Provider Call Center

1-866-270-5785 available Monday-Friday from 8:00 a.m.-5:00 p.m. PST

Mailing Addresses

San Diego County

UnitedHealthcare Community Plan of California, Inc.
4365 Executive Drive, Suite 500
San Diego, CA 92121

Sacramento County

UnitedHealthcare Community Plan of California, Inc.
8880 Call Center Drive, Suite, 300
Sacramento, CA 95826

Claims & Medical Records Mailing Address

UnitedHealthcare Community Plan of California, Inc.
P.O. Box 30884
Salt Lake City, UT 84130-0884

Provider Disputes Mailing Address

UnitedHealthcare Community Plan of California, Inc.
Attention: Provider Dispute
P.O. Box 31364
Salt Lake City, UT 84131

Member Grievance & Appeals

UnitedHealthcare Community Plan of California, Inc.
Attention: Grievance and Appeals
P.O. Box 31364
Salt Lake City, UT 84131-0364

For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.

UnitedHealthcare Community Plan of California and Solera are working together to offer a Diabetes Prevention Program at no cost to qualified members. Solera is a health care solutions company that specializes in managing cost-effective health programs using technology and disease prevention program strategies.

The Diabetes Prevention Program can help members make small changes to live healthier lives, lose weight and help lower their chance of developing type 2 diabetes.

How it Works

This program is geared towards members who:

• May need extra support in managing their eating and exercising habits
• Had a recent health screening and shows signs of concern for pre-diabetes
• Has family members with type 2 diabetes

Because UnitedHealthcare is working directly with Solera, your patients who are UnitedHealthcare members may be eligible to enroll in the program at no cost to them. You can refer a member to enroll in the program and, if the member qualifies, they’ll have access to weekly sessions, small group support, personal health coaches and more.

How to Refer a Member

• You can ask the member to take a one-minute quiz at solera4me.com/UHC and review their results to see if they would benefit from this type of personalized support. Members can also call 888-305-6015 for more information or to take the one-minute quiz over the phone.
• If you’d like additional updates on a member’s progress within the program please contact the Quality Department, Health Education and Cultural Linguistics Programs at uhchealthed@uhc.com.

For more information, call Solera at 877-486-0141, TTY 711, Monday – Friday, 6 a.m. – 6 p.m. Pacific Time.

UnitedHealthcare is here to help your practice successfully transition to the integrated care clinical model.

If you have any questions, please contact the community integration team at CAintegratedcare@uhc.com.

For more training and educational resources, please visit Training and Education on the UnitedHealthcare California Community Home Page.

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. 

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/CA for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.

Plan information is available for:

• UnitedHealthcare Community Plan of California - Medi-Cal

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

The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare tool, which allows you to:  

• Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the State Agency in order to remain eligible to receive Medicaid benefits
• See a complete list of all members, or just members added in the last 30 days
• Export the roster to Excel
• View most Medicaid and Medicare SNP members’ plans of care and health assessments
• Enter plan notes and view notes history (for some plans)
• Obtain HEDIS information for your member population
• Access information about members admitted to or discharged from an inpatient facility
• Access information about members seen in an Emergency Department

For help using CommunityCare, please see our Quick Reference Guide. If you’re not familiar with our portal, go to UHCprovider.com/portal.

Check out Care Conductor in the UnitedHealthcare Provider Portal under Clinical & Pharmacy.

UnitedHealthcare Community Plan of California conducts a Population Needs Assessment (PNA) on an annual basis. The goal of this analysis is to:

• Identify member health needs and health disparities
• Evaluate health education, cultural and linguistic services, quality improvement activities, and resources available to members
• Implement targeted strategies for programs and services

Access the most recent report: UHC Population Needs Assessment RY 2021

Search for a care provider by plan name:

• UnitedHealthcare Community Plan of California – Medi-Cal

Please complete the form below and mail it to the address provided to address concerns.

• Provider Dispute Resolution (PDR) Form (Last Modified 09.17.2018)
• Member COMPLAINT AND GRIEVANCE FORM (Last Modified 05.18.2020)

The UnitedHealthcare Community Plan of California Quality Improvement Program assesses the overall effectiveness of our health plan, including processes, goals and outcomes related to member care and services. If you’d like to request a copy of our Quality Improvement Program Annual Evaluation, please email uhccscaqualitydepartment_dl@ds.uhc.com. 

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.