Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Missouri

Welcome

For UnitedHealthcare Community Plan of Missouri

UnitedHealthcare Community Plan of Missouri 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

Provider Call Center

866-815-5334 available from 8 a.m. – 5 p.m. CST (except State designated holidays)

Provider Relations Team

Email: Missouri_PR_Team@uhc.com

Network Management Team

Phone: 866-574-6088
Email: mo_network_mgmt@uhc.com

Mailing Address

UnitedHealthcare Community Plan of Missouri
13655 Riverport Drive
Maryland Heights, MO 63043

Claims & Appeals Information

Claims Mailing Address

UnitedHealthcare Community Plan
PO Box 5240
Kingston, NY 12402-5240

Appeals Mailing Address

UnitedHealthcare Community Plan of Missouri
Attention: Provider Dispute
P.O. Box 31364
Salt Lake City, Utah 84131-0364

Behavioral Health Contact Information

Optum Behavioral Health

Phone: 866-815-5334
Online: https://www.providerexpress.com/content/ope-provexpr/us/en.html

Other Services

Dental Care Contact Information

UnitedHealthcare Dental
Phone: 855-934-9818
Online: https://uhcpwp.sciondental.com/PWP/Landing

Member Transportation Information

Medical Transportation Management
Phone: 866-292-0359
Online: https://www.mtm-inc.net/

Vision Care Contact Information

March Vision Care
Phone: 844-616-2724
Online: https://marchvisioncare.com/

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

UnitedHealthcare is here to help your practice successfully transition to the integrated care clinical model.

If you have any questions, please contact the community integration team at mocollaborativecare@uhc.com.

For more training and educational resources, please click here.

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.

Pediatric Care Network will provide delegated medical management services for UHC Community Plan Pediatric Care Network members including case management, utilization management and disease management. Resources are available for providers including reference guides, office forms, frequently asked questions and more.

View Pediatric Care Network Provider Resources

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

Plan information is available for:

  • Care Improvement Plus Dual Advantage
  • Missouri HealthNet Managed Care 
  • UnitedHealthcare Dual Complete

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

Provider Directories

Member Handbooks

Effective January 1, 2018, all providers servicing Missouri Medicaid members must be enrolled with Missouri HealthNet. Use the application form below that best applies to your situation.

Individual Provider Enrollment
Missouri HealthNet Individual Providers Application

Organizational Provider Enrollment
Missouri HealthNet Large Provider Organization Application

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.  

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

Quick Reference Guide - UnitedHealthcare Community Plan of Missouri

Last Modified | 11.23.2020

Use this reference guide for quick access to a variety of resources about the UnitedHealthcare Community Plan of Missouri.

Learn More
Retiring Admission Notification Fax Number Reminder - UnitedHealthcare Community Plan of Missouri

Last Modified | 11.12.2020

Fax numbers that some acute and post-acute facilities use to notify us when UnitedHealthcare Community Plan members have been admitted will be retired on Dec. 1, 2020.

Learn More
Medical Policy Documentation Requirement Updates Frequently Asked Questions - UnitedHealthcare Community Plans

Last Modified | 10.20.2020

We’ve refined medical policy documentation requirements and enhanced clinical coverage criteria for various procedures. This document contains information on effective dates by state and frequently asked questions.

Learn More
Inappropriate Primary Diagnosis Policy, Facility - Effective December 1, 2020 - UnitedHealthcare Community Plan of Missouri

Last Modified | 09.29.2020

UnitedHealthcare Community Plan is implementing a new Inappropriate Primary Diagnosis Policy, Facility, for facility claims with dates of services on or after December 1, 2020.

Learn More
Practice Matters - Fall 2019 - UnitedHealthcare Community Plan of Missouri

Last Modified | 05.15.2020

In this issue, you can read about maternity support resources, availability of electronic breast pumps, 2019 Member Incentive Programs and much more.

Learn More
View More News
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HEDIS Medical Record Collection

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.