UnitedHealthcare Community Plan of Missouri

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 our Community Plan of Missouri page for current member plan and benefit 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 on our UnitedHealthcare Community Plan member page.

Additional health benefits and benefits updates can be found on our UnitedHealthcare Community Plan – MO HealthNet Managed Care page.

Provider directories

• Eastern region
• Central region
• Western region
• Southwest region

Member handbooks

• Missouri HealthNet member handbook - English and Spanish available 

Pediatric Care Network (PCN) will provide delegated medical management services for UnitedHealthcare  Community Plan members including case management, utilization management and disease management. Resources are available for providers including reference guides, office forms, frequently asked questions and more.

View Pediatric Care Network provider resources

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:

• UnitedHealthcare Community Plan - Missouri HealthNet Managed Care
• UnitedHealthcare Dual Complete®

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 844-359-7736 or visit uhc.com/fraud to report any issues or concerns.