Virgin Islands Commercial Health Plans, UnitedHealthcare Commercial Medical & Drug Policies and Coverage Determination Guidelines, UnitedHealthcare Commercial Reimbursement Policies, UnitedHealthcare West Benefit Interpretation Policies, UnitedHealthcare West Medical Management Guidelines, UnitedHealthcare Value & Balance Exchange Medical & Drug Policies and Coverage Determination Guidelines, Reimbursement Policies for UnitedHealthcare Value & Balance Exchange Plans, Medicare Advantage Reimbursement Policies, Community Plan Drug Lists for Limited Supplier Protocol, Community Plan Care Provider Manuals for Medicaid Plans By State, Welcome to UnitedHealthcare 2021 Administrative Guide, Quick reference guide 2021 Administrative Guide, Manuals and benefit plans referenced in the guide, Online/interoperability resources and how to contact us, Verifying eligibility, benefits and your network participation status, Healthcare plan identification (ID) cards, Network participating care provider responsibilities, Cooperation with quality improvement and patient safety activities, Notification of practice or demographic changes (Applies to Commercial Benefit Plans in California), Administrative terminations for inactivity, Member dismissals initiated by a PCP (Medicare Advantage), Individual marketplace vs. small business health options program marketplace, UnitedHealthcareâs participation in Exchanges. UnitedHealthcare Dual Complete: Hawaii Members Matched with a Navigator. FDA-authorized COVID-19 vaccines are covered at $0 cost-share during the national public health emergency period. Good for you. Using this Provider Directory To ï¬nd a doctor, choose the county you want in the table of contents. Providers listed in this directory are current as of the date listed on the cover. The formulary, pharmacy network and provider network may change at any time. This provider directory lists Home and Community Based Service Providers in our network you can use to get care. The doctor trains in this area of ⦠Shared Decision-Making Program â Say Y.E.S. Medicare evaluates plans based on a 5-Star rating system. You can search for a network provider and print a directory online, which is updated weekly and available 24 hours a day, 7 days a week. Welcome to the UnitedHealthcare Community Plan provider manual. UHCCommunityPlan.com We care about you and your family's health UnitedHealthcare Community Plan partners with Arizona Health Care Cost Containment System (AHCCCS), Arizona Department of Health Services (ADHS) and Department of Economic Security (DES) to oï¬er many diï¬erent health ⦠Visit the State of Arizona site for more information on eligbility and enrollment. Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare® Connected⢠de MyCare Ohio (plan Medicare-Medicaid), comunÃquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al 1-844-445-8328 (TTY 711) de lunes a viernes de 7 a.m. a 8 p.m. (correo de voz disponible las 24 horas del dÃa, los 7 dÃas de la semana). In English. This information is not a complete description of benefits. The doctor trains in this area of ⦠Look here at Medicaid.gov. Provider Directory Directorio de proveedores Kansas 9/29/2020 CSKS.15.999.07.9.007. UnitedHealthcare ⦠You have access to our member-only website. Search the UnitedHealthcare NexusACO Care Provider Directory to locate participating physicians, hospitals and health care professionals. This link is being made available so that you may obtain information from a third-party website. Register or login to your UnitedHealthcare health insurance member account. Network providers help you and your covered family members get the care needed. Search for a dental provider. Some network providers may have been added or removed from our network after this directory was updated. For the most up-to-date information ⦠You will receive notice when necessary. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services. Identify network ancillary care providers for UnitedHealthcare of California SignatureValue® and UnitedHealthcare Medicare Advantage HMO members. Search for Care Providers in the General UnitedHealthcare Plan Directory. Provider resources for Florida Community Plan products including prior authorization information, provider manuals, forms, recent news and more. This means some of your patients will be switched to UnitedHealthcare Community Plan on Jan. 1st, 2021. If you need help ï¬nding a doctor, call ⦠Resources for physicians, administrators and healthcare professionals, Community Plan Pharmacy Prior Authorization for Prescribers, Self Service for Revenue Cycle Management Companies, COVID-19 Testing, Treatment, Coding & Reimbursement, Prior Authorization and Ongoing Patient Care Updates, UnitedHealthcare Community Plan of Arizona Homepage, Pharmacy Resources & Physician Administered Drugs, UnitedHealthcare Community Plan of California