Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Mississippi

Welcome

For UnitedHealthcare Community Plan of Mississippi

Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Mississippi

Welcome

For UnitedHealthcare Community Plan of Mississippi

UnitedHealthcare Community Plan of Mississippi 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

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

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

Learn about requirements for joining our network.

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.

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.

Current News, Bulletins and Alerts

Last Modified | 05.31.2022

We wanted to remind you that we offer personalized remote patient monitoring for patients living with Type 1 and Type 2 diabetes.

Learn More

Last Modified | 05.31.2022

With new COVID-19 variants emerging and vaccination rates plateauing, we’ve bundled together resources from trusted organizations and clinical data to aid in those tough conversations.

Learn More

Last Modified | 05.31.2022

Cultural Competency Training is one of the many training courses you can take to improve patient care.

Learn More

Last Modified | 05.31.2022

Mississippi Division of Medicaid is now requiring CCOs to report EPSDT compliance rates only for those providers who are currently EPSDT certified.

Learn More

Last Modified | 05.16.2022

Health care professionals who wish to contract with UnitedHealthcare Community Plan may need a site visit as part of the credentialing process.

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.

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.