Starting Jan. 1, 2021, all presumptive eligibility Medicaid members in Kentucky will be enrolled in managed care and assigned to UnitedHealthcare Community Plan. This means some of your patients will be switched to UnitedHealthcare Community Plan on Jan. 1st, 2021. Starting on that date, please submit claims for these members to us.
If you have questions, please reach out to our provider call center (866) 633-4449, Monday-Friday 8 a.m.-6 p.m. ET including on Jan. 1st.
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.
Phone: 866-633-4449 available 8 a.m. – 6 p.m. Eastern Time (including Federal holidays)
UnitedHealthcare Community Plan of Kentucky
9100 Shelbyville Rd., Suite 270
Louisville, KY 40222
Phone: 844-569-4147 (OptumRx)
Prior Auth Phone: 800-310-6826
Online Reference Guides: marchvisioncare.com
Contact Information: providers.eyesynergy.com
may be sent to email@example.com
Disclaimer: This email inbox is intended to be used solely for communications that do not contain unencrypted Protected Health Information (PHI). Email messages and any documents containing PHI are protected by various state and federal laws including 45 C.F.R. Part 164. No emails or documentation should be sent to this inbox that contain PHI unless the communication is encrypted. Examples of PHI include a member’s name, date of birth, any detail regarding their medical condition including diagnoses and any other combination of identifiable information.
For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information, or submit demographic changes at Community Plan Behavioral Health.
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:
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/KY for current member plan information including sample member ID cards, provider directories, value-added benefits, dental plans, vision plans and more.
Plan information is available for:
Member dental plan and benefit information can be found at UHCCommunityPlan.com/KY and myuhc.com/communityplan.
Access a PDF Provider Directory by Region:
The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare tool, which allows you to:
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 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.
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.
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.