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For UnitedHealthcare Community Plan of Maryland

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For UnitedHealthcare Community Plan of Maryland

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UnitedHealthcare Community Plan of Maryland 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.”

Hours of Operation: 8:00 am - 6:00 pm EST
Provider Call Center: 877-842-3210
Member Services Number: 800-318-8821 (TTY 711),  Monday-Friday, 8:00 am to 7:00 pm EST 

Mailing Address:
UnitedHealthcare Community Plan
6220 Old Dobbin Lane
Columbia, MD  21045

Claims Mailing Address:
UnitedHealthcare Community Plan
PO Box 31365
Salt Lake City, UT 84131 

Utilization Denial & Appeals Department Mailing Address:
UM Denial & Appeals Department
PO Box 31365
Salt Lake City, UT 84131

Claims Appeals Mailing Address:
UnitedHealthcare Community Plan Appeals-Maryland
PO Box 31365
Salt Lake City, UT 84131

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

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

Plan information is available for:

  • Maryland HealthChoice

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

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.

Helpful Resources

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

Maryland Department of Health and Mental Hygiene 2016 Fatal Overdose Report for UnitedHealthcare Community Plan of Maryland

Last Modified | 09.27.2018

The Department of Health and Mental Hygiene today released the 2016 Drug- and Alcohol-Related Intoxication Deaths in Maryland Report. The report found that 2,089 people died from overdoses last

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UnitedHealthcare Community Plan of Maryland Practice Matters Newsletter - Summer 2018

Last Modified | 09.17.2018

We hope you enjoy this edition of Practice Matters. In this issue, you can read about UHCCommunityPlan.com content moving to UHCprovider.com, an important update for the EPSDT program, prevention of health care fraud and abuse, and much more.

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Audiology Coverage for All Members, Effective July 1, 2018

Last Modified | 09.14.2018

To improve access to audiology services for all Medicaid participants, the Maryland Department of Health will begin providing access to these services through the HealthChoice program, regardless of age, effective July 1, 2018. This is a change to the current policy that limits audiology coverage to members under age 21.

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UnitedHealthcare of the Mid-Atlantic, 2016 - 2017 Outreach Program Plan (6/19/2017) for UnitedHealthcare Community Plan of Maryland

Last Modified | 08.21.2018

UnitedHealthcare selects preventive service, chronic condition indicators that reflect important aspects of care for UnitedHealthcare members and indicators that are relevant to the enrolled population, and reflective of high-volume services that span a variety of delivery settings.

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Helping Patients Better Understand Asthma Medication Ratio for UnitedHealthcare Community Plan of Maryland

Last Modified | 08.21.2018

UnitedHealthcare can provide you with a list of your patients that have an asthma medication ratio of greater than 0.50, which you can use to schedule an office visit to discuss his/her medication usage.

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UHC On Air gives you in-depth program information and meaningful updates from UnitedHealthcare 24/7and from any device.

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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.