Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Indiana

Welcome

For UnitedHealthcare Community Plan of Indiana

Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Indiana

Welcome

For UnitedHealthcare Community Plan of Indiana

UnitedHealthcare Community Plan of Indiana Homepage

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

UHC Provider Services (Claims, Prior Authorization and Eligibility Questions)

877-610-9785
Available 8 a.m. – 8 p.m. Eastern Time, Monday through Friday

Prior Authorization
877-610-9785
Fax: 844-897-6514

Member Services
800-832-4643, TTY 711 for help accessing member account
Available 8 a.m. – 8 p.m. Eastern Time, Monday through Friday

Multilingual/Telecommunication Device for the Deaf (TDD) Services
800-832-4643 (members)
877-610-9785 (providers)
TDD 711
Available 8 a.m. – 8 p.m. Eastern Time, Monday through Friday, except state-designated holidays

Nurseline
800-832-4643
Available anytime

Optum Behavioral Health
800-888-2998 (toll-free)
Fax 844-897-6514
providerexpress.com

Dental Services
www.uhcdental.com
844-402-9118

MARCH Vision Care
www.marchvisioncare.com
844-486-2724

Vision Providers: Learn more about becoming a vision provider for Indiana Community Plan members at Join Our MARCH Network

Transportation Services (Arrange Non-emergent transportation 48 hours in advance)
Member Services: 800-832-4643

Pharmacy Services (OptumRX)
866-215-5046

Pharmacy Prior Authorization/Notification

800-310-6826

What is a Provider Advocate? 

Medical Provider Advocates by Counties Served (For Medical Providers)

Cindy Fabian, Provider Advocate
Cynthia_Fabian@uhc.com
(312) 803-5632
Counties Served: Lake, Porter and LaPorte

Lori Reeder, Provider Advocate
Lreeder@uhc.com
(763) 321-3822
Counties Served: St. Joseph, Elkhart, LaGrange, Steuben, DeKalb, Noble, Kosciusko, Marshall, Starke, Jasper, Newton, Benton, White, Pulaski, Fulton, Cass, Carroll, Howard, Miami, Wabash, Whitley, Allen, Huntington, Grant, Wells, Adams and Blackford

Zakiya Cooper, Provider Advocate
Zakiya_Cooper@uhc.com
(612) 383-4914
Counties Served: Warren, Tippecanoe, Clinton, Tipton, Madison, Delaware, Jay, Randolph, Henry, Hancock, Marion, Hamilton, Boone, Montgomery, Fountain, Vermillion, Parke, Putnam, Hendricks, Wayne, Union, Fayette, Rush, Shelby, Johnson, Morgan, Owen, Vigo, Franklin, Decatur, Bartholomew, Brown, Monroe and Clay

Kim Berry, Provider Advocate
Kim_Berry@uhc.com
(612) 395-8106
Counties Served: Sullivan, Greene, Lawrence, Jackson, Jennings, Ripley, Switzerland, Jefferson, Scott, Washington, Orange, Martin, Daviess, Knox, Gibson, Pike, Dubois, Crawford, Posey, Vanderburgh, Warrick, Spencer, Perry, Harrison, Floyd and Clark

Christopher Turner, Provider Advocate
Chris_W_Turner@uhc.com
(763) 957-6842
Counties Served: Dearborn and Ohio

Jodie Hattery, Director of Provider Market Operations
Jodie_Hattery@uhc.com
(952)406-6449

Behavioral Health Provider Advocates (For Behavioral Health Providers) - Statewide

Misty Ray, Senior Provider Relations Advocate
Misty_Ray@optum.com
(612) 642-7990

David Hoover, Senior Provider Relations Advocate
David_Hoover@optum.com
(763) 330-7588

Belen Stewart, Provider Relations Advocate
Belen.Stewart@optum.com
(612) 632-5962

David Lauter, Director of Provider Relations
David.Lauter@optum.com
(314) 592-3740

