Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of California


For UnitedHealthcare Community Plan of California

Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of California


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.

Prior Authorization and Notification

Current Policies and Clinical Guidelines

Provider Manual and Guides

COVID-19 Resources for Providers

  • Important Reminders for Care Providers
    • Balance billing is never allowed – including for COVID-19 testing.
    • Authorization is not required for medically necessary emergency care by network or out-of-network care providers.
    • Authorization is not required for medically necessary screening and testing related to COVID-19.

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

  • Fill out the Diabetes Prevention Program Form and follow the instructions to submit the form. Once completed, a Solera representative will contact the member about additional program details.
  • You can also 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.

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.

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

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. 

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

Find COVID-19 vaccine availability for your state or territory

Last Modified | 05.21.2021

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.

Read More
2020 DSNP County Expansion

Last Modified | 09.17.2019

Provider resources for Commercial, Medicare Advantage and Medicaid / Community Plan products for individuals, employers, and groups available in this state.

Read More
View All News
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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.

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.


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.