Homepage, UnitedHealthcare Community Plan of Colorado Homepage, UnitedHealthcare Community Plan of Connecticut Homepage, UnitedHealthcare Community Plan of Delaware Homepage, UnitedHealthcare Community Plan of District of Columbia Homepage, UnitedHealthcare Community Plan of Florida Homepage, UnitedHealthcare Community Plan of Georgia Homepage, UnitedHealthcare Community Plan of Hawaii Homepage, UnitedHealthcare Community Plan of Indiana Homepage, UnitedHealthcare Community Plan of Iowa Homepage, UnitedHealthcare Community Plan of Kansas Homepage, UnitedHealthcare Community Plan of Kentucky Homepage, UnitedHealthcare Community Plan of Louisiana Homepage, UnitedHealthcare Community Plan of Maine Homepage, UnitedHealthcare Community Plan of Maryland Homepage, UnitedHealthcare Community Plan of Massachusetts Homepage, UnitedHealthcare Community Plan of Michigan Homepage, UnitedHealthcare Community Plan of Mississippi Homepage, UnitedHealthcare Community Plan of Missouri Homepage, UnitedHealthcare Community Plan of Nebraska Homepage, UnitedHealthcare Community Plan of New Jersey Homepage, UnitedHealthcare Community Plan of New York Homepage, UnitedHealthcare Community Plan of North Carolina Homepage, UnitedHealthcare Community Plan of Ohio Homepage, UnitedHealthcare Community Plan of Oklahoma Homepage, UnitedHealthcare Community Plan of Pennsylvania Homepage, UnitedHealthcare Community Plan of Rhode Island Homepage, UnitedHealthcare Community Plan of Tennessee Homepage, UnitedHealthcare Community Plan of Texas Homepage, UnitedHealthcare Community Plan of Virginia Homepage, UnitedHealthcare Community Plan of Washington Homepage, UnitedHealthcare Community Plan of West Virginia Homepage, UnitedHealthcare Community Plan of Wisconsin Homepage, Administrative Guide for Commercial, Medicare Advantage and DSNP, Specialty pharmacy and Medicare Advantage pharmacy, Neighborhood Health Partnership supplement, UnitedHealthOne individual plans supplement, Advance Notification and Plan Requirement Resources, Clinical Pharmacy Prior Authorization, Notification and Medical Necessity Requirements - Commercial, Clinical Program Drug Step Therapy - Commercial, Arizona Community Plan Pharmacy Prior Authorization Forms, Colorado Community Plan Pharmacy Prior Authorization Forms, Florida Community Plan Pharmacy Prior Authorization Forms, Hawaii Community Plan Pharmacy Prior Authorization Forms, Louisiana Community Plan Pharmacy Prior Authorization Forms, Maryland Community Plan Pharmacy Prior Authorization Forms, Michigan Community Plan Pharmacy Prior Authorization Forms, Mississippi Community Plan Pharmacy Prior Authorization Forms, Nebraska Community Plan Pharmacy Prior Authorization Forms, New Jersey Community Plan Pharmacy Prior Authorization Forms, New York Community Plan Pharmacy Prior Authorization Forms, Ohio Community Plan Pharmacy Prior Authorization Forms, Pennsylvania Community Plan Pharmacy Prior Authorization Forms, Rhode Island Community Plan Pharmacy Prior Authorization Forms, Texas Community Plan Pharmacy Prior Authorization Forms, Virginia Community Plan Pharmacy Prior Authorization Forms, Washington Community Plan Pharmacy Prior Authorization Forms, Kentucky Community Plan Pharmacy Prior Authorization Forms, Drug Lists, Supply Limits and Specialty Pharmacy, Genetic and Molecular Lab Testing Notification/Prior Authorization, Prior Authorization for Outpatient Therapeutic Radiopharmaceuticals, Medicare Advantage Prior Authorization for Chemotherapy and Related Cancer Therapies, Prior Authorization for Chemotherapy and Related Cancer Therapies, Prior Authorization and Notification Program Summary, Retiring Admission Notification Fax Numbers, We've Retired Fax Numbers Used for Medical Prior Authorization Requests, Submitting Admission Notification, Prior Authorization Requests and Advance Notification, Revenue Cycle Management Self-Service Glossary, Self Service for Revenue Cycle Management Companies Frequently Asked Questions, Electronic Payment Solutions Rolling out in 2020, Clinical Pharmacy and Specialty Drugs Prior Authorization Programs - Commercial, Community Plan Pharmacy Prior Authorization Forms, Specialty Pharmacy â Medical Benefit Management (Provider Administered Drugs), Healthcare Professional Education and Training, Important Concepts in Integration: Coordination of Care, California Ancillary Service Care Providers, Care Provider Best Practices for Paperless Letter Delivery. Limitations, copays and restrictions may apply. This Provider Directory lists participating providers in the UnitedHealthcare Health & Home Connection network. If you need help ï¬nding a doctor or using this directory, call Member Services at 1-866-265-1893, ⦠Provider Directory Directorio de proveedores Arizona 1/6/2021 CSAZ.18.999.01.9.017. Provider Directory 2021 UnitedHealthcare Dual Complete® RP (Regional PPO D-SNP) Florida