UnitedHealthcare Community Plan of Mississippi Homepage
Planning for the end of the COVID-19 Continuous Coverage Requirement
We need your partnership to ensure eligible members can keep their health coverage and those who no longer qualify know where they can go for affordable coverage resources.
To learn more about the planning for the end of the COVID-19 Continuous Coverage Requirement and how you can help; please visit the Mississippi Division of Medicaid (ms.gov) website.
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.
For commercial and Medicare credentialing and attestation updates, contact the National Credentialing Center at 877-842-3210.
All MississippiCAN and CHIP providers must be credentialed through the Mississippi Division of Medicaid’s Medicaid Enterprise System Assistance (MESA) provider portal.
Once your credentialing is complete with the Mississippi Division of Medicaid and you have an active MS Medicaid ID number, submit your practice’s letter of intent or request for participation by email to hpdemo@uhc.com. Once the Mississippi Division of Medicaid’s credentialling process is complete, contact UnitedHealthcare to request a participation agreement to join our network. You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours, please double-check your spam or junk folders before resubmitting. Please do not copy anyone on your participation request, as this can cause a submission error that prevents your letter from being received.
As part of your application, please include a statement that the practice is requesting a new medical group agreement, along with the specific medical group specialty, practice roster and copies of Form W-9. The average turnaround time for demographic loading is 30 days, with an additional 30–45 days for completion of the contract process. Please be aware that credentialing approval does not imply or guarantee participation with our health plans. Approved and signed physician contracts are required for participation.
Contact Us
Contract, Demographic, and Network Related Issues: 800-557-9933
Claims or Service Related Questions: 800-557-9933
Provider Customer Service Hours of Operation: 8:00 am - 6:00 pm CST
Postal Mailing Address
UnitedHealthcare
795 Woodlands Parkway, Suite 301
Ridgeland, MS 39157
Claims Mailing Address
UnitedHealthcare
P.O. Box 5032
Kingston, NY 12402-5032
Facility/Hospital-Based Providers, Group/Practice Providers and Individually-Contracted Clinicians
Step 1:
Learn about commercial and Medicare requirements for joining our network. Get credentialed through the Mississippi Division of Medicaid’s Medicaid Enterprise System Assistance (MESA) provider portal.
All MississippiCAN and CHIP providers must get credentialed through the Mississippi Division of Medicaid’s Medicaid Enterprise System Assistance (MESA) provider portal.
Step 2:
Once we receive your state-approved credentialing application for commercial and/or Medicare participation, we’ll send you a contract – called your participation agreement. This usually happens within 10 business days.Request a participation agreement to join the UnitedHealthcare network. Once we receive your state-approved credentialing application, we’ll send you a contract – called your participation agreement. This usually happens within 10 business days.
All MississippiCAN and CHIP providers: If your Medicaid credentialing is complete with the Mississippi Division of Medicaid and you have an active MS Medicaid ID number, please submit your practice’s letter of intent or request for participation by email to hpdemo@uhc.com.
You should receive a reference number (starts with PR) for your request within an hour. If you have not received a PR number within 24 business hours, please check your spam or junk folders before resubmitting. Please do not copy anyone on your participation request, as this can cause a submission error that prevents your letter from being received.
As part of your application, please include a statement that the practice is requesting a new medical group agreement, along with the specific medical group specialty, practice roster and copies of Form W-9. The average turnaround time for demographic loading is 30 days, with an additional 30–45 days for completion of the contract process. Please be aware that credentialing approval does not imply or guarantee participation with our health plans. Approved and signed physician contracts are required for participation.
Step 3:
Set up your online tools, paperless options and complete your training.
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.
Hospitals and Healthcare Facilities
Submit your request to join our network through UnitedHealthcare’s Facility RFP portal.
Federally qualified health centers (FQHCs) and rural health centers (RHCs) should use the practitioner enrollment form for each practitioner, not the Facility RFP portal.
All MississippiCAN and CHIP providers must be credentialed through the Mississippi Division of Medicaid’s Medicaid Enterprise System Assistance (MESA) provider portal.
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.
Visit UHCCommunityPlan.com/MS for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.
Member plan and benefit information can also be found at UHCCommunityPlan.com/MS and myuhc.com/communityplan.
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:
- Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the State Agency in order to remain eligible to receive Medicaid benefits
- 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 our portal, go to UHCprovider.com/portal.
Check out Care Conductor in the UnitedHealthcare Provider Portal under Clinical & Pharmacy.
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, UnitedHealthcare works to detect, correct and prevent fraud , waste and abuse in the health care system.
Call us at 1-844-359-7736 or at 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.
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.
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.