Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Arizona

Welcome!

For UnitedHealthcare Community Plan of Arizona

Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Arizona

Welcome!

For UnitedHealthcare Community Plan of Arizona

UnitedHealthcare Community Plan of Arizona Homepage

Electronic Visit Verification now required for personal care and home health services

As of Jan. 1. 2021, AHCCCS has implemented Electronic Visit Verification (EVV) for non-skilled in-home services (attendant care, personal care, homemaker, habilitation, respite) and for in-home skilled nursing services (home health). Important changes include the elimination of paper timesheets. Visit the AHCCCS website to learn more about what these changes mean for you. 

Effective April 15, 2021, authorizations are required for non-COVID-19-related services for acute inpatient hospitalizations. You can submit your requests through the Prior Authorization and Notification Tool.

We know you don't have time to spare, so we put all the UnitedHealthcare Community Plan resources you need in one place. Use the navigation on the left to quickly find what you're looking for. Be sure to check back frequently for updates.

Prior Authorization and Notification Resources

Current Policies and Clinical Guidelines

Provider Administrative Manual and Guides

Provider Call Center

1-800-445-1638, available from 8:00 a.m. - 5:00 p.m. Central Time.

Arizona AHCCCS Complete Care / Medicaid Contact Information

Mailing Address

UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004

Claims & Medical Records Mailing Address

UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290

Behavioral Health Claims & Medical Records Mailing Address

United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760

Provider Claim Disputes Mailing Address

UnitedHealthcare Community Plan
Attn: Provider Appeals and Disputes
PO Box 31364
Salt Lake City, UT 84131-0364

Developmentally Disabled Services (DD) Contact Information

Mailing Address

UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004

Claims & Medical Records Mailing Address

UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290

Behavioral Health Claims & Medical Records Mailing Address

United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760

Provider Claim Disputes Mailing Address

UnitedHealthcare Community Plan
Attn: Provider Appeals and Disputes
PO Box 31364
Salt Lake City, UT 84131-0364

Long Term Care Contact Information

Long Term Care Provider Call Center

1-800-293-3740, available from 8:00 a.m.- 5:00 p.m. Arizona Time

Mailing Address

UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004

Claims & Medical Records Mailing Address 

UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290

Behavioral Health Claims & Medical Records Mailing Address

United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760

Provider Claim Disputes Mailing Address

UnitedHealthcare Community Plan
Long Term Care Claims
Attn: Provider Appeals and Disputes
PO Box 31364
Salt Lake City, UT 84131-0364

UnitedHealthcare Dual Complete One (HMO-SNP) Contact Information

Mailing Address

UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004

Claims & Medical Records Mailing Address

UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290

Behavioral Health Claims & Medical Records Mailing Address

United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760

Provider Claim Disputes Mailing Address

UnitedHealthcare Dual Complete
Attn: Provider Appeals and Disputes
PO Box 31364
Salt Lake City, UT 84131-0364

Part C Member Appeals and Grievance Department

Attn: CA124-0187
PO Box 6103
Cypress, CA 90630-0023

Part D Member Appeals and Grievance Department

Attn: CA124-0197
PO Box 61063
Cypress, CA 90630

For more information about the credentialing process for network care providers, please read the AHCCCS Credentialing Tip Sheet. You can also visit UHCprovider.com/join > Step 2: Get Credentialed for additional credentialing resources and information.

For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.

Member dental plan and benefit information can be found at UHCCommunityPlan.com/AZ and myuhc.com.

UnitedHealthcare Dental Provider Portal

Dental practitioners that are currently serving Mediciad plans can access Community & State dental information by logging into uhcdental.com under Community & State.

Behavioral Health Providers

Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information, or submit demographic changes at Community Plan Behavioral Health.

Facility/Hospital-Based Providers, Group/Practice Providers and Individually-Contracted Clinicians

The state-specific requirements and process on how to join the UnitedHealthcare Community Plan network is found in the UnitedHealthcare Community Plan Care Provider Manuals.  

Learn about requirements for joining our network

Overview

The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:

  • Promote quality of care
  • Strengthen efforts to reform the delivery of care to individuals covered under Medicaid and Children’s Health Insurance Plans (CHIP)
  • Strengthen program integrity by improving accountability and transparency

Enhance policies related to program integrity With the Medicaid Managed Care Rule, CMS updated the type of information managed care organizations are required to include in their care provider directories.

Visit UHCCommunityPlan.com/AZ for current member plan information including member handbooks, sample member ID cards, provider directories, dental plans, vision plans and more.

Plan information is available for:

  • Arizona Complete Care / Medicaid
  • Arizona Developmentally Disabled (DD)
  • Arizona Long Term Care 

Member plan and benefit information can also be found at UHCCommunityPlan.com/AZ and myuhc.com/communityplan.

Member Eligibility

Verifying Member Eligibility through AHCCCS Online / State of Arizona

The Division of Developmental Disabilities services are based on age and specific eligibility based on federal requirements and referral/application processes. Click here for details.

Reporting Fraud, Waste or Abuse to Us

When you report a situation that could be considered fraud, you’re doing your part to help save money for the health care system and prevent personal loss for others. If you suspect another provider or member has committed fraud, waste or abuse, you have a responsibility and a right to report it. 

Taking action and making a report is an important first step. After your report is made, we will work to detect, correct and prevent fraud, waste, and abuse in the health care system.

Call us at 1-844-359-7736 or visit uhc.com/fraud to report any issues or concerns.  

How to Report Fraud, Waste or Abuse to the State of Arizona

The Office of Inspector General for the State of Arizona provides a way for members, plans, providers, and the public to report all forms of suspected fraud, waste or abuse of the program. We encourage medical professionals and their staff to review the information available on the AHCCCS website. 

UnitedHealthcare Dual Complete® Special Needs Plan

UnitedHealthcare Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, and may include transportation to medical appointments and vision exams. Members must have Medicaid to enroll.

Current News, Bulletins and Alerts

Arizona: Free translation services for your patients

Last Modified | 06.14.2021

UnitedHealthcare Community Plan of Arizona offers free translation and interpretation services to help ensure members understand their diagnosis and treatment plan in a culturally sensitive manner. More than 240 non-English languages and hearing-impaired services are available.

Learn More
06/2021: Medicaid anti-emetic prior authorization update

Last Modified | 06.02.2021

Effective Aug. 1, 2021, prior authorization is required for 8 anti-emetics codes for cancer patients with UnitedHealthcare Community Plans in Arizona, Kentucky and Tennessee.

Learn More
Find COVID-19 vaccine availability for your state or territory

Last Modified | 05.21.2021

Use this list of local health departments to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.

Learn More
Arizona: Help for your patients with chronic pain

Last Modified | 05.12.2021

UnitedHealthcare Community Plan of Arizona has identified Pima Pain Center as a Center of Excellence in the treatment of complex pain conditions. Pima Pain Center provides integrated care for patients who struggle with chronic pain, including those who have an opioid use disorder.

Learn More
Arizona: Update your AHCCCS registration

Last Modified | 05.04.2021

Referring, ordering, prescribing and attending providers: Update registration with the Arizona Healthcare Cost Containment System (AHCCCS).

Learn More
View More News

Health Insurance Portability and Accountability Act (HIPAA) Information

HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes. View our updated HIPAA information for UnitedHealthcare Community Plan.

Integrity of Claims, Reports, and Representations to the Government

UnitedHealth Group requires compliance with the requirements of federal and state laws that prohibit the submission of false claims in connection with federal health care programs, including Medicare and Medicaid. View our policy.

Disclaimer

If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. To see updated policy changes, select the Bulletin section at left.