UnitedHealthcare Community Plan of Arizona Homepage
Electronic Visit Verification now required for personal care and home health services
As of Jan. 1. 2021, AHCCCS has implemented Electronic Visit Verification (EVV) for non-skilled in-home services (attendant care, personal care, homemaker, habilitation, respite) and for in-home skilled nursing services (home health). Important changes include the elimination of paper timesheets. Visit the AHCCCS website to learn more about what these changes mean for you.
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
COVID-19 Resources for Providers
- Important Information from UnitedHealthcare on COVID-19
- AZ COVID-19 vaccine billing guidelines
- Request for Virtual Onsite Interpreting in Response to COVID-19
- AHCCCS Guidance: Reimbursement for COVID-19 Testing and Treatment of Uninsured Arizonans
- COVID-19 Billing Updates for UnitedHealthcare Community Plan of Arizona
- Drug Enforcement Administration (DEA) Diversion Control COVID-19 Information
- Information and Resources from AHCCCS
- AHCCCS COVID-19 Frequently Asked Questions
- No changes to newborn screening guidelines during COVID-19
- Arizona Medicaid COVID-19 Information at Health Current
- AHCCCS Telehealth Webinar - April 9, 2020
- AHCCCS “Your Doctor Is In” Toolkit for Providers
- AHCCCS: HHS CARES Act Provider Relief Fund Payments
Provider Call Center
1-800-445-1638, available from 8:00 a.m. - 5:00 p.m. Central Time.
Arizona AHCCCS Complete Care / Medicaid Contact Information
Mailing Address
UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004
Claims & Medical Records Mailing Address
UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290
Behavioral Health Claims & Medical Records Mailing Address
United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760
Provider Claim Disputes Mailing Address
UnitedHealthcare Community Plan
Attn: Provider Appeals and Disputes
PO Box 31364
Salt Lake City, UT 84131-0364
Developmentally Disabled Services (DD) Contact Information
Mailing Address
UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004
Claims & Medical Records Mailing Address
UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290
Behavioral Health Claims & Medical Records Mailing Address
United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760
Provider Claim Disputes Mailing Address
UnitedHealthcare Community Plan
Attn: Provider Appeals and Disputes
PO Box 31364
Salt Lake City, UT 84131-0364
Long Term Care Contact Information
Long Term Care Provider Call Center
1-800-293-3740, available from 8:00 a.m.- 5:00 p.m. Arizona Time
Mailing Address
UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004
Claims & Medical Records Mailing Address
UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290
Behavioral Health Claims & Medical Records Mailing Address
United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760
Provider Claim Disputes Mailing Address
UnitedHealthcare Community Plan
Long Term Care Claims
Attn: Provider Appeals and Disputes
PO Box 31364
Salt Lake City, UT 84131-0364
UnitedHealthcare Dual Complete One (HMO-SNP) Contact Information
Mailing Address
UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004
Claims & Medical Records Mailing Address
UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290
Behavioral Health Claims & Medical Records Mailing Address
United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760
Provider Claim Disputes Mailing Address
UnitedHealthcare Dual Complete
Attn: Provider Appeals and Disputes
PO Box 31364
Salt Lake City, UT 84131-0364
Part C Member Appeals and Grievance Department
Attn: CA124-0187
PO Box 6103
Cypress, CA 90630-0023
Part D Member Appeals and Grievance Department
Attn: CA124-0197
PO Box 61063
Cypress, CA 90630
For more information about the credentialing process for network care providers, please read the AHCCCS Credentialing Tip Sheet. You can also visit UHCprovider.com/join > Step 2: Get Credentialed for additional credentialing resources and information.
For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
Member dental plan and benefit information can be found at UHCCommunityPlan.com/AZ and myuhc.com.
- AHCCCS Dental Provider Benefits Matrix - Provides information needed to properly document dental benefits provided through UnitedHealthcare Community Plan.
- Newborn Dental Health Tips - Transcript of Newborn Dental Health Tips video.
UnitedHealthcare Dental Provider Portal
Dental practitioners that are currently serving Mediciad plans can access Community & State dental information by logging into uhcdental.com under Community & State.
