Do you file claims with Rhode Island Medicaid? Keep your billing privileges by completing your state screening and enrollment.
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.
For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
877-842-3210 - 24 hours a day, 7 days a week and holidays
UnitedHealthcare Community Plan
Attn: Medicaid Program
475 Kilvert Street
Warwick, RI 02886
UnitedHealthcare Community Plan
P.O. Box 31364
Salt Lake City, Utah 84131
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 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.
Visit UHCCommunityPlan.com/RI 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/RI and myuhc.com/communityplan.
To help you more easily deliver care to UnitedHealthcare Community Plan of Rhode Island members, we’re temporarily removing the referral requirement for members who see in-network specialists. For dates of service starting April 21, 2020, and extending until further notice, we won’t deny claims for covered services because there’s no referral in the system.
This change to the referral requirements doesn’t affect existing prior authorization and notification requirements.
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, UnitedHealthcare works to detect, correct and prevent fraud , waste and abuse in the health care system.
Call us at 1-844-359-7736 or at 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.
This Dental Provider Manual is designed as a comprehensive reference guide for the dental plans in your area, primarily UnitedHealthcare Dental Medicaid and Medicare plans. Here you will find the tools and information needed to successfully administer UnitedHealthcare plans.
Last Modified | 04.29.2022
Effective Aug. 1, 2022, Optum will manage prior authorization requests for non-oncology injectable medications that are covered on the medical benefit for UnitedHealthcare Community Plans.
Learn MoreLast Modified | 07.09.2021
UnitedHealthcare Community Plan network providers will have the opportunity to share their feedback about their experience working with us by taking our Physician Satisfaction Survey. This survey applies to physicians who participate in Medicaid.
Learn MoreLast Modified | 06.30.2021
We encourage you to use non-pharmacologic and non-opioid alternatives when deciding on the best course of treatment for Medicaid patients in Rhode Island with chronic pain.
Learn MoreLast Modified | 04.29.2022
Effective Aug. 1, 2022, Optum will manage prior authorization requests for non-oncology injectable medications that are covered on the medical benefit for UnitedHealthcare Community Plans.
Learn MoreLast Modified | 07.09.2021
UnitedHealthcare Community Plan network providers will have the opportunity to share their feedback about their experience working with us by taking our Physician Satisfaction Survey. This survey applies to physicians who participate in Medicaid.
Learn MoreLast Modified | 06.30.2021
We encourage you to use non-pharmacologic and non-opioid alternatives when deciding on the best course of treatment for Medicaid patients in Rhode Island with chronic pain.
Learn MoreHIPAA 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.
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.