Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of District of Columbia

Welcome

For UnitedHealthcare Community Plan of District of Columbia

Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of District of Columbia

Welcome

For UnitedHealthcare Community Plan of District of Columbia

UnitedHealthcare Community Plan of District of Columbia 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.

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. Enrollees must have Medicaid to enroll.

Continuity of Care for Dual Choice Program

Per the UnitedHealthcare contract with the Department of Health Care Finance, we will adhere to the continuity of care period requirements. This will help ensure that UnitedHealthcare Community Plan enrollees continue to have access to Medicaid and long-term services and supports (LTSS) services and can safely maintain their placement in the community.

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Provider Services at 888-350-5608.

Medical Providers/Facilities

For providers who wish to join the network.

DME Providers

For DME providers who wish to join the network, send an email to: DMEPOSNetwork@UHC.com.

Long Term Care Services and Support (LTSS) Providers

  • To request participation and credentialing for LTSS care providers, email UnitedHealthcare Community Plan at: hcbsprovidernetwork@uhc.com​.
  • To request participation and credentialing for Home Health/Hospice Providers, email UnitedHealthcare Community Plan at: HHCNetwork@uhc.com.

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

Learn about requirements for joining our network

UnitedHealthcare Community Plan determines and maintains its list of covered medications. This list applies to all UnitedHealthcare Community Plan of District of Columbia members.

Click on the link below to view the List of Covered Medications

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.

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

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

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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.  

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.

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.