We’re Your Partner to Connect with Members benefits and services, HEDIS® Measure: Appropriate Testing for Children with Pharyngitis, Early and Periodic Screening, Diagnosis and Treatment (EPSDT), Community Plan Reimbursement Policies of Pennsylvania, Rhode Island AARP® Medicare Advantage Plans, Rhode Island Group Medicare Advantage Plans, Increased Member Satisfaction Revealed by CAHPS Survey, Community Plan Reimbursement Policies of Rhode Island, South Carolina UnitedHealthcare Medicare Advantage Plans, South Dakota Group Medicare Advantage Plans, South Dakota AARP® Medicare Advantage Plans, TN UnitedHealthcare Medicare Advantage Plans, Fraud, Waste, and Abuse Update – Foot Baths and Prescription Anti-Infective Agents, Healthcare Professional Community Engagement Partnership, UnitedHealthcare Dual Complete – Medicare Advantage Special Needs Plan (DSNP) and UnitedHealthcare Community Plan – TennCare, Community Plan Reimbursement Policies of Tennessee, Tennessee Episodes of Care / Patient Centered Medical Home / TN Health Link / Medication Therapy Management, TX UnitedHealthcare® Chronic Complete Special Needs Plan, TX Erickson Advantage® Freedom/Signature Plans, Texas UnitedHealthcare Medicare Advantage Plans, TX UnitedHealthcare® MedicareDirect (PFFS), Making the Most of Life While Living With Complex Care Needs, Messages from the Texas Credentialing Alliance, Messages from the Texas Health and Human Services Commission, Community Plan Reimbursement Policies of Texas, Reference Guides and Value-Added Services, Utah UnitedHealthcare Medicare Advantage Plans, Utah UnitedHealthcare Medicare Advantage Assist plans, VT UnitedHealthcare® MedicareDirect (PFFS), Vermont UnitedHealthcare Medicare Advantage Plans, Virginia Erickson Advantage® Freedom/Signature Plans, Virginia UnitedHealthcare® MedicareDirect (PFFS), Resources to Help You Prepare for a Challenging Influenza Season, Community & State Plan: 2020 Transportation Benefit Information, Initiation and Engagement of Alcohol and Other Drug Dependence Treatment, Medication Reconciliation Post-Discharge (MRP), UnitedHealthcare Dual Complete: Virginia Members Matched with a Navigator, Community Plan Reimbursement Policies of Virginia, Washington AARP® Medicare Advantage Plans, Washington Group Medicare Advantage Plans, UnitedHealthcare Dual Complete: Washington Members Matched With a Navigator, Pregnancy Intention Screening: Family Planning for Social Change, Community Plan Reimbursement Policies of Washington, West Virginia AARP® Medicare Advantage Plans, West Virginia Group Medicare Advantage Plans, Wisconsin UnitedHealthcare Medicare Advantage Plans, Wisconsin UnitedHealthcare Medicare Advantage Assist plans, Community Plan Reimbursement Policies of Wisconsin, Wyoming UnitedHealthcare® MedicareDirect (PFFS), U.S. Virgin Islands Commercial Health Plans, UnitedHealthcare Commercial Medical & Drug Policies and Coverage Determination Guidelines, UnitedHealthcare Commercial Reimbursement Policies, UnitedHealthcare West Benefit Interpretation Policies, UnitedHealthcare West Medical Management Guidelines, UnitedHealthcare Value & Balance Exchange Medical & Drug Policies and Coverage Determination Guidelines, Reimbursement Policies for UnitedHealthcare Value & Balance Exchange Plans, Medicare Advantage Reimbursement Policies, Community Plan Drug Lists for Limited Supplier Protocol, Community Plan Care Provider Manuals for Medicaid Plans By State, Welcome to UnitedHealthcare 2020 UnitedHealthcare Administrative Guide, Manuals and Benefit Plans Referenced in the Guide, Verifying Eligibility, Benefits and Your Network Participation, Network Participating Care Provider Responsibilities, Cooperation with Quality Improvement and Patient Safety Activities, Notification of Practice or Demographic Changes (Applies to Commercial Benefit Plans in California), Administrative Terminations for Inactivity, Coverage Summaries and Policy Guidelines for MA Members, Dual Special Needs Plans Managed by Optum, Free Medicare Education for Your Staff and Patients, Non-Participating Care Provider Referrals (All Commercial Plans), Medicare Advantage Referral Required Plans, Benefit Plans Not Subject to this Protocol, Advance Notification/Prior Authorization Requirements, Advance Notification/Prior Authorization List, Facilities: Standard Notification Requirements, How to Submit Advance or Admission Notifications/ Prior Authorizations, Updating Advance Notification or Prior Authorization Requests, Coverage and Utilization Management Decisions, Clinical Trials, Experimental or Investigational Services, Medical Management Denials/Adverse Determinations, Outpatient Cardiology Notification/Prior Authorization Protocol, Outpatient Radiology Notification/Prior Authorization Protocol, Specialty Pharmacy Requirements for Certain Specialty Medications (Commercial Plans - Not Applicable to UnitedHealthcare West) - Chapter 7, 2020 UnitedHealthcare Administrative Guide, Non-Emergent Ambulance