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For UnitedHealthcare Community Plan of Washington

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For UnitedHealthcare Community Plan of Washington

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UnitedHealthcare Community Plan of Washington 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.

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

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


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/WA 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 Washington - Apple Health

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

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

Pediatric Private Duty Nursing Hours Scoring Tool - UnitedHealthcare Community Plan of Washington

Last Modified | 10.29.2018

Calculate the number of eligible Private Duty Nursing hours. The scoring tool uses a point system for each required technology and skilled nursing need.

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Pediatric Private Duty Nursing Hours Review Process Change - UnitedHealthcare Community Plan of Washington

Last Modified | 10.29.2018

Beginning December 31, 2018, UnitedHealthcare Community Plan of Washington will change the way we calculate the number of Private Duty Nursing hours a child is eligible for based on their technology and nursing needs.

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UnitedHealthcare Community Plan of Washington Spring/Summer Practice Matters Newsletter 2018

Last Modified | 09.14.2018

Practice Matters is a quarterly publication for physicians and other health care professionals and facilities in the UnitedHealthcare network.

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Apple Health PDL – Effective January 1, 2018 for UnitedHealthcare Community Plan of Washington

Last Modified | 07.06.2018

The Health Care Authority (HCA) is creating a preferred drug list (PDL) for Apple Health (Medicaid) in partnership with managed care plans that serve Apple Health clients.

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Washington Apple Health Renewal Notices for UnitedHealthcare Community Plan of Washington

Last Modified | 07.06.2018

Your Washington Apple Health (Medicaid) patients may need to renew their coverage. Remind them to act quickly if they receive a Medicaid renewal notice. Together, we can help Washington Apple Health patients avoid a lapse in coverage.

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UHC On Air gives you in-depth program information and meaningful updates from UnitedHealthcare 24/7and from any device.

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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.


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.