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.
The University of Washington’s Collaborative Care Model is an integrated, evidence-based approach that aims to bring together primary care providers and behavioral health care providers to deliver care to eligible members. The Collaborative Care Model gives the PCP access to additional care management support and regular psychiatric consultation for members receiving behavioral health treatment. The Washington State Health Care Authority and UnitedHealthcare Community Plan are encouraging care providers to learn more about how they may integrate this model into their practice.
Interested? The first step is to submit an attestation – Washington State Health Care Authority form 13- 0017 – to become an approved collaborative care provider for UnitedHealthcare Community Plan members. Email the form to us at WAcollaborativecare@uhc.com. After that, one of our Transformation Advocates will contact you.
For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
UnitedHealthcare is here to help your practice successfully transition to the integrated managed care (IMC) clinical care model.
If you have any questions, please contact the clinical practice performance consultants at WACollaborativeCare@uhc.com.
For more training and educational resources, please click here.
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. Provider groups and facilities in Washington who employ both medical and behavioral health providers and wish to contract for Medicaid should contact Washington Network Management at Networkhelp@uhc.com. Include “Request for Participation in Behavioral and Medical Contracting” in the subject line. Note: this is for provider groups and facilities who have both medical and behavioral health providers only. If you are a hospital, facility, group or individual that practices only behavioral health or only medical health, please refer to the instructions found under “Get Started” here.
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/WA for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.
Member plan and benefit information can also be found at UHCCommunityPlan.com/WA and myuhc.com/communityplan.
The Partnership Access Line (PAL) is a mental health consultation resource available to all primary care providers to help practices deliver more effective mental health care for any child they see, regardless of insurance. PAL also includes PAL for Moms, which is focused on support for postpartum depression. Learn more about PAL and upcoming care provider training on the Seattle Children’s website, Washington Partnership Access Line - Seattle Children's (seattlechildrens.org).
The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare tool, which allows you to:
For help using CommunityCare, please see our Quick Reference Guide. If you’re not familiar with our portal, go to UHCprovider.com/portal.
Check out Care Conductor in the UnitedHealthcare Provider Portal under Clinical & Pharmacy.
Alert: The federal sterilization form, HHS-687, expires on December 31, 2018. At this point, HHS hasn't updated the federal form. Therefore, please use the current form until further notification.
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.
WISe is a voluntary service that takes a team approach to meeting the needs of children and youth. It provides intensive mental health services to support you and your family in meeting your goals.
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.
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.
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.