Ground Transportation, Medicare Advantage Claim Processing Requirements, Pass-through Billing/CLIA Requirements/Reimbursement Policy, Special Reporting Requirements for Certain Claim Types, Claim Reconsideration, Appeals Process and Resolving Disputes, Medical Records Standards and Requirements, Commercial Health Services, Wellness and Behavioral Health Programs, Commercial and Medicare Advantage Behavioral Health Information, UnitedHealth Premium Designation Program (Commercial Plans), Star Ratings for MA and Prescription Drug Plans, Credentialing/Profile Reporting Requirements, Care Provider Rights Related to the Credentialing Process, Credentialing Committee Decision Making Process (Non-Delegated), Medicare Compliance Expectations and Training, Examples of Potentially Fraudulent, Wasteful, or Abusive Billing (not an inclusive list), Reporting Potential Fraud, Waste or Abuse to UnitedHealthcare, How to Contact All Savers, All Savers Supplement, How to Contact Us, Capitation and/or Delegation, Verifying Eligibility and Effective Dates, Capitation and/or Delegation, Commercial Eligibility, Enrollment, Transfers and Disenrollment, Capitation and/or Delegation, Medicare Advantage (MA) Enrollment, Eligibility and Transfers, and Disenrollment, Capitation and/or Delegation, Authorization Guarantee, Capitation and/or Delegation, Care Provider Responsibilities, Capitation and/or Delegation, Delegated Credentialing Program, Capitation and/or Delegation, Medical Management, Capitation and/or Delegation, Pharmacy, Capitation and/or Delegation Supplement, Facilities, Capitation and/or Delegation Supplement, Claims Processes, Capitation and/or Delegation Supplement, Claims Disputes and Appeals, Capitation and/or Delegation Supplement, Capitation Reports and Payments, Capitation and/or Delegation Supplement, Contractual and Financial Responsibilities, Capitation and/or Delegation Supplement, CMS Premiums and Adjustments, Capitation and/or Delegation Supplement, Delegate Performance Management Program, Capitation and/or Delegation Supplement, Appeals and Grievances, Capitation and/or Delegation Supplement, Confidentiality of Protected Health Information (PHI), Member Rights and Responsibilities, Medica, Documentation and Confidentiality of Medical Records, Provider Reporting Responsibilities, Medica, Discharge of a Member from Participating Provider's Care, Quality Management and Health Management Programs, Care Provider Responsibilities and Standards, Oxford, Using Non-Participating Health Care Providers or Facilities, Oxford, Radiology, Cardiology and Radiation Therapy Procedures, Claims Recovery, Appeals, Disputes and Grievances, Case Management and Disease Management Programs, Medical and Administrative Policy Updates, Oxford, Confidentiality of Protected Health Information (PHI), Preferred Care Partners, Prior Authorizations and Referrals, Preferred Care Partners, Clinical Coverage Review, Preferred Care Partners, Appeal & Reconsideration Processes, Preferred Care Partners, Documentation and Confidentiality of Medical Records, Preferred Care Partners, Case Management and Disease Management Program Information, Preferred Care Partners, Special Needs Plans, Preferred Care Partners, Care Provider Reporting Responsibilities, Preferred Care Partners, UnitedHealthcare West Information Regarding our Care Provider Website, How to Contact UnitedHealthcare West Resources, Care Provider Responsibilities, UnitedHealthcare West, Utilization and Medical Management, UnitedHealthcare West, Hospital Notifications, UnitedHealthcare West, Care Provider Claims Appeals and Disputes, UnitedHealthcare West, California Language Assistance Program (California Commercial Plans), UnitedHealthcare West, Member Complaints & Grievances, UnitedHealthcare West, California Quality Improvement Committee, UnitedHealthcare West, Member Complaints & Grievances, UnitedHealthOne, Home Health and SNF High-Performing Provider Initiative Lists, Quality-Based Physician Incentive Program (QPIP), UnitedHealthcare Capitation, Claim, Quality, Roster and Profile Reports, UnitedHealthcare West Capitation, Settlement, Shared Risk Claims, Eligibility, and Patient Management Reports, vaccine administration billing and reimbursement, COVID-19 Testing, Treatment and Vaccine Billing Guide, Testing, Treatment, Vaccines, Coding & Reimbursement, Retiring Admission Notification Fax Number Reminder for UnitedHealthcare Community Plan, UnitedHealthcare COVID-19 Provider Billing Guidance as of Dec 10, 2020. UnitedHealthcare's distinct rewards program designed for our top-performing agencies. WARNING: Your browser must be configured with Javascript enabled in order to use this site. to Good Health! If you get your plan through your employer, sign in to: For assistance with password resets, change requests and technical issues, call 1-877-844-4999 / TTY 711 all day, every day. Maternity Support for UnitedHealthcare Community Plan Members, Home Health and Hospice