Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Michigan

Welcome

For UnitedHealthcare Community Plan of Michigan

Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Michigan

Welcome

For UnitedHealthcare Community Plan of Michigan

UnitedHealthcare Community Plan of Michigan 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.

Prior Authorization and Notification Resources

Current Policies and Clinical Guidelines

Provider Administrative Manual and Guides

Learn how our Application Programming Interface (API), Electronic Data Interchange (EDI) and UnitedHealthcare Provider Portal digital solutions can help you save time, reduce paper and get paid faster.

Easily manage your practice’s submission of claims, payment information, eligibility and benefits, prior authorization and more.

Need to register or modify your access within the UnitedHealthcare Provider Portal? Check out the:

Help patients find you by verifying your practice data in our provider directories. There are multiple ways to do this.

You now have more flexibility to access trainings on your time, search topics and get the resources you need.

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

Plan information is available for:

  • Healthy Michigan
  • UnitedHealthcare Community Plan of Michigan

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

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

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

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.

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:

  • See a complete list of all members, or just members added in the last 30 days
  • Export the roster to Excel
  • View most Medicaid and Medicare SNP members’ plans of care and health assessments
  • Enter plan notes and view notes history (for some plans)
  • Obtain HEDIS information for your member population
  • Access information about members admitted to or discharged from an inpatient facility
  • Access information about members seen in an Emergency Department

For help using CommunityCare, please see our Quick Reference Guide. If you’re not familiar with, go to UHCprovider.com/portal.

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

Michigan: Resources for your sickle cell care plan

Last Modified | 08.12.2021

To help you treat patients with sickle cell disease, UnitedHealthcare Community Plan of Michigan has training, care managers and support resources.

Learn More
Medicaid: Take 5 minutes to share your point of view

Last Modified | 07.09.2021

UnitedHealthcare Community Plan network providers will have the opportunity to share their feedback about their experience working with us by taking our Physician Satisfaction Survey. This survey applies to physicians who participate in Medicaid.

Learn More
Find COVID-19 vaccine availability for your state or territory

Last Modified | 05.21.2021

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
Winter 2021: Benefit enhancements for Michigan dual special needs plan (DSNP)

Last Modified | 01.04.2021

In addition to expanding the UnitedHealthcare Dual Complete® plan coverage area to include individuals in six new counties, the following improvements were made to the dual special needs plan (DSNP) in Michigan for 2021.

Learn More
10/2020: Dual Complete: Members Matched with a Navigator

Last Modified | 10.07.2020

The UnitedHealthcare Dual Complete® plan will now pair our members with a Navigator.

Learn More
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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.