Our California Referral Directories are updated and distributed each month to help you and your staff refer UnitedHealthcare of California SignatureValue® and UnitedHealthcare® Medicare Advantage HMO members to in-network ancillary providers. Online care provider directories should be used for all other health plans.
Please Report Inaccurate Directory Listing Information
If a care provider listed in California Referral Directories is no longer in business, no longer serving a particular county, or has a change in address or phone number, please contact your Physician Advocate so that we may contact the care provider and update the directory accordingly.
Access to contracted UnitedHealthcare care providers for California patient referrals is available from both the National Ancillary Referral Directory and the California Ancillary Referral Directory.
The National Ancillary Referral Directory is a listing of specialty services such as dialysis, hearing aid services, hospice and sleep studies. If a National Care Provider is not listed for the ancillary specialty you seek for a patient referral, please use the California Ancillary Referral Directory.
To view the National Ancillary Care Provider Referral Directory, see the current UnitedHealthcare Administrative Guide.
The California Ancillary Referral Directory is a listing of all contracted care providers in California, regardless of division of financial responsibility and risk.
For referrals to physical therapy, occupational therapy and speech therapy providers, visit myoptumhealthphysicalhealth.com for a directory of providers in your area.
Optum manages and develops the skilled nursing facility network for UnitedHealthcare. Refer to the Skilled Nursing Facility (SNF) Roster before placing a member in a facility.
The SNF Roster will tell you the following:
- The type of patient to be placed in the SNF (based on the plan the patient is enrolled in)
- Whether that SNF can accept a UnitedHealthcare of California SignatureValue® or UnitedHealthcare® Medicare Advantage member
- How to authorize patient care if you need to stipulate a level of care based on UnitedHealthcare of California contract paper for each SNF
- Which SNF has specialty services (TPN, sub-acute, trachs, vents, psych unit, bariatric, age criteria, Medi-Cal licensed, 24 hour transfers and admits)
- How to find an SNF that is most convenient for the member based on demographic information
Please review your use of SNFs each month for changes and look for new or terminated SNFs in your area (shown on separate worksheets in the SNF Roster).
Rate and Methodology Updates
Skilled Nursing Facilities (SNF) on contract with UnitedHealthcare can accept members from any UnitedHealthcare plan, including SignatureValue and Medicare Advantage.
The per diem rate for the SNF is the blend of two calculated components. This single-blended rate applies to all levels of care and has no exclusions.
- Four levels of care rates (LC4): Require authorization at a specific level of care.
- Resource Utilization Groups (RUGS): Medicare rates
SNFs contracted with UnitedHealthcare of California (formerly PacifiCare) can only accept UnitedHealthcare of California Special Needs Plans (SNP) and Medicare Advantage members.
Other important information on the SNF Roster and key services provided by each SNF include:
- Total parenteral nutrition care
- Tracheotomy care
- Ventilator care, sub-acute care
- Bariatric beds (maximum weight accommodated and number of beds)
- Psychiatric lock down unit or specific psychiatric disorder handled
- Minimum age criteria accepted for facility admission
- Medi-Cal license status and acceptance of 24-hour admits or transfers
Level of care descriptions for UnitedHealthcare and UnitedHealthcare of California are located on separate worksheets in the SNF Roster.
Members of Medicare Advantage Plans for eligible counties should be referred to hiHealthInnovations for hearing aid services. If you have questions, please call hiHealthInnovations at 855-523-9355.
If you have any questions regarding the SNF Roster, please contact Miriam Harris, West Regional Contract Manager, at 612-642-7773 or email@example.com.
Medical groups with contracts stating that durable medical equipment (DME) is the Health Plan Risk on their Division of Financial Responsibility (DOFR) must use Apria Healthcare for DME Services, as outlined in the capitated DME service list.
Apria Healthcare is a capitated DME provider for all UnitedHealthcare Commercial and Medicare Advantage members. For a full list of Apria services, see the most current DME Capitated Service List.
As a member of the capitated medical group, you are authorized to direct care to a participating (par) provider in UnitedHealthcare’s contracted network. If no par provider is available to provide the ancillary services, you may direct care from a non-contracted provider when it has been deemed medically necessary that a member is to receive care.
Apria's letter of agreement includes oxygen, commodities, ostomy, medical supplies, TENS and bone growth provided in home or Skilled Nursing Facilities (SNF). If a care provider will not service the member without a Letter of Agreement, please complete the Letter of Agreement request and forward to your UnitedHealthcare Provider Advocate.
Letters of Agreement are no longer required in order for claims to be paid for a non-contracted provider for managed care members.