Skip left navigation

How to Contact Us, Medica - 2020 UnitedHealthcare Administrative Guide

How to Contact Us, Medica HealthCare

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

Where to Go: 
  • Online: UHCprovider.com/paan
  • Phone: 866-273-9444, Monday through Friday from 9 a.m. to 5 p.m. Eastern Time
  • After Hours Phone: 305-421-1220 
    • Monday through Friday from 5 p.m. to 11 p.m. Eastern Time
    • Saturdays, Sundays, and Holidays from 8 a.m. to 5 p.m. Eastern Time
What You Can Do There:
  • 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 admission
Where to Go: 
What You Can Do There:
  • Verify eligibility and benefits of enrolled members
Where to Go: 
  • Online: UHCprovider.com/claims
  • Phone: 800-348-5548, Monday through Friday from 8 a.m. to 5 p.m. Eastern Time
  • Fax: 866-725-9337
What You Can Do There:
  • Submit or review claims, encounters, inquiries, status, or review requests
  • Check claims, eligibility, benefits

Claims (WellMed)

Where to Go: 

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

What You Can Do There:

  • Use payer ID #WELM2
Where to Go: 
  • Phone: 800-845-6592
What You Can Do There:
  • Obtain assistance with password or technical support issues
 
Where to Go: 
What You Can Do There:
  • Ask questions related to overpayments
Where to Go: 
What You Can Do There:
  • Access list of participating Physical Therapist providers in our directory
Where to Go: 
  • Phone: 800-963-6495, Monday through Friday from 9 a.m. to 5 p.m. Eastern Time
  • Fax: 844-897-6352
What You Can Do There:
  • Update or complete credentialing, re-credentialing, document changes, or recent hires or terminations in your practice or facility
Where to Go: 
  • Phone: 800-819-0751
What You Can Do There:
  • Register for these services
  • On call 24 hours a day
  • You may also call Utilization Management or Network Management
Where to Go: 
What You Can Do There:
  • Information and registration for electronic payment services
Where to Go: 
  • Onlinemedicaplans.com
  • Phone: 800-455-4521, Monday through Friday from 9 a.m. to 5 p.m. Eastern Time
  • Fax: 888-659-0617
  • Email: ReportFraud@UHCsouthflorida.com
  • Mail:
    Medica HealthCare
    Special Investigations Unit
    P.O. Box 56-6596
    Miami FL 33256-6596
What You Can Do There:
  • Report concerns related to fraud, waste, or abuse.
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 There:
  • Obtain information about filing a grievance or appeal on behalf of a member, status inquiries, or requests for forms.
Where to Go: 
  • Phone: 305-883-2940
What You Can Do There:
  • Arrange for services
  • On-call 24 hours a day
  • You may also call Utilization Management or Network Management
Where to Go: 
  • Phone: 800-407-9069, Seven Days a Week from 8 a.m. to 8 p.m. Eastern Time
  • TTY: 711
  • Fax: 800-517-6924
What You Can Do There:
  • 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: 
What You Can Do There:
  • Ask questions regarding your Agreement, in-servicing and follow-up and outreaches
  • Report demographic changes such as TIN changes, care provider terminations and additions
  • Submit Informal complaints
  • Find or request forms or other materials
  • Panel status
Where to Go: 
  • Phone: 800-711-4555
What You Can Do There:
  • Verify pharmacy benefits and eligibility, adjudications, or authorizations
Where to Go: 
What You Can Do There:
  • Report incidents involving all privacy issues (potential breeches of PHI or PII) immediately to our Risk Manager
Where to Go: 
  • Phone: 855-575-0293
What You Can Do There:
  • Speak to a nurse to triage to emergency or urgent care, or to refer them to their primary care physician
Where to Go: 
  • Online: providerexpress.com
    • Licensed clinicians are available 24 hours. 
    • Member Services are available 24 hours.
  • Phone - No DSNP: 800-985-2596
  • Phone - DSNP & ISNP: 800-496-5841
What You Can Do There:
  • 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: 
What You Can Do There:
  • Access a list of Solstice dental providers in the provider directory
Where to Go: 
Where to Go: 
  • Phone: 877-670-8432, Monday through Friday from 9 a.m. to 5 p.m. Eastern Time

Laboratory (LabCorp) 

Where to Go: 
  • Online: labcorp.com
  • Phone: 855-277-8669 Automated Line
  • Phone: 800-877-7831 Live Scheduling
What You Can Do There:
  • Find information on locations, to make an appointment, and to order lab tests and view results

QUEST

Where to Go: 
What You Can Do There:
  • Find information on locations, to make an appointment, and to order lab tests and view results
Where to Go: 
What You Can Do There:
  • Obtain mail-order medications
Where to Go: 
  • Phone: 877-670-8432, Monday through Friday from 9 a.m. to 5 p.m. Eastern Time
What You Can Do There:
  • Access a list of podiatrists in our provider directory
Where to Go: 
  • Phone: 888-774-7772, Monday through Friday from 9 a.m. to 5 p.m. Eastern Time
What You Can Do There:
  • Request services
Where to Go: 
  • Phone: 877-670-8432, Monday through Friday from 9 a.m. to 5 p.m. Eastern Time
What You Can Do There:
  • Access a list of vision providers in our provider directory

WellMed Medical Management, Inc. (WellMed)

For members who belong to a Primary Care Physician (PCP) in the Medica Healthcare Network, 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