Vision Provider Advocates (For Vision Providers) - Statewide

Jennifer Brett, Provider Advocate
Jbrett@uhc.com
(317) 405-3513

Keisha Brown, Provider Advocate
Keisha_Brown@uhc.com
(952) 202-8696

Cassandra Pattison, Provider Advocate
Cassandra_Pattison@uhc.com
(210) 474-5592

Dental Provider Advocates (For Dental Providers) - Statewide

Paul Curry, Provider Advocate
Paul_Curry@uhc.com
(952) 202-2072

Catrice Campbell, Provider Advocate
Catrice_Campbell@uhc.com
(763) 283-4522

Nursing Facility Provider Advocates (For Nursing Facility Providers) - Statewide

Kelly Vorpahl, Provider Advocate
Kelly_Vorpahl@optum.com
(612) 474-6318 

Tiffany Cashion, Provider Advocate
Tiffany.Cashion@optum.com
(317) 352-6578

Stephen Price, Provider Advocate
Stephen.A.Price@optum.com
(612) 474-7315

Lynette Gatewood, Provider Advocate
Lynette.Gatewood@optum.com
(952) 246-4983 

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

UnitedHealthcare Community Plan offers comprehensive dental benefits to Hoosier Care Connect Members.

Join our Dental Network

Learn more about becoming a dental provider for Indiana Community Plan members at Join our Dental Network.

Claims, Authorizations, and Appeals

For more information on prior authorizations, clinical criteria, service appeals, claims, informal objections, and formal claim appeals, please refer to the Dental Quick Reference Guide and our Dental Provider Manual.

Dental Provider Services

For more information on providing dental service to Hoosier Care Connect members,
providers may call 1-844-402-9118.

Thank you for your interest in becoming a network provider with UnitedHealthcare Community Plan of Indiana. In joining our network, you’ll become part of a group of health care professionals and facilities who share our commitment to helping Indiana Hoosier Care Connect members live healthier lives and making the health care system better for everyone.

Step 1: Get started

The first step is to let us know you’d like to join our network – known as submitting a Request for Participation (RFP).

To participate with UnitedHealthcare Community Plan and Indiana Hoosier Care Connect, you must also be enrolled in Indiana Medicaid:

Step 2: Get credentialed

Credentialing is required for all licensed individual health care professionals in order to participate in the UnitedHealthcare Community Plan and Indiana Hoosier Care Connect network and prior to seeing UnitedHealthcare members. During the credentialing process, we’ll work with you to verify your qualifications, practice history, certifications and registration to practice in a health care field.

General care providers (excluding specialties listed below): You can start the application process at CAQH.org. If you have questions on accessing the CAQH ProView database, call the CAQH Help Desk at 888-599-1771 for assistance.

Once we receive your completed application from CAQH, we’ll review your application and verify your credentials. Specifically:

  • Verifying credentials – We’ll contact the state board for your license and verify your professional training/education, etc. This primary source verification is conducted by Aperture on behalf of UnitedHealthcare.
  • Application review – Your application will be presented to a committee of your peers to determine if you meet UnitedHealthcare’s credentialing requirements. This peer review can take up to 25 calendar days

If you have questions about our credentialing process or need assistance, please email networkhelp@uhc.com the health care professional’s full name, National Provider Identifier (NPI), Tax Identification Number (TIN) and brief description of the request. A UnitedHealthcare representative will respond to your request.

Behavioral Health or Substance Abuse Practitioners: Contact Optum Behavioral Health Solutions, which handles credentialing and contracting on behalf of UnitedHealthcare Community Plan and Indiana Hoosier Care Connect. To get started, go to providerexpress.com or call 800-817-4705. If you provide medical services, in addition to behavioral health and substance abuse services, you’ll need to work directly with UnitedHealthcare on credentialing.

Dental: Work with UnitedHealthcare Community Plan and Indiana Hoosier Care Connect vendor UnitedHealthcare Dental on credentialing at UHCdental.com or call 844-402-9118.

Vision: Contact UnitedHealthcare Community Plan and Indiana Hoosier Care Connect vendor MarchVision on credentialing at marchvisioncare.com or call 844-486-2724.

Step 3: Get contracted

Contracting is a separate process from credentialing – but to help keep things moving, we’ll start the contracting process with you while you’re working through credentialing.

