Good health outcomes start in the communities where your patients live. Starting October 8, 2021, we invite you to take the Providers CARE Survey. The CARE survey will ask you about the needs of your patients, your experiences, and learning opportunities that can assist your practice team.
Our goal is to help you improve your patients’ health by:
C= Connecting them with community resources (like food pantries and housing help);
A= Acting for better health by teaching them about their care needs;
R=Reducing differences; and
E= Encouraging them. Take the time to listen to your patients. Treating them with kindness and support can help them take the steps they need for better health and it supports them on their journey to their best life
To fill out the survey, please visit https://www.tn.gov/tenncare/providers/social-and-health-needs.html
Your answers will not have your name on them and will be combined with information from other providers.
Get the latest COVID-19 vaccine information and FAQs from the TN Department of Health.
Interested in becoming a COVID-19 vaccinating provider? Learn more on their website.
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.
Good health outcomes start in the communities where your patients live. Starting October 2, we invite you to Connect with Us by taking the Providers CARE Survey.
By taking the survey, you’ll give us information about challenges your patients are facing in their communities. Our goal is to help you improve your patients’ health by:
C= Connecting them with community resources (like food pantries and housing help);
A= Acting for better health by teaching them about their care needs;
R=Reducing stigma by showing compassion to others and taking time to think about your actions and thoughts about yourself and others; and
E= Encouragement. Take the time to listen to your patients. Treating them with kindness and support can help them take the steps they need for better health and support them on their journey to their best life.
We are here to help you Connect your patients to CARE. The CARE survey will ask you about the social conditions impacting your patients and learning opportunities that can assist your practice team.
To fill out the survey, please visit https://www.tn.gov/tenncare/providers/social-and-health-needs.html
Your answers will not have your name on them and will be combined with information from other providers.
Thank you for caring about the health of your community.
We’re publishing this notification at TennCare’s request.
800-690-1606, available Monday-Friday from 8 a.m. – 6 p.m. Eastern Time.
Postal Mailing Address
UnitedHealthcare Community Plan
8 Cadillac Drive, Suite 100
Brentwood, TN 37027
Claims Address
UnitedHealthcare Community Plan
P.O. Box 5220
Kingston, NY 12402
Utilization Management Appeals Address
UnitedHealthcare Community Plan
P.O. Box 5220
Kingston, NY 12402
Part C Claims Appeals and Grievance Department
UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131-0364
Part D Appeals and Grievance Department
Attn: CA124-0197
P.O. Box 6106
Cypress, CA 90630-9948
For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
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.
View TennCare's policy related to fraud and the Federal and State False Claims Act.
To report fraud, waste, or abuse concerns you can call 800-690-1606 (UnitedHealthcare Community Plan tipline) or 800-433-3982 (Division of TennCare & Office of Inspector General). Or, you can report fraud, waste and abuse concerns at the following link: EthicsPoint - UnitedHealthcare Fraud, Waste and Abuse Hotline.
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/TN 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 atUHCCommunityPlan.com/TN and myuhc.com/communityplan.
The UnitedHealthcare Community Plan Member Rights and Responsibilities can be found in the Provider Manual. Member Rights and Responsibilities are distributed to new members upon enrollment. On an annual basis, members are referred to their handbook to review their Member Rights and Responsibilities.
UnitedHealthcare Community Plan members can access and manage their TennCare benefit information online with TennCare Connect.
Effective Jan. 1, 2021 UnitedHealthcare Community Plan is participating in the CoverKids program.
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 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.
Last Modified | 10.22.2021
TennCare is updating abortion, sterilization and hysterectomy forms and guidance effective July 1, 2021, for Tennessee Medicaid members.
Learn MoreLast Modified | 10.22.2021
It was previously communicated Oct. 1, 2020, on the Community Plan Portal, that the UnitedHealthcare Community Plan is implementing a new Inappropriate Primary Diagnosis Policy, Facility, for facility claims. Implementation of this new facility policy has been delayed until on or after date of process June 1, 2021.
Learn MoreLast Modified | 06.02.2021
Effective Aug. 1, 2021, prior authorization is required for 8 anti-emetics codes for cancer patients with UnitedHealthcare Community Plans in Arizona, Kentucky and Tennessee.
Learn MoreLast Modified | 05.21.2021
Use this list of local health departments to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.
Learn MoreLast Modified | 04.15.2021
UHCprovider.com and the UnitedHealthcare Community Plan care provider administrative manuals contain helpful information that give you and your staff an easy way to find important topics, such as prior authorization requirements, eligibility verification, claim submission, updated protocols and the TennCare Regulatory Appendix Addendum, as well as other resources and UnitedHealthcare contact information.
Learn MoreLast Modified | 10.22.2021
TennCare is updating abortion, sterilization and hysterectomy forms and guidance effective July 1, 2021, for Tennessee Medicaid members.
Learn MoreLast Modified | 10.22.2021
It was previously communicated Oct. 1, 2020, on the Community Plan Portal, that the UnitedHealthcare Community Plan is implementing a new Inappropriate Primary Diagnosis Policy, Facility, for facility claims. Implementation of this new facility policy has been delayed until on or after date of process June 1, 2021.
Learn MoreLast Modified | 06.02.2021
Effective Aug. 1, 2021, prior authorization is required for 8 anti-emetics codes for cancer patients with UnitedHealthcare Community Plans in Arizona, Kentucky and Tennessee.
Learn MoreLast Modified | 05.21.2021
Use this list of local health departments to learn about availability in your area. Availability may vary by location and time. We encourage you to check back often as information becomes more available.
Learn MoreLast Modified | 04.15.2021
UHCprovider.com and the UnitedHealthcare Community Plan care provider administrative manuals contain helpful information that give you and your staff an easy way to find important topics, such as prior authorization requirements, eligibility verification, claim submission, updated protocols and the TennCare Regulatory Appendix Addendum, as well as other resources and UnitedHealthcare contact information.
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.
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.