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For UnitedHealthcare Community Plan of Ohio

Welcome to the Home for Ohio Community Plan Care Provider Resources

For UnitedHealthcare Community Plan of Ohio

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UnitedHealthcare Community Plan of Ohio 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

(800) 600-9007
Monday-Friday, 8 a.m. – 5 p.m.

Postal Mailing Address

UnitedHealthcare Community Plan
9200 Worthington Road, 3rd Floor
Westerville, OH 43082

Claims Mailing Address

UnitedHealthcare Community Plan
P.O. Box 8207
Kingston, NY 12402

Utlization Management Appeals Address  

UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131
Fax: (801) 994-1082

Claims Appeals Mailing Address

UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131
Fax: (801) 994-1082

UHC Connected™ For MyCare Ohio Appeals Mailing Address

Part C Appeals or Grievances:
UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131
Fax: (801) 994-1082

Medicare Part D Grievances:
UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131
Fax: (801) 994-1082

Medicare Part D Appeals:
UnitedHealthcare Community Plan
Attn: Part D Standard Appeals
P.O. Box 6103
Cypress, CA 90630-9998
Fax: (877) 960-8235

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

Need to make a change to your provider or facility directory information? 

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

Plan information is available for:

  • UnitedHealthcare Community Plan of Ohio
  • UnitedHealthcare Connected® for MyCare Ohio
  • UnitedHealthcare Dual Complete (HMO SNP)
  • UnitedHealthcare Dual Complete (HMO-POS SNP)

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

Search for a Care Provider 

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Need to make a change to your provider or facility directory information? 

The Ohio provider contract with United HealthCare Community Plan is listed below.

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

Alpha Agonist Use in Pediatric Members - Drug Utilization Review Newsletter - UnitedHealthcare Community Plan (Limited Availability)

Last Modified | 02.13.2019

Alpha-Agonist Use in Pediatric Members A Retrospective Drug Utilization Review

Learn More
National MedTrans Transition Starting Jan. 1, 2019 for Florida, Ohio, Mississippi, Missouri and New York - UnitedHealthcare Dual Complete Plans

Last Modified | 02.11.2019

Starting Jan. 1, 2019, National MedTrans (MedTrans) will be the non-emergency medical transportation benefit provider all UnitedHealthcare Dual Complete® plan members in Missouri, Florida, Michigan, Ohio and New York.

Learn More
New All Savers Care Provider Website

Last Modified | 02.04.2019

On Feb. 20, 2019, All Savers Alternate Funding will launch a new care provider website – myallsaversconnect.com. You can use the new website to view and verify member eligibility and coverage details and view and print claim detail and payment summaries

Learn More
Revision to Readmission Policy for Facilities - Effective Feb. 1, 2019 - UnitedHealthcare Community Plan of Ohio

Last Modified | 01.09.2019

We want to let you know about a change to our Readmission Policy for UnitedHealthcare Community Plan members in Ohio. Starting Feb. 1, 2019, the policy requirements will apply to all inpatient admissions.

Learn More
Ohio Unified Preferred Drug List Delayed Indefinitely

Last Modified | 12.31.2018

The Ohio Department of Medicaid, along with the Medicaid managed care plans (MCPs), previously communicated moving toward creating a unified preferred drug list (PDL). The initiative to implement the unified PDL on January 1, 2019 has been delayed indefinitely. Thank you in advance for your understanding and we apologize for any confusion. Providers may refer to the ODM Pharmacy website https://pharmacy.medicaid.ohio.gov/ under “Drug Coverage” for more information

Learn More
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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.