Welcome to the New Home for Care Provider Resources

For UnitedHealthcare Community Plan of New Mexico

Welcome to the Home for New Mexico Community Plan Care Provider Resources

For UnitedHealthcare Community Plan of New Mexico

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UnitedHealthcare Community Plan of New Mexico 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.”

Provider Call Center

888-702-2202

UnitedHealthcare Provider Advocate/Network Contracting Contact Guide

Contact Information

Medical, Behavioral Health and Long-Term Care Services Customer Call Center
Available 8:00 am - 5:00 pm, Monday through Friday
Customer Call Center: 877-236-0826
Customer Call Center TTY: 711  

Credentialing
Medical: 888-702-2202
Behavioral Health: 877-614-0484

Pharmacy
Optum RX
Phone: 800-310-6826
Fax: 866-940-7328

Transportation
Logisticare (non-emergent, medically necessary)
Reservations: 866-913-2492
Ride Assistance: 866-913-2493
Recurring Appointments: 866-400-8233
TTY: 866-288-3133

Dental
United Dental Benefits
Phone 877-408-0159

Vision
March Vision
Phone: 844-706-2724 (providers only) 

Contact Addresses

Main Office Address

220 San Pedro NE, Suite 300
Albuquerque, NM 87113

Electronic Claim Submission

Payer ID Number 87726

Paper Claim Submission

Centennial Care Plan
United Healthcare Community Plan
P.O. Box 31365
Salt Lake City, UT 84131-0350

UnitedHealthcare Dual Complete Plan
UnitedHealthcare Community Plan
P.O. Box 31345
Salt Lake City, UT 84131-0348

Behavioral Health for UnitedHealthcare Dual Complete Plan
Optum Behavioral Services
P.O. Box 30757
Salt Lake City, UT 84130-0757

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

Visit UHCCommunityPlan.com/NM for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.

Plan information is available for:

  • New Mexico Centennial Care

Member plan and benefit information can also be found at UHCCommunityPlan.com/NM and myuhc.com.

Provider Directories

Search for a care provider by plan name:

Search for a dentist 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.  

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Current News, Bulletins and Alerts

New Mexico Practice Matters - Summer 2018

Last Modified | 07.13.2018

Practice Matters is a quarterly publication for physicians and other health care professionals and facilities in the UnitedHealthcare network.

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Taxonomy Codes on Claim Submissions for UnitedHealthcare Community Plan of New Mexico

Last Modified | 07.06.2018

On April 1, 2017, UnitedHealthcare Community Plan in New Mexico will require Centennial Care and UnitedHealthcare Dual Complete care providers to use taxonomy codes on claims submissions. This follows our established billing guidelines.

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Correct Coding Guidelines for UnitedHealthcare Community Plan of New Mexico

Last Modified | 07.06.2018

Action Required for New Mexico Centennial Care and UnitedHealthcare® Dual Complete® Plans – Reminder to follow National Correct Coding Guidelines

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Centennial Care and UnitedHealthcare Dual Complete Frequently Asked Questions for Enrollment and Claims Payment System, Efffective Jan. 1, 2017

Last Modified | 06.20.2018

The following frequently asked questions and answers will help care providers and their staff when UnitedHealthcare Community Plan of New Mexico transitions to an enhanced enrollment and claims payment system on Jan. 1, 2017. You’ll want to check for new member ID cards and use your new care provider electronic remittance advice (ERA) payer ID on claims submissions. There will be a new Provider Services phone number for UnitedHealthcare Dual Complete, and new mailing addresses for paper claims submissions starting Jan. 1.

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Claims System Updates for UnitedHealthcare Community Plan of New Mexico

Last Modified | 06.20.2018

New Mexico Centennial Care and UnitedHealthcare® Dual Complete® plans: Claims system updates that may affect care providers

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HEDIS Medical Record Collection

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.