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 menu on the left to quickly find what you're looking for. Be sure to check back frequently for updates.
Prior Authorization and Notification Resources
Current Policies and Clinical Guidelines
Provider Administrative Manual and Guides
COVID-19 Resources for Providers
- Important Information from UnitedHealthcare on COVID-19
- Maryland Medicaid COVID-19 Information
- Maryland Department of Health COVID-19 Information
- MDH ALERT: Becoming a COVID-19 vaccine provider - March 22, 2021
- MDH ALERT: Medicaid Provider Partnership Required to Support COVID-19 Testing Goals
- MDH ALERT: COVID-19 vaccine registration and ordering
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
10175 Little Patuxent Parkway
Columbia, MD 21044
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
Credentialing Updates:
Contact the National Credentialing Center at 1-877-842-3210.
Additional Resources
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.
Search for a care provider by plan name:
Search for Preferred Drug List by plan name:
Visit UHCCommunityPlan.com/MD for current member plan information including 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/communityplan.
Referrals are required for most specialty services.
The links below provide more information on our referral requirements including how to submit online referrals.
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.
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.
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. Members must have Medicaid to enroll.
Current News, Bulletins and Alerts
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Find COVID-19 vaccine availability for your state or territory
Last Modified | 01.11.2021
Use this list of local health departments to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.
Learn More -
Benefit enhancements for Maryland dual special needs plan (DSNP)
Last Modified | 01.04.2021
The UnitedHealthcare Dual Complete® plan is available for individuals who qualify for both Medicare and Medicaid.
Learn More -
Referral Process/Referrals tool
Last Modified | 12.18.2020
Tagline/blurb You are responsible for coordinating care for members and generating referrals to network specialists.
Learn More
Find COVID-19 vaccine availability for your state or territory
Last Modified | 01.11.2021
Use this list of local health departments to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.
Learn MoreBenefit enhancements for Maryland dual special needs plan (DSNP)
Last Modified | 01.04.2021
The UnitedHealthcare Dual Complete® plan is available for individuals who qualify for both Medicare and Medicaid.
Learn MoreReferral Process/Referrals tool
Last Modified | 12.18.2020
Tagline/blurb You are responsible for coordinating care for members and generating referrals to network specialists.
Learn More
UHC On Air gives you in-depth program information and meaningful updates from UnitedHealthcare 24/7and from any device.
Learn MoreHealth 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.