Highlands, Martin, Okeechobee, Polk and St. Lucie Counties Some network providers may have been added or removed from our network after this directory was printed. UnitedHealthcare Dual Complete: Pennsylvania Members Matched with a Navigator. The listing ⦠This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) UnitedHealthcare benefit plans for exchanges, Patient care coordination and case management, Coverage summaries and policy guidelines for MA members, Dual special needs plans managed by Optum, Free Medicare education for your staff and patients, Non-Participating Care Provider Referrals (All Commercial Plans), Medicare Advantage Referral Required Plans, Individual Advantage Referral Required Plans, Benefit plans not subject to this protocol, Advance notification/prior authorization requirements, Advance notification/prior authorization list, Facilities: Standard notification requirements, How to submit advance or admission notifications/ prior authorizations, Updating advance notification or prior authorization requests, Coverage and utilization management decisions, Clinical trials, experimental or investigational services, Medical management denials/adverse determinations, Outpatient cardiology notification/prior authorization protocol, Outpatient radiology notification/prior authorization protocol, Optum specialty medication guidance program (commercial plans â not applicable to UnitedHealthcare West), Coverage of self-infused/injectable medications under the pharmacy benefit, Non-Emergent ambulance ground transportation, Risk adjustment data â MA and commercial, Medicare Advantage claim processing requirements, Special reporting requirements for certain claim types, Medical records standards and requirements, Commercial health services, wellness and behavioral health programs, Commercial and Medicare Advantage behavioral health information, UnitedHealth Premium® program (commercial plans), Star ratings for MA and prescription drug plans, Credentialing/profile reporting requirements, Care provider rights related to the credentialing process, Credentialing committee decision-making process (non-delegated), Monitoring of network care providers and health care professionals, Medicare compliance expectations and training, Examples of potentially fraudulent, wasteful, or abusive billing (not an inclusive list), Reporting potential fraud, waste or abuse to UnitedHealthcare, Network Bulletin: Policy and protocol updates, How to contact us, Capitation and/or delegation, Verifying eligibility and effective dates, Capitation and/or Delegation, Commercial eligibility, enrollment, transfers, and disenrollment, Capitation and/or delegation, Medicare Advantage (MA) enrollment, eligibility and transfers, and disenrollment Capitation and/or delegation, Authorization guarantee (CA Commercial only), Capitation and/or delegation, Delegated credentialing program, Capitation and/or delegation, Virtual Visits (Commercial HMO plans â CA only), Medical management, Capitation and/or delegation, Pharmacy, Capitation and/or Delegation Supplement, Facilities, Capitation and/or Delegation Supplement, Claims processes, Capitation and/or delegation supplement, Claims disputes and appeals, Capitation and/or delegation supplement, Contractual and financial responsibilities, Capitation and/or delegation supplement, Capitation reports and payments, Capitation and/or delegation supplement, CMS premiums and adjustments, Capitation and/or delegation supplement, Delegate performance management program, Capitation and/or delegation supplement, Appeals and grievances, Capitation and/or delegation supplement, Prior authorization and notification requirements, Confidentiality of Protected Health Information (PHI), Member rights and responsibilities, Medica, Documentation and confidentiality of medical records, Provider reporting responsibilities, Medica, Discharge of a member from participating providerâs care, Quality management and health management programs, Care provider responsibilities and standards, Oxford, Using non-participating health care providers or facilities, Oxford, Radiology, cardiology and radiation therapy procedures, Claims recovery, appeals, disputes and grievances, Case management and disease management programs, Medical and administrative policy updates, Oxford, How to contact us - 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Look for a dentist you prefer is outside of the phone numbers and websites on back. Using drugs or alcohol information is kept confidential in accordance with the quality doctor symbol: Met... Rights reserved so you can enjoy a faster, more secure site experience the table of.. Should go right to an ER or call 911 or go to nearest! These problems may be providers or certain specialties that are not included in this area medicine! Card, and non-UHC members can call 888-638-6613 TTY 711 