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
1-866-270-5785 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.
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.
Resources
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.
Search for a care provider by plan name:
Please complete the form below and mail to the address provided to address concerns.
- Provider Dispute Resolution (PDR) Form (Last Modified 09.17.2018)
- Member COMPLAINT AND GRIEVANCE FORM (Last Modified 09.17.2018)
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
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Drug Safety Communication - Risks with Sudden Discontinuation of Opioids for UnitedHealthcare Community Plan of California
Last Modified | 05.10.2019
Opioids are a class of prescription medicines that are used to manage pain when other treatments and medicines cannot be taken or are not able to provide enough pain relief. Opioids have serious risks, including abuse, addiction, overdose, and death. Examples of common opioids include codeine, fentanyl, hydrocodone, hydromorphone, morphine, oxycodone, and oxymorphone.
Read More -
Update to Procedure to Modifier Policy for “Always Therapy” Codes – Effective July 1, 2019 for UnitedHealhcare Community Plan of CA, HI, FL, LA, MD, MA, MI, MS, NE, NJ, NY, OH, PA, RI, WA, WI, VA
Last Modified | 05.06.2019
UnitedHealthcare Community Plan is updating its Procedure to Modifier Policy for claims for dates of service on or after July 1, 2019. Physical therapy (GP), occupational therapy (GO) or speech-language pathology (GN) modifiers will be required on “Always Therapy” codes to align with the Centers for Medicare & Medicaid Services (CMS).
Read More -
Drug Safety Communication - Updated Adverse Effects from Fluoroquinolones
Last Modified | 04.08.2019
On December 20, 2018, the U.S. Food and Drug Administration (FDA) issued a warning that fluoroquinolones administered orally or intravenously may increase the risk of ruptures of an aortic aneurysm or aortic dissections, which are rare but serious events that can lead to dangerous bleeding or even death. The FDA requires inclusion of the new risks in the prescribing information and patient Medication Guide for all fluoroquinolones.
Read More
Drug Safety Communication - Risks with Sudden Discontinuation of Opioids for UnitedHealthcare Community Plan of California
Last Modified | 05.10.2019
Opioids are a class of prescription medicines that are used to manage pain when other treatments and medicines cannot be taken or are not able to provide enough pain relief. Opioids have serious risks, including abuse, addiction, overdose, and death. Examples of common opioids include codeine, fentanyl, hydrocodone, hydromorphone, morphine, oxycodone, and oxymorphone.
Read MoreUpdate to Procedure to Modifier Policy for “Always Therapy” Codes – Effective July 1, 2019 for UnitedHealhcare Community Plan of CA, HI, FL, LA, MD, MA, MI, MS, NE, NJ, NY, OH, PA, RI, WA, WI, VA
Last Modified | 05.06.2019
UnitedHealthcare Community Plan is updating its Procedure to Modifier Policy for claims for dates of service on or after July 1, 2019. Physical therapy (GP), occupational therapy (GO) or speech-language pathology (GN) modifiers will be required on “Always Therapy” codes to align with the Centers for Medicare & Medicaid Services (CMS).
Read MoreDrug Safety Communication - Updated Adverse Effects from Fluoroquinolones
Last Modified | 04.08.2019
On December 20, 2018, the U.S. Food and Drug Administration (FDA) issued a warning that fluoroquinolones administered orally or intravenously may increase the risk of ruptures of an aortic aneurysm or aortic dissections, which are rare but serious events that can lead to dangerous bleeding or even death. The FDA requires inclusion of the new risks in the prescribing information and patient Medication Guide for all fluoroquinolones.
Read More
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Learn MoreHEDIS Medical Record Collection
- HEDIS® Medical Record Collection - Frequently Asked Questions
- HEDIS® Medical Record Collection - Overview
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
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.