Welcome to the New Home for Care Provider Resources

For UnitedHealthcare Community Plan of Arizona

Welcome to the Home for Arizona Community Plan Care Provider Resources

For UnitedHealthcare Community Plan of Arizona

UnitedHealthcare Community Plan of Arizona Homepage

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.

Provider Call Center

1-800-445-1638, available from 8:00 a.m.-5:00 p.m. Central Time 

 

AHCCCS / Medicaid and Developmentally Disabled 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

Member Appeals & Provider Claim Disputes Mailing Address

UnitedHealthcare Community Plan
Attn: Appeals & Claim Disputes
1 East Washington, Suite 900
Phoenix, AZ 85004 

 

Children's Rehabilitative Services 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

Member Appeals & Provider Claim Disputes Mailing Address

UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
1 East Washington, Suite 900
Phoenix, AZ 85004 

 

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

Member Appeals & Provider Claim Disputes Mailing Address

UnitedHealthcare Community Plan
Long Term Care Claims
Attn: Provider Claim Dispute Coordinator
1 East Washington Street, Suite 900
Phoenix, AZ 85004 

 

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

Member Appeals & Provider Claim Disputes Mailing Address

UnitedHealthcare Dual Complete
Attn: Appeals
PO Box 31364
Salt Lake City, UT 84131-0364

Part C Appeals and Grievance Department

UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
PO Box 31364
Salt Lake City, UT 84131-0364

Part D Appeals and Grievance Department

Attn: CA124-0197
PO Box 6106
Cypress, CA 90630

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 (PDF, Last Modified 06.20.2018) - Provides information needed to properly document dental benefits provided through UnitedHealthcare Community Plan.

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 Administrative Guide (PDF, Last Modified 06.26.2018).  

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.

Helpful Resources

Visit UHCCommunityPlan.com/AZ for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.

Plan information is available for:

  • Arizona AHCCCS/Medicaid
  • Arizona Children's Rehabilitative Services (CRS) Program
  • Arizona Developmentally Disabled Program
  • Arizona Long Term Care 

Member plan and benefit information can also be found at UHCCommunityPlan.com/AZ and myuhc.com.

Verifying Member Eligibility through AHCCCS Online - How to verify member eligibility through the State of Arizona.

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. Learn more about how to report fraud, waste or abuse to the State of Arizona.

Current News, Bulletins and Alerts

Laboratory Services Update - UnitedHealthcare Community Plan of Arizona

Last Modified | 07.20.2018

UnitedHealthcare Community Plan of Arizona has chosen Laboratory Corporation of America (LabCorp) as our exclusive in-network laboratory services provider. This means that all laboratory services for UnitedHealthcare Community Plan members should be conducted by LabCorp.

Learn More
UnitedHealthcare Community Plan of Arizona Practice Matters - Winter 2018

Last Modified | 07.10.2018

Practice Matters is a quarterly newsletter with important information for health care professionals and facilities.

Learn More
Non-Emergent Ambulance and Transportation Reminders

Last Modified | 06.26.2018

We’ve prepared this overview as a helpful reminder of the Arizona Health Care Cost Containment System (AHCCCS) guidelines around non-emergent ambulance and transportation.

Learn More
Circumcision Guidelines Reminder

Last Modified | 06.26.2018

We’ve prepared this overview as a helpful reminder of the Arizona Health Care Cost Containment System (AHCCCS) guidelines regarding circumcision. According to the AHCCCS Medical Policy Manual (AMPM), Policy 410; AHCCCS only covers circumcision for fee-for-service and contracted care providers, as follows:

Learn More
AHCCCS Complete Care Program Frequently Asked Questions

Last Modified | 06.26.2018

AHCCCS has selected UnitedHealthcare to participate in the AHCCCS Complete Care Program in Gila, Maricopa, Pima and Pinal counties. While all current UnitedHealthcare Community Plan of Arizona members are covered through Sept. 30, 2018, members in other counties will be transitioned to a different health plan.

Learn More
View More News

HEDIS Medical Record Collection

Health 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 (PDF, Last Modified 06.01.2018).

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 (PDF, Last Modified 05.16.2018).

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.