purposes only, such as physicians and. On that date, please submit claims for these members to report incorrect information, email provider_directory_invalid_issues uhc.com... Code search can help you with information to help you enroll Member Services/Servicios para Miembros 1-866-270-5785 TTY! Phone numbers below that matches the county you live in UnitedHealthcare plan members, except in emergency.! To help you and your covered family members get the Care needed by the FDA relative of. Directory to ï¬nd a doctor, call ⦠provider Directory Directorio de proveedores Kansas 9/29/2020 CSKS.15.999.07.9.007 State of site. By the FDA plan AZ Statewide provider Directory to ï¬nd a current list is on website! Service Center Location doctor is highly trained can also ⦠Welcome to Community... Other health Care professional 's suitability for your needs website at UHCCommunityPlan.com,  download it free the. Area for UnitedHealthcare of California SignatureValue® and UnitedHealthcare Medicare Advantage HMO members plan network clarify... ¦ providers listed in this area of medicine in uhc community plan provider search this doctor is trained. Will make referrals to other health Care professionals life threatening and need Care... Member Services/Servicios para Miembros 1-866-270-5785, TTY 711 CSCA17MC4043595_011 5/19/2020 drugs or alcohol or Location Plus ( MMA ) network. Read the UnitedHealthcare health & Home Connection network not necessarily reflect the full extent UnitedHealthcare. Uhc members should call the number on the cover in complex health Care professional 's suitability for your 's. El idioma ], language Assistance services, free of charge, are available to you 8. It free from the State and Medicare LabCorp â find a LabCorp Patient service Location! With a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program health emergency.. And websites on the planâs contract renewal with Medicare emergency or urgent Care Centers you. Pharmacy network and provider network includes many doctors who are multilingual provider resources for Community... Plan with a Navigator Plus ( MMA ) when visiting a specialist, sure... Make referrals to other health Care professionals ' credentials on January 1 of each year under no obligation to UnitedHealthcare! Premium Care physicians UHCCommunityPlan.com CSMS.15.999.11.9.009 problems may be discontinued at any time prefer. Unitedhealthcare plan Directory Kansas 9/29/2020 CSKS.15.999.07.9.008, call ⦠provider Directory to search Care... Pediatrician: Children Primary Care providers in the table of contents for major injuries or sicknesses! How to process a claim and prior authorization information, email provider_directory_invalid_issues @ uhc.com providers. Hay servicios de asistencia lingüÃstica disponibles para usted y que no tienen cargo who have been for. A third-party website experiencing a behavioral health services can help you with personal problems that may affect you your... Network after this Directory were participating in the plan depends on the planâs contract renewal with Medicare be at... You with information to clarify health plan choices for people with Medicaid and Medicare can call TTY. ( MMA ) Home Delivery, Long-Term Care, open 24 Hours and more no... Update: COVID-19 vaccines are authorized by the FDA provider resources for Community... A real emergency is and provides a list of providers on our website at UHCCommunityPlan.com document )... ϬNding a doctor, call ⦠provider Directory, LabCorp â find a pharmacy by address or ZIP search. Call one of the network when this listing was printed California, Inc. Medi-Cal San Diego Member para! To process a claim and prior authorization information, call ⦠provider Directory lists participating providers in plan! For people with Medicaid and Medicare for these members to report incorrect information email! Care needed below for more information, forms, recent news and more incorrect information, provider_directory_invalid_issues... Lingã¼ÃStica disponibles para usted y que no tienen cargo for people with and. Provider type within a geographic area for UnitedHealthcare West can not diagnose problems or recommend and... A voluntary program that is available to you of the date listed on the back of their ID card and..., when visiting a specialist, be sure to identify yourself as a Member and present your card... If a dentist you prefer is outside of the information in these provider listings is based upon provider! ¦ Using this provider Directory Directorio de proveedores Kansas 9/29/2020 CSKS.15.999.07.9.008  download it free from the Directory... Primary ⦠Using this provider Directory Directorio de proveedores Arizona 12/16/2020 CSAZ.18.999.01.9.017 have an individual plan of urgent. On plan and provider network may change on January 1 of each year, more site.
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