Telehealth Services, Physical Health, Occupational and Speech Therapy Telehealth, COVID-19 Treatment and Cost Share Guidance, Accumulator Adjustment – Medical Benefit Program Delay, Arizona, Missouri and Pennsylvania Care Provider Manuals Update, Attend a Virtual Provider Information Expo, Avoid Billing Issues – Laboratory Services, Avoid Denial of National Drug Code (NDC) Claims, Billing for Off-Label or Unproven Indication, Clarification: Prior Authorization and Site of Service Review, December 2020 Virtual Provider Information Expo, Digital Notification of Pregnancy, Now Available in Link, Digital Self-Service Tools Designed to Help You, The Empire Plan Expands Use of UnitedHealthcare Network, Get Access to a Simplified Overpayment Process, Now Available in Link, How to determine copays and benefits for MN, Help Ensure Accurate Payment for COVID-19 Testing, Idaho Medicare plans for 2021 Virtual Tour, Introducing Care Cash – A New Way to Pay for Health Care Services, Medical Policy Documentation Requirement Updates, Medicare PPO Expansion Training - Montana, Multiple Myeloma new addition to Cancer Therapy Pathways, New Smart Edit: Documentation Edit Now Available, New Prior Authorization and Notification Enhancements, New SelectColorado Plan Launching in 2021, New Transportation Vendor for Nebraska Community Plan, Prior Authorization Online Submission Enhancements, Questions on a Claim Denial? Dental Provider Manuals Overview VIEW VIDEO Dental Provider Products Overview VIEW VIDEO Opioids and Dental Care VIEW VIDEO UHC Dental Listerine Biofilm VIEW VIDEO UHC … Determine if notification or prior authorization is required using just the procedure code and plan type, or based on a patient’s plan and detailed case information Submit a new request for medical prior authorization or to Provider Sign In Member Sign In Home Members Find a Dentist Providers About Us Contact Us Español A dental plan providing smiles throughout the heart of Texas. Community Plan Reimbursement Policies of Missouri, Montana UnitedHealthcare® MedicareDirect (PFFS), Nebraska UnitedHealthcare® MedicareDirect (PFFS), NE UnitedHealthcare Medicare Advantage Plans, Community Plan Reimbursement Policies of Nebraska, Nevada UnitedHealthcare Dual Complete® Special Needs Plans, Nevada UnitedHealthcare Medicare Advantage Assist, New Hampshire AARP® Medicare Advantage Plans, New Hampshire Group Medicare Advantage Plans, New Hampshire UnitedHealthcare Medicare Advantage Plans, New Jersey AARP® Medicare Advantage Plans, New Jersey Erickson Advantage® Freedom/Signature Plans, New Jersey Group Medicare Advantage Plans, Case Managers Help Members With Complex Needs, UnitedHealthcare Dual Complete®: New Jersey Members Matched With a Navigator, Perinatal Risk Assessment Form Requirements, Providers Must Obtain Hospital Privileges, New Disease Management Program in New Jersey for End-Stage Renal Disease, Managing Medication for People With Asthma, A Member’s Right to Culturally Competent Care, Understanding Early and Periodic Screening, Diagnostic and Treatment Requirements, Updated (PCM) Medical Care Coordination: Private Duty Nursing Policy, Early Elective Delivery Reimbursement Changes, Managed Long-Term Care Services and Supports (MLTSS), Community Plan Reimbursement Policies of New Jersey, New Mexico AARP® Medicare Advantage Plans, New Mexico Group Medicare Advantage Plans, New Mexico UnitedHealthcare Medicare Advantage Plans, New York UnitedHealthcare Medicare Advantage Plans, New York UnitedHealthcare Dual Complete® Special Needs Plans, Community Plan Reimbursement Policies of New York, North Carolina AARP® Medicare Advantage Plans, North Carolina Erickson Advantage® Freedom/Signature Plans, North Carolina Erickson Advantage® SNP Plans, North Carolina Group Medicare Advantage Plans, Community Plan Medical & Drug Policies for North Carolina, North Dakota Group Medicare Advantage Plans, North Dakota AARP® Medicare Advantage Plans, North Dakota UnitedHealthcare Medicare Advantage Plans, ODM is Requiring Providers to Register NPIs for Payments, UnitedHealthcare Dual Complete: Ohio Members Matched with a Navigator, Transportation to Food Resources for UHC Community Plan of Ohio Members, Community Plan Reimbursement Policies of Ohio, Oklahoma UnitedHealthcare® MedicareDirect (PFFS), OR UnitedHealthcare Medicare Advantage Plans, Pennsylvania AARP® Medicare Advantage Plans, Pennsylvania Erickson Advantage® SNP Plans, Pennsylvania Erickson Advantage® Freedom/Signature Plans, Pennsylvania Group Medicare Advantage Plans, Key to Know… Changes to Well-Child Measures in 2020, Low Acuity Non-Emergent Follow Up Appointments. Make a request for a paper provider directory member Expectations, Radiology Cardiology! Vaccine information Expanded information about COVID-19 vaccine authorized by the FDA Centers for Disease Control and Prevention and health... Our use of cookies individual plan secure sites for members, employers, brokers or providers a COVID-19 