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For UnitedHealthcare Community Plan of Michigan

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For UnitedHealthcare Community Plan of Michigan

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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

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.

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.

Helpful Resources

The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare tool on Link, 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 Link, go to UHCprovider.com/link.

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.  

Read our quick reference guide for more information.

Current News, Bulletins and Alerts

Update to Procedure to Modifier Policy for “Always Therapy” Codes – Effective July 1, 2019 for UnitedHealthcare Community Plan of CA, HI, FL, LA, MD, MA, MI, MS, NE, NJ, NY, OH, PA, RI, WA, WI, VA

Last Modified | 05.14.2020

UnitedHealthcare Community Plan is updating its Procedure to Modifier Policy for claims for dates of service on or after July 1, 2019. Physical therapy (GP), occupational therapy (GO) or speech-language pathology (GN) modifiers will be required on “Always Therapy” codes to align with the Centers for Medicare & Medicaid Services (CMS).

Learn More
MDHHS Message to Providers: Executive Order No. 2020-17

Last Modified | 05.06.2020

Under current COVID-19 restrictions what services can be provided

Learn More
DUR Educational Newsletter: Safety in Respiratory Therapy - UnitedHealthcare Community Plan

Last Modified | 04.24.2020

The National Asthma Education and Prevention Program (NAEPP) published guidelines for the treatment of asthma in2007.¹ The guidelines outline goals of therapy that include the prevention of recurrent exacerbation and need for emergency department or hospital care, the prevention of reduced lung growth in children or loss of lung function in adults, and the optimization of pharmacotherapy with minimal or no adverse effects.

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Update: Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional - Effective March 31, 2020 - UnitedHealthcare Community Plan of FL, HI, MD, MI, OH, PA, VA

Last Modified | 03.02.2020

Effective with dates of process on or after March 31, 2020 in alignment with and CPT ®, reimbursement for Evaluation and Management (E/M) codes (99201-99499) submitted by an audiologist will be denied.

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Update: the Physical Medicine and Rehabilitation Multiple Therapy Reduction Policy, Professional will be processing by date of service, effective 6/1/2020 for CA, FL, HI, MD, MA, MI, MO,NY,OH,PA,VA, WA, WI

Last Modified | 02.28.2020

Update: the Physical Medicine and Rehabilitation Multiple Therapy Reduction Policy, Professional will be processing by date of service, effective 6/1/2020

Learn More
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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.