  • After credentialing is complete, we’ll send you a Participation Agreement (contract) through a secure application called DocuSign. If we don’t have a valid email address, we’ll mail you the Participation Agreement.
  • Once contracting is complete, you’ll receive the countersigned agreement with your effective date
  • If you’re joining a medical group that already has a Participation Agreement, you’ll be added to the group agreement once credentialing is approved. A new contract will not be issued.

Step 4: Get connected

Once credentialing and contracting is complete, it’s time to get connected with our online systems and resources. You’ll find everything you need from seeing patients to getting paid at UHCprovider.com/getconnected.

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/IN for current member plan information including sample member ID cards, provider directories, value-added benefits, dental plans, vision plans and more for: 

  • UnitedHealthcare Community and State Hoosier Care Connect

Find a Care Provider:

UHC C&S member ID card for Hoosier Care Connect:

IN Hoosier Care Connect membership card front and back

Network Management

Have questions about your contract, demographics or fee schedule?
Email: IN_NM_Team@uhc.com
Please ensure your email includes:

  1. Physician or facility name
  2. Organization Tax ID Number
  3. Contact representative name & telephone number

Northwest Indiana Network Management-Managed by Illinois Network Management
Address: 200 E Randolph St, Ste 5300 Chicago, IL 60601
Phone: 1-312-803-5900
Fax Number: 1-888-311-4599

Indiana Network Management-Indianapolis and Fort Wayne
Address: 7440 Woodland Drive, Dept. 100 Indianapolis, IN 46278
Contract/Credentialing/Premium Designation Inquiries: Email networkhelp@uhc.com and include health care professional / facility name, contact name and phone number, NPI, TIN, and brief description of your inquiry including any reference numbers.
Demographic Changes: 1-877-842-3210

Network Management-Southeast & Southwest
Address: 7440 Woodland Drive, Dept. 100 Indianapolis, IN 46278
Contract/Credentialing/Premium Designation Inquiries: Email networkhelp@uhc.com and include health care professional / facility name, contact name and phone number, NPI, TIN, and brief description of your inquiry including any reference numbers.
Demographic Changes: 1-877-842-3210

Provider Relations

Physician and Facility Advocate Team
Have questions about claims challenges or educational opportunities?
Email:  Indiana_PR_Team@uhc.com

If you have a claim that remains unresolved after submission of a claim reconsideration, please ensure your email includes:

  1. Physician or facility name
  2. Organization Tax ID Number
  3. Contact representative name & telephone number
  4. Link ticket number (PTPCR # or CM #) or call reference number
  5. Member name
  6. Member ID
  7. Date of service
  8. Charge amount

CommunityCare

The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare feature on the UnitedHealthcare Provider Portal, which allows you to:  

  • Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the State Agency in order to remain eligible to receive Medicaid benefits
  • See a complete list of all members, or just members added in the last 30 days
  • Export the roster to Excel
  • View most Medicaid and Medicare SNP members’ plans of care and health assessments
  • Enter plan notes and view notes history (for some plans)
  • Obtain HEDIS information for your member population
  • Access information about members admitted to or discharged from an inpatient facility
  • Access information about members seen in an Emergency Department

For help using CommunityCare feature on the UnitedHealthcare Provider Portal, please see our Quick Reference Guide. If you’re not familiar with UnitedHealthcare Provider Portal, go to UHCprovider.com/portal.

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.  

For more information on the Right Choices Program providers may call 877-610-9785. Providers can refer a member to the Right Choices Program by submitting the referral form via e-mail to in_rcp@uhc.com or by fax to 888-842-6007. 

UnitedHealthcare Community Plan offers routine vision benefits to Hoosier Care Connect Members.

Join our Vision Network:

Learn more about becoming a vision provider for Indiana Community Plan members at Join Our MARCH Network

Claim and Appeals:

For more information on clinical criteria, service appeals, claims, informal objections, and formal claim appeals, please refer to the Vision Provider Reference Guide and our Indiana State Specific Guide

Vision Provider Services:

For more information on providing vision service to Hoosier Care Connect members, providers may call 1-844-486-2724. 

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.

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NCQA Health Plan

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.