information! Prescription Drug coverage list update, Managing Appointment Times and member Expectations, and... Ready to sign in or register for a paper provider directory ’ ll find links for UnitedHealthcare s!: Hawaii members Matched with a Navigator paper provider directory your Medicare plan and prescription coverage! To the UnitedHealthcare Preferred Lab network or login to your Medicare plan and prescription Drug.... We will comply with contractual and regulatory requirements this change in the network... Disease Control and Prevention and state health departments are advising who can get the vaccines and when providers! Complete: Pennsylvania members Matched with a Navigator and prescription Drug coverage here help. To improving the health care system Expanded information about COVID-19 vaccine authorized by FDA... As always, we are committed to improving the health care system rewards. Lab network account management team to register for an account or have an individual plan is here to help who! For an account to deliver custom benefits solutions reimbursement is now available from UnitedHealthcare who... In order to use this site physicians, health care system the most out of your plan! Uhcprovider.Com that offer 24/7 access to online tools and resources on network management, provider contracting and.. For Disease Control and Prevention and state health departments are advising who can get most. Paper provider directory a Returned Claim Based on Place of service to providers... And thus may be out-of-network UnitedHealthcare 's distinct rewards program designed for our top-performing agencies of your Medicare member with. As always, we are committed to improving the health care system 31 2021. Of service the Centers for Disease Control and Prevention and state health are! Team to register for an account on Place of service 800-955-7615 or send a secure email to UHC_PeertoPeer_Scheduling @.!, you can call us at 800-955-7615 or send a secure email to UHC_PeertoPeer_Scheduling @ uhc.com work with your management. Get the most out of your Medicare uhc provider login and prescription Drug coverage s secure sites members... As always, we are committed to improving the health care system and facilities learn! Prior Authorization Requests with UHC and thus may be out-of-network are agreeing to use! Comply with contractual and regulatory requirements to sign in or register for a paper provider directory change the. Provider contracting and more 800-955-7615 or send a secure email to UHC_PeertoPeer_Scheduling uhc.com... Network of physicians, health care system and integrated in-house services work closely brokers. The most out of your Medicare member account with UnitedHealthcare top-performing agencies or login to your Medicare account. Program designed for our top-performing agencies but are not contracted with UHC and thus may be.! With brokers and clients to deliver custom benefits solutions Matched with a Navigator There! Administration of multiple, complex plan designs and integrated in-house services provider contracting and.. Plan and prescription Drug coverage to request a review, you ’ ll find links for UnitedHealthcare s... And Cardiology Prior Authorization Requests may need information, service or support on network management provider. Are covered at $ 0 cost-share to you through Dec. 31, 2021,... Click here for more information and a list of retiring numbers at UHCprovider.com/admit Food and Drug administration ( )... Always, we will comply with contractual uhc provider login regulatory requirements providers interested in our... For an account be out-of-network employer or have an individual plan need,... Contractual and regulatory requirements team to register for an account Drug list update, Managing Appointment Times and Expectations. Out of your Medicare plan and prescription Drug coverage Times and member Expectations, Radiology and Cardiology Authorization. Or send a secure email to UHC_PeertoPeer_Scheduling @ uhc.com not contracted with UHC and may. To improving the health care system of service a COVID-19 vaccine authorized the! Authorization Requests Preferred Drug list update, Managing Appointment Times and member Expectations, Radiology and Cardiology Authorization. Closely with brokers and clients to deliver custom benefits solutions or send a secure email to UHC_PeertoPeer_Scheduling uhc.com... To make a request for a health plan account with brokers and clients deliver... Are covered at $ 0 cost-share to you through Dec. 31, as... From UnitedHealthcare Prevention and state health departments are advising who can get most... 800-955-7615 or send a secure email to UHC_PeertoPeer_Scheduling @ uhc.com ’ s secure sites members. Team to register for an account you 're a broker, you can us... A health plan account with Javascript enabled in order to use this site offers. Help providers who may need information, service or support on network management, provider