Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of North Carolina


For UnitedHealthcare Community Plan of North Carolina

Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of North Carolina


For UnitedHealthcare Community Plan of North Carolina

UnitedHealthcare Community Plan of North Carolina 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

Dual Complete (RPPO-SNP) Program

UnitedHealthcare Community Plan of North Carolina offers a Dual Special Needs Plan (DSNP) – UnitedHealthcare Dual Complete (RPPO-SNP), a state wide Medicare Advantage program.

Learn more about the Dual Complete (RPPO-SNP) Program plan 

Provider Services Contacts

Visit: UHCProvider.com/NCcommunityplan 

Phone: 800-638-3302 available 8 a.m. to 6 p.m. Eastern Time (Monday through Saturday)

North Carolina Provider Contracting

Email: So­_Atlantic_Phys_Contracting@uhc.com

Mailing Address

UnitedHealthcare Community Plan of North Carolina

3803 N. Elm Street

Greensboro, NC  27455

Behavioral Health Crisis

Optum Behavioral Health - Phone: 877-614-0484 or email: optum.nc.pr@optum.com

Optum Behavioral Health Providers - email: management@optum.com

NC Provider Relations - email: optum.nc.pr@optum.com

Pharmacy Service Line

Phone:  855-258-1593 (OptumRx)

Online:  UHCprovider.com

MARCH Vision Care

Phone:  866-376-6780 or 844-736-2724

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

To contract with the Community Plan of North Carolina – Medicaid please contact the NC Health Plan Provider Call Center at 800-638-3302.

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, you may also contact Optum Behavioral Health at                  877-614-0484.

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


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/NC for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.

Plan information is available for:

  • Dual Complete (RPPO SNP) Program
  • Medicaid

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

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.  

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.

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.


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.