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How to Contact Us - Medica HealthCare Supplement, 2018 UnitedHealthcare Administrative Guide

Questions or Comments

Questions or comments about this manual should be emailed to Network Management Services (NMS) at pcp-NetworkManagementServices@uhcsouthflorida.com, or submitted by mail to: 

Medica HealthCare
Network Management Services
9100 South Dadeland Blvd.
Suite 1250
Miami, FL 33156-6420 

Contact Us

What You Can Do:
  • Initiate requests for notifications and authorizations electronically
  • Submit notifications, prior authorizations, referrals, admissions, and discharge planning
  • Submit after-hours or weekend emergencies, notifications or hospital admissions
Where to Go: 
  • Online: UHCprovider.com/PriorAuth
  • Fax: 855-307-8531
  • Phone: 866-273-9444,  M-F 9 a.m. to 5 p.m.
  • After Hours Phone: 305-421-1220, M-F 5 p.m. to 11 p.m., S-S, Holidays 8 a.m. to 5 p.m. 
What You Can Do:
  • Verify eligibility and benefits of enrolled members
Where to Go: 
What You Can Do:
  • Submit or review claims, encounters, inquiries, status, orreview requests
Where to Go: 
What You Can Do:
  • Obtain assistance with password or technical support issues
Where to Go: 
  • Phone: 800-845-6592
What You Can Do:
  • Ask questions related to overpayments
Where to Go: 
  • Phone: 877-842-3210
What You Can Do:
  • Update or complete credentialing, re-credentialing, document changes, or recent hires or terminations in your practice or facility
Where to Go: 
  • Phone: 800-963-6495, M-F, 9 a.m. to 5 p.m. 
  • Fax: 866-567-0144
What You Can Do:
  • Register for these services.
  • On call 24 hours a day
  • You may also call Utilization Management or Network Management
Where to Go: 
  • Phone: 800-819-0751
What You Can Do:
  • Information and registration for electronic payment services
Where to Go: 
What You Can Do:
  • Report concerns related to fraud, waste, or abuse.
Where to Go: 
What You Can Do:
  • Obtain information about filing a grievance or appeal on behalf of a member, status inquiries, or requests for forms.
Where to Go: 
  • Phone: Call the provider number listed on the back of the member’s identification card.
  • Mail:
    Medica Healthcare
    Grievances & Appeals Department
    P.O. Box 30997
    Salt Lake City, UT 84130
What You Can Do:
  • Arrange for services
  • On-call 24 hours a day
  • You may also call Utilization Management or Network Management
Where to Go: 
  • Phone: 305-883-2940
What You Can Do:
  • To assist our members with any questions, help locate specialists, and perform other related functions.
  • Also printed on the member’s Plan ID card
Where to Go: 
  • Phone: 800-407-9069, M-F 9 a.m. to 5 p.m.
  • TTY: 711
  • Fax: 800-517-6924
What You Can Do:
  • Ask questions regarding provider agreements, inservicing and follow-up and outreaches
  • Report demographic changes
  • Submit Informal complaints
  • Find or request forms or other materials
  • Verify a member’s eligibility, including plan benefits, deductibles, and information on the member’s primary care provider, as applicable
  • Submit, search for, and print authorizations for outpatient services or inpatient stays
  • Search for, view, and check the status of claims
Where to Go: 
What You Can Do:
  • Verify pharmacy benefits and eligibility, adjudications, or authorizations
Where to Go: 
  • Phone: 800-711-4555
  • Fax: 800-527-0531
What You Can Do:
  • Report incidents involving all privacy issues (potential breeches of PHI or PII) immediately to our Risk Manager
Where to Go: 
  • Phone: 952-406-4806
What You Can Do:
  • Speak to a nurse to triage to emergency or urgent care, or to refer them to their primary care physician
Where to Go: 
  • Phone: 855-575-0293
What You Can Do:
  • Obtain information about behavioral health and substance use services for all members
  • Access a list of behavioral health practitioners and care providers in the provider directory
Where to Go: 
  • Online: providerexpress.com
    Licensed clinicians are available 24 hours. Member Services – 24 hours.
  • Phone - No DSNP: 800-985-2596
  • Phone - DSNP & ISNP: 800-496-5841
What You Can Do:
  • Access a list of Solstice dental providers in the provider directory
Where to Go: 
  • Phone: 855-351-8163
Where to Go: 
Where to Go: 
  • Phone: 877-670-8432, M-F 9 a.m. to 5 p.m.
What You Can Do:
  • Find information on locations, to make an appointment, and to order lab tests and view results
Where to Go: 
  • Online: labcorp.com
  • Phone: 855-277-8669 Automated Line
  • Phone: 800-877-7831 Live Scheduling
What You Can Do:
  • Obtain mail-order medications
Where to Go: 
What You Can Do:
  • Access a list of podiatrists in our provider directory
Where to Go: 
  • Phone: 877-670-8432, M-F 9 a.m. to 5 p.m.
What You Can Do:
  • Request services
Where to Go: 
  • Phone: 888-774-7772, M-F 9 a.m. to 5 p.m.
What You Can Do:
  • Access a list of vision providers in our provider directory
Where to Go: 
  • Phone: 877-670-8432, M-F 9 a.m. to 5 p.m.

WellMed Medical Management, Inc. (WellMed)

For members who belong to a Primary Care Physician (PCP) in the Preferred Care Partners Medical Group (PCPMG), their utilization management (UM) and claim services are handled through WellMed.

To identify these members, refer to the member ID card. The payer ID is listed as WELM2 and “WellMed” is listed in the lower right corner of the card.

Claims Processing for WellMed Members

Submit claims electronically to payer ID WELM2.

If mailing, send to:

WellMed Claims
P.O. Box 400066
San Antonio, TX 78229