Welcome to the New Home for Care Provider Resources

For UnitedHealthcare Community Plan of California

Welcome to the Home for California Community Plan Care Provider Resources

For UnitedHealthcare Community Plan of California

UnitedHealthcare Community Plan of California 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.”

Select a plan below for contact information (call center, mailing address and more).

Provider Call Center: 866-270-5785
Hours of Operation: M-F 8:00 am-5:00 pm PST

Mailing Address:
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.

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

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.

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

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. 

Current News, Bulletins and Alerts

APL 16-014 Comprehensive Tobacco Prevention and Cessation Services for Medical Beneficiaries for UnitedHealthcare Community Plan of California

Last Modified | 06.20.2018

The purpose of this All Plan Letter (APL) is to provide Medi-Cal managed care health plans (MCPs) with additional information and explanation regarding requirements for comprehensive tobacco cessation services. This letter supersedes Policy Letter (PL) 14-006 and extends the implementation date for MCPs to develop a system to identify tobacco users and track utilization data of tobacco cessation interventions until December 15, 2016. All other requirements in PL 14-006 were to have been implemented by November 14, 2014.

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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.