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.
Visit UHCCommunityPlan.com/AZ for current member plan information including member handbooks, sample member ID cards, provider directories, dental plans, vision plans and more.
Plan information is available for:
- Arizona Complete Care / Medicaid
- Arizona Developmentally Disabled (DD)
- Arizona Long Term Care
Member plan and benefit information can also be found at UHCCommunityPlan.com/AZ and myuhc.com.
Member Eligibility
Verifying Member Eligibility through AHCCCS Online / State of Arizona
The Division of Developmental Disabilities services are based on age and specific eligibility based on federal requirements and referral/application processes. Click here for details.
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.
How to Report Fraud, Waste or Abuse to the State of Arizona
The Office of Inspector General for the State of Arizona provides a way for members, plans, providers, and the public to report all forms of suspected fraud, waste or abuse of the program. We encourage medical professionals and their staff to review the information available on the AHCCCS website.
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
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Ordering, Referring and Supervising Provider Billing Requirements (Updated in 2021) - UnitedHealthcare Community Plan of Arizona
Last Modified | 02.16.2021
In accordance with Chapter 5 and Chapter 10 of the Arizona Healthcare Cost Containment System (AHCCCS) Fee-for-Service Provider Manual, as well as the federal 21st Century Cures Act, an ordering, referring or supervising care provider must be included on CMS-1500 and 837P claims.
Learn More -
Find COVID-19 vaccine availability for your state or territory
Last Modified | 01.11.2021
Use this list of local health departments to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.
Learn More -
AHCCCS Independent Oversight Committee (IOC) Requests and Inquiries Requirement
Last Modified | 01.06.2021
This memo serves to provide clarification andguidance regarding the requirements for processing IOC requests for all AHCCCS MCOs untilrevisions can formally be made to AMPM 960.
Learn More -
Arizona Community Plan pharmacy billing guidelines for COVID-19 vaccines
Last Modified | 12.29.2020
As the COVID-19 vaccine has been approved, UnitedHealthcare Community Plan wanted to provide direction for our pharmacies regarding the billing guidelines as they may differ from the normal process.
Learn More -
Care provider billing guidelines for COVID-19 vaccines - UnitedHealthcare Community Plan of Arizona
Last Modified | 12.29.2020
We want to provide you instructions and billing guidelines from the Arizona Department of Health Services (ADHS) and Arizona Health Care Cost Containment System (AHCCCS) to administer approved COVID-19 vaccines.
Learn More
Ordering, Referring and Supervising Provider Billing Requirements (Updated in 2021) - UnitedHealthcare Community Plan of Arizona
Last Modified | 02.16.2021
In accordance with Chapter 5 and Chapter 10 of the Arizona Healthcare Cost Containment System (AHCCCS) Fee-for-Service Provider Manual, as well as the federal 21st Century Cures Act, an ordering, referring or supervising care provider must be included on CMS-1500 and 837P claims.
Learn MoreFind COVID-19 vaccine availability for your state or territory
Last Modified | 01.11.2021
Use this list of local health departments to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.
Learn MoreAHCCCS Independent Oversight Committee (IOC) Requests and Inquiries Requirement
Last Modified | 01.06.2021
This memo serves to provide clarification andguidance regarding the requirements for processing IOC requests for all AHCCCS MCOs untilrevisions can formally be made to AMPM 960.
Learn MoreArizona Community Plan pharmacy billing guidelines for COVID-19 vaccines
Last Modified | 12.29.2020
As the COVID-19 vaccine has been approved, UnitedHealthcare Community Plan wanted to provide direction for our pharmacies regarding the billing guidelines as they may differ from the normal process.
Learn MoreCare provider billing guidelines for COVID-19 vaccines - UnitedHealthcare Community Plan of Arizona
Last Modified | 12.29.2020
We want to provide you instructions and billing guidelines from the Arizona Department of Health Services (ADHS) and Arizona Health Care Cost Containment System (AHCCCS) to administer approved COVID-19 vaccines.
Learn MoreHealth 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.