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
COVID-19 Resources for Providers
Provider Call Center
866-815-5334 available from 8 a.m. – 5 p.m. CST (except State designated holidays)
Provider Relations Team
Email: Missouri_PR_Team@uhc.com
Network Management Team
Phone: 866-574-6088
Email: mo_network_mgmt@uhc.com
Mailing Address
UnitedHealthcare Community Plan of Missouri
13655 Riverport Drive
Maryland Heights, MO 63043
Claims & Appeals Information
Claims Mailing Address
UnitedHealthcare Community Plan
PO Box 5240
Kingston, NY 12402-5240
Appeals Mailing Address
UnitedHealthcare Community Plan of Missouri
Attention: Provider Dispute
P.O. Box 31364
Salt Lake City, Utah 84131-0364
Behavioral Health Contact Information
Optum Behavioral Health
Phone: 866-815-5334
Online: https://www.providerexpress.com/content/ope-provexpr/us/en.html
Other Services
Dental Care Contact Information
UnitedHealthcare Dental
Phone: 855-934-9818
Online: https://uhcpwp.sciondental.com/PWP/Landing
Member Transportation Information
Medical Transportation Management
Phone: 866-292-0359
Online: https://www.mtm-inc.net/
Vision Care Contact Information
March Vision Care
Phone: 844-616-2724
Online: https://marchvisioncare.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
Pediatric Care Network will provide delegated medical management services for UHC Community Plan Pediatric Care Network members including case management, utilization management and disease management. Resources are available for providers including reference guides, office forms, frequently asked questions and more.
Visit UHCCommunityPlan.com/MO for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.
Plan information is available for:
- Care Improvement Plus Dual Advantage
- Missouri HealthNet Managed Care
- UnitedHealthcare Dual Complete
Member plan and benefit information can also be found at UHCCommunityPlan.com/MO and myuhc.com.
Provider Directories
Member Handbooks
Effective January 1, 2018, all providers servicing Missouri Medicaid members must be enrolled with Missouri HealthNet. Use the application form below that best applies to your situation.
Individual Provider Enrollment
Missouri HealthNet Individual Providers Application
Organizational Provider Enrollment
Missouri HealthNet Large Provider Organization Application
Search for a care provider by plan name:
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.
Current News, Bulletins and Alerts
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Update: Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional - Effective May 1, 2020 - UnitedHealthcare Community Plan of MA, MO
Last Modified | 03.02.2020
Effective with dates of process on or after May 1, 2020 in alignment with and CPT ®, reimbursement for Evaluation and Management (E/M) codes (99201-99499) submitted by an audiologist will be denied.
Learn More -
Update: Laboratory Services Policy, Professional - Effective May 18, 2020 UnitedHealthcare Community Plan of AZ, CA, FL, HI, KS, MD, MA, MS, MO, NE, NJ, NY, PA, RI, TN, TX, VA, WA, WI
Last Modified | 03.02.2020
Laboratory Services Policy, Professional - Effective May 18, 2020 UnitedHealthcare Community Plan of AZ, CA, FL, HI, KS, MD, MA, MS, MO, NE, NJ, NY, PA, RI, TN, TX, VA, WA, WI
Learn More -
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 -
Site of Service Reviews for Surgical Procedures – Code List Change - UnitedHealthcare Community Plan
Last Modified | 02.03.2020
We recently announced the expansion of our notification/prior authorization requirements and site of service medical necessity reviews to include certain surgical codes. This announcement is an update to the original announcements.
Learn More -
Practice Matters - Winter 2019 - UnitedHealthcare Community Plan of Missouri
Last Modified | 02.04.2020
In this issue, you can read about the transition of flu vaccine recommendations, member surveys, the importance of oral cancer prevention and much more.
Learn More
Update: Nonphysician Health Care Professionals Billing Evaluation and Management Codes Policy, Professional - Effective May 1, 2020 - UnitedHealthcare Community Plan of MA, MO
Last Modified | 03.02.2020
Effective with dates of process on or after May 1, 2020 in alignment with and CPT ®, reimbursement for Evaluation and Management (E/M) codes (99201-99499) submitted by an audiologist will be denied.
Learn MoreUpdate: Laboratory Services Policy, Professional - Effective May 18, 2020 UnitedHealthcare Community Plan of AZ, CA, FL, HI, KS, MD, MA, MS, MO, NE, NJ, NY, PA, RI, TN, TX, VA, WA, WI
Last Modified | 03.02.2020
Laboratory Services Policy, Professional - Effective May 18, 2020 UnitedHealthcare Community Plan of AZ, CA, FL, HI, KS, MD, MA, MS, MO, NE, NJ, NY, PA, RI, TN, TX, VA, WA, WI
Learn MoreUpdate: 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 MoreSite of Service Reviews for Surgical Procedures – Code List Change - UnitedHealthcare Community Plan
Last Modified | 02.03.2020
We recently announced the expansion of our notification/prior authorization requirements and site of service medical necessity reviews to include certain surgical codes. This announcement is an update to the original announcements.
Learn MorePractice Matters - Winter 2019 - UnitedHealthcare Community Plan of Missouri
Last Modified | 02.04.2020
In this issue, you can read about the transition of flu vaccine recommendations, member surveys, the importance of oral cancer prevention and much more.
Learn More
HEDIS Medical Record Collection
- HEDIS® Medical Record Collection - Frequently Asked Questions
- HEDIS® Medical Record Collection - Overview
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.