How to contact Preferred Care Partners - 2021 UnitedHealthcare Administrative Guide

Questions or comments

Email questions or comments to Network Management Services (NMS) at PCP-NetworkManagementServices@uhcsouthflorida.com, or send mail to:

Preferred Care Partners Network Management Services
9100 South Dadeland Blvd. Suite 1250
Miami, FL 33156-6420

Where to go

EDI: Transactions 278 and 278N

Online: UHCprovider.com/paan

Information: UHCprovider.com/priorauth (Policies, instructions and tips)

Phone: 1-800-995-0480

What you can do there

Submit notifications, prior authorizations, referrals, admissions and discharge planning. Initiate requests for notifications and authorizations electronically. If the request cannot be completed electronically, our staff is available to answer questions or discuss any issues with referrals, prior authorizations, case management, concurrent review, and admission certification or notification.

Where to go

Online: eprg.wellmed.net

Outpatient Notifications

Phone: 877-299-7213

Fax: 866-322-7276

Inpatient Notifications

Phone: 877-490-8982

Fax: 877-757-8885

Where to go

Online: UHCprovider.com/claims

Phone: 1-866-725-9334

Fax: 1-866-725-9337

Mail: Preferred Care Partners

P.O. Box 30448

Salt Lake City, UT 84130-0448

What you can do there

  • Check claims, eligibility, benefits.
  • Use Payer ID 65088

Where to go

Online: eprg.wellmed.net

Phone: 1-800-550-7691

Mail:    WellMed Claims

P.O. Box 30508

Salt Lake City, UT 84130-0508

What you can do there

  • Check claims, eligibility, benefits.
  • Use Payer ID WELM2

Where to go

Phone: 1-800-845-6592

What you can do there

  • Obtain assistance with password or technical support issues.
  • Obtain information on electronic claims submission.

Where to go

Phone: 1-800-963-6495

Monday–Friday, 9 a.m. – 5 p.m. (ET)

Fax:     1-844-897-6352

What you can do there

Submit or update credentialing, re- credentialing, document changes, or recent hires or terminations in your practice or facility.

Where to go

Online: ChangeHealthcare.com

Phone: 1-800-845-6592

What you can do there

Get information and register for electronic payment services.

Where to go

Online: UHCprovider.com/eligibility

Phone: 1-866-725-9334

What you can do there

  • Verify eligibility and benefits of enrolled members.
  • Access a summary of benefits for each plan online.

Where to go

Online: uhc.com/fraud

Phone: 1-844-359-7736

What you can do there

Report concerns related to fraud, waste or abuse.

Where to go

MA and MA Prescription Drug (MAPD) Plans:

Preferred Care Partners, Inc.
P.O. Box 6106
Mail Stop CA 124-0157
Cypress, CA 90630

For Medicare and Retirement Prescription Drug Plans (PDP):

Preferred Care Partners, Inc.
P.O. Box 6106
Mail Stop CA 124-0197
Cypress, CA 90630

What can you do there

For information about filing a grievance or appeal on behalf of a member, status inquiries, or requests for forms.

Where to go

Online: mypreferredcare.com > Member Resources

Phone: 1-866-231-7201, Monday–Friday, 8 a.m. to 5 p.m. (ET)

TTY:     711

Fax:     1-888-659-0618

What you can do there

  • Members may ask questions about care providers, benefits, and claims.
  • This toll-free phone number is also printed on the member’s plan ID card.

Where to go

Phone: 1-877-670-8432, Monday–Friday, 9 a.m. – 5 p.m. (ET)

Fax:     1-888-659-0619

Email: PCP-NetworkManagementServices@uhcsouthflorida.com

What you can do there

  • Ask questions regarding your Agreement, in- servicing and follow-up or outreaches.
  • Report demographic changes. Submit informal complaints.
  • Request forms or other materials.

 

Where to go

Online: professionals.optumrx.com

Phone: 1-800-711-4555

Mail:    OptumRx

P.O. Box 650287

Dallas, TX 75265-0287

What you can do there

  • Verify pharmacy benefits and eligibility, adjudications, or authorizations.
  • See pharmacy benefit updates.

Where to go

Phone: 1-952-406-4806

What you can do there

Report incidents involving all privacy issues (potential breaches of PHI or PII) immediately to our risk manager.

Contact us: Ancillary and enhanced benefit providers

Where to go

Online: providerexpress.com

Phone: 1-800-985-2596 No DSNP

1-800-496-5841 iSNP

Member Services available 24 hours.

Licensed clinicians are on call 24 hours a day, 7 days a week.

What you can do there

  • Obtain information about behavioral health and substance use services for all members.
  • Access a list of behavioral health care providers in the provider directory.

 

Where to go

Online: SolsticeBenefit.com

Phone: 1-855-351-8163

What you can do there

Access a list of Solstice dental providers in the provider directory.

Where to go

Phone: 1-800-819-0751, Monday–Friday, 9 a.m. – 5 p.m. (ET)

On call: 24 hours a day, 7 days a week

What can you do there

  • Contact MedCare to arrange for these services.
  • Call UM or Network Management for additional assistance.

Where to go

Online: Preferredcare.myrenewactive.com

Phone: 1-866-231-7201

Where to go

Phone: 1-877-670-8432, Monday–Friday, 9 a.m. – 5 p.m. (ET)

Where to go

Phone: 1-305-883-2940

What you can do there

  • Contact MedCare to arrange for these services.
  • Call UM or Network Management for additional assistance.

Where to go

Labcorp

Online: labcorp.com

Phone: 1-855-277-8669 Automated Line

Phone: 1-800-877-7831 Live Scheduling

Quest

Online: questdiagnostics.com

Phone: 1-866-697-8378

What you can do there

Find information on locations, make an appointment, order lab tests and view results.

Where to go

Online: optumrx.com 

Phone: 1-877-889-6358

What you can do there

Obtain mail-order medications.

Where to go

Phone: 1-855-575-0293, Available 24 hours a day, 7 days a week.

What you can do there

  • Only available under certain plans.
  • Speak to a nurse to triage emergency or urgent care, or to refer them to their primary care physician.

Where to go

Phone: 1-877-670-8432, Monday–Friday, 9 a.m. – 5 p.m. (ET)

What you can do there

Access a list of podiatrists in our provider directory.

Where to go

Phone: 1-888-774-7772, Monday–Friday, 9 a.m. – 5 p.m. (ET)

What you can do there

Request services.

Where to go

Phone: 1-877-670-8432, Monday–Friday, 9 a.m. – 5 p.m. (ET)

What you can do there

Access a list of vision providers in our provider directory.

WellMed Medical Management, Inc. (WellMed)

WellMed handles utilization management (UM) and claim services for members who belong to a primary care physician (PCP) in the Preferred Care Partners Medical Group (PCPMG). To identify these members, refer to the member ID card. The Payer ID is listed as WELM2. “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.