Chapter 13: Care Provider Communications & Outreach

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The UnitedHealthcare Community Plan care provider education and training program is built on years of experience with you and Ohio’s managed care program. It includes the following care provider components:

  • Website
  • Forums/town hall meetings
  • Office visit
  • Newsletters and bulletins
  • Manual

UnitedHealthcare Community Plan promotes the use of web-based functionality among its provider population. The UHCprovider.com portal facilitates care provider communications related to administrative functions.

Our interactive website empowers you to electronically determine member eligibility, submit claims, and view claim status.

We have also implemented an internet-based prior authorization system on UHCprovider.com. This site lets you request medical and advanced outpatient imaging procedures online rather than by phone. The website also has:

  • An online version of this manual
  • Clinical practice guidelines (which cover diabetes, ADHD, depression, preventive care, prenatal, and other guidelines)
  • Electronic data interchange
  • Quality and utilization requirements
  • Educational materials such as newsletters and bulletins
  • Provider service updates – new tools and initiatives (UHC on Air, PreCheck MyScript, etc.)

In addition, we have created a member website that gives access to the Member Handbook, newsletters, provider search tool and other important plan information. It is UHCCommunityPlan.com > select Member.

You may also find training on various topics at UHCprovider.com > Menu > Resource Library. Look under More Resource Topics, then click Training.

Care provider advocates regularly visit PCPs and specialist offices. Each advocate is assigned to a care provider group to deliver face-to-face support. We do this to create program awareness, promote compliance and problem resolution.

UnitedHealthcare Community Plan produces a care provider newsletter to the entire Hawaii network at least three times a year. The newsletters include articles about:

  • Program updates
  • Claims guidelines
  • Information regarding policies and procedures
  • Cultural competency and linguistics
  • Clinical practice guidelines
  • Special initiatives
  • Emerging health topics

Network Bulletins

The Network Bulletin is a monthly publication that features important protocol and policy changes, administrative information and clinical resources.

View the latest news or sign up to receive the monthly bulletin at UHCprovider.com > News and Network Bulletin.

UnitedHealthcare Community Plan publishes this manual online. It includes an overview of the program, a toll-free number for Provider Services, a removable quick reference guide and a list of additional care provider resources. If you do not have internet access, request a hard copy of this manual by contacting Provider Services.

Find the following forms on the state’s website at medicaid.ohio.gov:

  • Sterilization Consent Form
  • Informed Consent for Hysterectomies Form
  • Provider Service Agreement (MC 19 Form)