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.
Telehealth is an important way for many members to access needed services. During the federal public health emergency (PHE), Nebraska Medicaid implemented many temporary flexibilities which expanded available telehealth services.
The federal government has said the PHE will end on May 11, 2023, therefore guidance on telehealth has been updated.
Please reference the DHHS Nebraska Medicaid bulletin to review important updates on the following:
Medicaid Provider Bulleting 23-08: Guidance on Telehealth (ne.gov)
The Nebraska Department of Health and Human Services has signed contracts with Molina Healthcare, Nebraska Total Care and United Healthcare to provide services (Including dental services) for the upcoming contract term. This new contract term for Medicaid’s managed care program -Heritage Health – begins January 1, 2024.
MCNA, which is currently the dental benefits manager for Nebraska Medicaid, will provide dental benefits through December 31, 2023.
Please see the DHHS links below which include the prior news release and provider bulletin for more information.
866-331-2243, available Monday - Friday from 7:00 am - 6:00 pm CST (6:00 am - 5:00 pm MST)
UnitedHealthcare Community Plan
2717 N 118th Street, Suite 300
Omaha, NE 68164
UnitedHealthcare
PO Box 31365
Salt Lake City, UT 84131
National A&G Service Center
PO Box 31365
Salt Lake City, UT 84131
Claims Appeals Mailing Address
UnitedHealthcare Community Plan Appeals
PO Box 31365
Salt Lake City, UT 84131
For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
Nebraska Medicaid and Long-Term Care (MLTC) has expanded Medicaid coverage under the Heritage Health Adult (HHA) Expansion program. The HHA program expands Medicaid coverage to adults, ages 19–64, whose income is at or below 138% of the federal poverty level. Heritage Health Adult members are enrolled in managed care plans through the existing Heritage Health program and are eligible for the same benefit package. This includes comprehensive medical, behavioral health and prescription drug coverage as well as vision services, dental services and over-the-counter (OTC) medication benefits.
Resources
The Nebraska Department of Health and Human Services (DHHS) also has information on the Medicaid expansion available at dhhs.ne.gov.
Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information, or submit demographic changes at Community Plan Behavioral Health.
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.
The Known Issues Log is a current list of open and closed known global claims issues. For questions related to open issues, reach out to your Provider Advocate or call Provider Services at 866-331-2243.
| Open Issues | |||
|---|---|---|---|
| Description | Impacted provider type | Resolution status | Estimated completion date |
No open issues. |
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Visit UHCCommunityPlan.com/NE for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.
Plan information is available for:
Member plan and benefit information can also be found at UHCCommunityPlan.com/NE and myuhc.com/communityplan.
The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:
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.
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:
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.
Search for a care provider by plan name:
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.
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.
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.
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.
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.