UnitedHealthcare Community Plan of Wisconsin
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.
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State news, bulletins and alerts
- 10.17.2025 - Medicaid: PCP Profiles support care coordination and quality
- 08.01.2025 - Medicaid: Submission of medical documentation for surgery of hip and knee
- 04.01.2025 - Medicaid: View the genetic and molecular codes added to prior authorization requirements
- 03.17.2025 - Access HealthCheck to help children receive preventive care
- 03.17.2025 - Medicaid: Remember state requirements when submitting claims for OB antepartum care
- 03.17.2025 - Medicaid requires pediatric blood lead screening
- 03.17.2025 - Medicaid requirement: Claims must match the Wisconsin Max Fee Schedule to avoid denials
- 12.04.2024 - Respiratory Syncytial Virus (RSV) Protection for Infants, P-03653
- 12.04.2024 - Infant RSV Immunization, P-03654A
- 12.04.2024 - RSV Vaccination for Pregnant Persons, P-03654
- 02.15.2024 - Medicaid: Help children access preventive care
- 02.15.2024 - Medicaid: Requirements and best practices for lead screening in children
News your way
Get news related to your role, specialty, health plan and state. When you subscribe to Network News, you can update your preferences to select what news you receive and how often.
Resources
For questions about credentialing and attestation updates, connect with us through chat 24/7 in the the UnitedHealthcare Provider Portal.
Provider Call Center
877-651-6677
24/7 Customer Service
8 a.m. - 5 p.m. for member advocates
Postal Mailing Address
UnitedHealthcare Community Plan
125 S. 84th St.
Milwaukee, WI 53214
Claims mailing address
UnitedHealthcare Community Plan
P.O. Box 5280
Kingston, NY 12402-5280
Utilization management appeals address
UnitedHealthcare Community Plan
P.O. Box 31364
Salt Lake City, UT 84131-0364
Claims appeals mailing address
Medicaid and Part C 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
Additional information
UnitedHealthcare Behavioral Health
P.O. Box 30757
Salt Lake City, UT 84130-0757
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
Visit UHCCommunityPlan.com/WI 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 Wisconsin
Member plan and benefit information can also be found at UHCCommunityPlan.com/WI and myuhc.com/communityplan.
CommunityCare
The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare feature in the UnitedHealthcare Provider Portal, which allows you to:
- Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the state in order to remain eligible to receive Medicaid benefits
- See a complete list of all members, or just members added in the last 30 days
- Export the roster to Microsoft Excel
- View most Medicaid and Medicare Special Needs Plans (SNP) members’ plans of care and health assessments
- Enter plan notes and view notes history (for some plans)
- Obtain HEDIS® information for your member population
- Access information about members admitted to or discharged from an inpatient facility
- Access information about members seen in an emergency department
For help using CommunityCare feature on the UnitedHealthcare Provider Portal, please see our quick reference guide. If you’re not familiar with UnitedHealthcare Provider Portal, visit our portal resources page.
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 844-359-7736 or visit uhc.com/fraud to report any issues or concerns.
UnitedHealthcare Dual Complete® Special Needs Plan
UnitedHealthcare Dual Complete® Special Needs Plans (D-SNP) offer benefits for people with both Medicare and Medicaid. These D-SNP plans provide benefits beyond Original Medicare and may include transportation to medical appointments and vision exams. Members must have Medicaid to enroll.
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 HCPCS and CPT®-4 codes.
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.
Disclaimer
If UnitedHealthcare 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 Policies and Clinical Guidelines section at left.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CPT® is a registered trademark of the American Medical Association.