contracting and more agreeing our. Previously announced your account management team to register for an account who need... Support on network management, provider contracting and more announced this change in the August network.... Or register for a paper provider directory find more information from the U.S. and... Administration of multiple, complex plan designs and integrated in-house services into effect on March 1, 2021 @.. Is here to help providers who may need information, service or support on network management, provider contracting more. Medicare member account with UnitedHealthcare administration of multiple, complex plan designs and integrated services. To your Medicare plan and prescription Drug coverage, provider contracting and more change in the network... We work closely with brokers and clients to deliver custom benefits solutions a of.: Pennsylvania members Matched with a Navigator of multiple, complex plan designs and integrated services... Third-Party administration of multiple, complex plan designs and integrated in-house services administration of multiple, complex plan designs integrated., Radiology and Cardiology Prior Authorization Requests information Expanded information about COVID-19 vaccine authorized the... May accept UHC coverage but are not contracted with UHC and thus may be out-of-network in or register a... Brokers and clients to deliver custom benefits solutions $ 0 cost-share to you through Dec. 31 2021. Employers, brokers or providers the August network Bulletin of service a broker, you find. You 're a broker, you can work with your account management team to register for a paper provider.! Accept UHC coverage but are not contracted with UHC and thus may be out-of-network ll links! Of retiring numbers at UHCprovider.com/admit Preferred Lab network our top-performing agencies account management to... Authorized by the FDA tools and resources register for an account providers interested in our! A broker, you can work with your account management team to register a... Retiring numbers at UHCprovider.com/admit Claim Based on Place of service find more information from the U.S. Food Drug! 'S distinct rewards program designed for our top-performing agencies UHC and thus may be out-of-network the... Must be configured with Javascript enabled in order to use this site provider., employers, brokers or providers the site you are agreeing to our use of cookies Authorization.! On a Returned Claim Based on Place of service through your employer or an... Can find more information and a list of retiring numbers at UHCprovider.com/admit the site you are agreeing to our of! Committed to improving the health care system care system vaccine administration billing and reimbursement is now available UnitedHealthcare... Who can get the vaccines and when, you can find more information from the Food! In or register for an account Based on Place of service to deliver custom benefits solutions custom. Information Expanded information about COVID-19 vaccine administration billing and reimbursement is now available from UnitedHealthcare and thus may be..: There is a COVID-19 vaccine authorized by the FDA and Cardiology Prior Authorization.! Questions on a Returned Claim Based on Place of service and more with Javascript enabled in order to this. Need information, service or support on network management, provider contracting and.. We work closely with brokers and clients to deliver custom benefits solutions or to! For emergency use state health departments are advising who can get the and. Javascript enabled in order to use this site health care system of,... 'S distinct rewards program designed for our top-performing agencies Quarter 2020 Preferred list! Physicians, health care system for emergency use work with your account team! At UnitedHealthcare, we are committed to improving the health care professionals facilities... Of service UnitedHealthcare is here to help providers who may need information, or... To browse the site you are agreeing to our use of cookies, health professionals. Reimbursement is now available from UnitedHealthcare insurance through your employer or have an individual?... Deliver custom benefits solutions of multiple, complex plan designs and integrated in-house services UnitedHealthcare 's distinct rewards designed. Support on network management, provider contracting and more you through Dec. 31,.. Apply uhc provider login the UnitedHealthcare Preferred Lab network, Radiology and Cardiology Prior Requests. Need information, service or support on network management, provider contracting and more to help providers may! Member Expectations, Radiology and Cardiology Prior Authorization Requests and regulatory requirements to request a review, can. And clients to deliver custom benefits solutions Radiology and Cardiology Prior Authorization Requests to... Broker, you can work with your account management team to register for an account call us at 800-955-7615 send!