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For UnitedHealthcare Community Plan of Iowa

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For UnitedHealthcare Community Plan of Iowa

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UnitedHealthcare Community Plan of Iowa 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 Community Plan No Longer Affiliated with IA Health Link and Hawki Program; UnitedHealthcare Dual Complete® (HMO SNP) Not Affected

As of July 1, 2019, UnitedHealthcare Community Plan of Iowa will no longer provide Medicaid and Hawki coverage in Iowa; however, we’ll continue to serve our UnitedHealthcare Dual Complete (HMO SNP) members. We’re honored to have served Iowans in the IA Health Link program for the past three years and the Hawki program for the past twenty years.

Directing Your Patients

If patients have questions, please have them call their new managed care organization’s (MCO’s) Member Service’s phone number, which they’ll find on their ID card. If members have questions related to any services they received before July 1, 2019, they can call UnitedHealthcare Community Plan member services at 800-464-9484.

How this Affects UnitedHealthcare Dual Complete® (HMO SNP)

The UnitedHealthcare Dual Complete (HMO SNP) plan won’t be affected by this change. Eligible members can enroll in, and will be served by, the UnitedHealthcare Dual Complete (HMO SNP) plan, regardless of their MCO. UnitedHealthcare will still serve as their primary payer and members will continue to receive all the additional benefits of the plan. If members have questions about their UnitedHealthcare Dual Complete (HMO SNP) plan, they can call us at: 844-368-6883 (TTY 711),

8 a.m. – 8 p.m. in your time zone, 7 days a week.

Questions

If you have questions, please call Provider Services at 888-650-3462.

Provider Call Center

1-888-650-3462, available from 7:30 a.m.-6:00 p.m. Central Time (CST).

Contact us for information regarding:

  • Behavioral Health referral
  • Claims corrections
  • Getting a member a ride
  • Language interpreter services
  • Member eligibility
  • Prior authorization
  • Reach a community-based case manager
  • Referrals to specialists

Mailing Address

UnitedHealthcare Community Plan
1089 Jordan Creek Parkway, Suite 320
West Des Moines, IA 50266

Claims and Appeals

Claims Mailing Address

UnitedHealthcare
Attn: Claims
P.O. Box 5220
Kingston, NY 12402-5220

Claims Appeals and Disputes

UnitedHealthcare Community Plan
P.O. Box 31364
Salt Lake City, UT 84131

Pharmacy Contact Information

Prior Authorizations Phone: 800-310-6826
Prior Authorizations Fax: 866-940-7328

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

If you’re a Home- and Community-Based Service (HCBS) provider, please contact hcbs_iacred@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

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.

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

Plan information is available for:

Member dental plan and benefit information can be found at UHCCommunityPlan.com/IA and myuhc.com.

Provider Advocate Information

Clinical Practice Consultant Information

The Clinical Practice Consultant program supports provider’s efforts to help members overcome barriers to health care. As part of this initiative, the dedicated Clinical Practice Consultant (CPC) will work with providers to help manage the clinical requirements involved with meeting Healthcare Effectiveness Data and Information Set (HEDIS) and other quality measures.

Manager of Case Manager Information

If the care provider is unable to contact a Community-Based Case Manager (CBCM) or has a situation that they are unable to resolve with the CBCM, please contact the Manager of Case Manager (MCM) for further assistance.

  • Please contact Provider Services at 888-650-3462 for inquiries related to your MCM.

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

UnitedHealthcare Community Plan of Iowa Practice Matters - Winter 2018

Last Modified | 08.08.2019

We hope you enjoy the winter edition of Practice Matters. In this issue, you can read about our Dual Complete® Plan (DSNP) expansion and benefits, lead exposure risks, new training opportunities and much more.

Learn More
Market Exit Consumer-Directed Attendant Care (CDAD) Frequently Asked Questions for UnitedHealthcare Community Plan of Iowa

Last Modified | 04.26.2019

We're currently working with the state to finalize timing and will share more details with you as they are available.

Learn More
Market Exit Frequently Asked Questions for UnitedHealthcare Community Plan of Iowa

Last Modified | 04.26.2019

We're currently working with the state to finalize timing and will share more details with you as they are available.

Learn More
UnitedHealthcare Community Plan Update

Last Modified | 04.22.2019

The State of Iowa and UnitedHealthcare have announced that UnitedHealthcare Community Plan will exit the IA Health Link and Hawki programs once the current contract ends and UnitedHealthcare members have been transitioned, which is anticipated to be on June 30, 2019.

Learn More
Billing Guidelines for Home Health Services

Last Modified | 02.27.2019

Home health services are medical services provided in the member’s home by Medicare-certified home health agencies. Members who require only Home health aide services are entitled to these services without needing skilled services. Members do not need to be homebound to be eligible for services; however, they are covered only when provided in the member’s home.

Learn More
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Logos: ia health link, hawk-i and NCQA seal

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.

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.