This provider directory is current as of the date on the front cover, but listing a health care provider does not guarantee their continued status as a participating physician or health care provider. Additionally, many of our Member Services representatives speak multiple languages, so when you call they will be able to help … Also, when visiting a specialist, be sure to identify yourself as a member and present your ID card. UnitedHealthcare Community Plan displays the words “Quality Doctor” with the symbol in our provider search tools and MO HealthNet Managed Care member directories. Find commercial medical, vision, dental and behavioral health providers based on plan and provider type within a geographic area for UnitedHealthcare West. If you would like a copy of the member handbook or provider directory, please call Member Services at 1-800-941-4647 (TTY: 711). If a dentist you prefer is outside of the network, check with your plan to see how much your services may cost. If you are experiencing a behavioral health crisis call one of the phone numbers below that matches the county you live in. Individuals can also report potential inaccuracies via phone. In addition, you can use the directory to identify your practice’s tiered status for members with a NexusACO tiered benefit plan. UnitedHealthcare Dual Complete: Pennsylvania Members Matched with a Navigator. Provider Directory Directorio de proveedores Arizona 1/6/2021 CSAZ.18.999.01.9.017. This directory includes care providers who serve our Commercial, Medicaid / Community Plan (excludes United Healthcare Community Plan of Rhode Island) and Medicare members. Behavioral health services can help you with personal problems that may affect you and/or your family. Once there, select "NJ UnitedHealthcare Community Plan" to access a list of in-network dentists. © 2021 UnitedHealthcare Services, Inc. All rights reserved. information in the online or paper directories. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Medicare evaluates plans based on a 5-Star rating system. In an emergency, call 911 or go to the nearest emergency room. Print ID cards, chat with a nurse online, and more. This provider directory lists Home and Community Based Service Providers in our network you can use to get care. Sample Provider Listing All of the information in these provider listings is based upon the provider's application. UnitedHealthcare Connected (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees. Medicare PFFS plans that provide dental coverage typically do … A member, a representative of the member's choice, or a CCN-S provider, acting on behalf of the member with the member's written consent, may file a grievance with UnitedHealthcare Community Plan. Benefits and/or copayments may change on January 1 of each year. Questions on a Returned Claim Based on Place of Service? The Centers for Disease Control and … Using this Provider Directory To find a doctor, choose the county you want in the table of contents. Information to clarify health plan choices for people with Medicaid and Medicare. You’re Invited to Provider Information Expo! It is not a complete list of network providers available to you. UnitedHealthcare benefit plans for exchanges, Patient care coordination and case management, 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, Individual 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, Optum specialty medication guidance program (commercial plans – not applicable to UnitedHealthcare West), Coverage of self-infused/injectable medications under the pharmacy benefit, Non-Emergent ambulance ground transportation, Risk adjustment data – MA and commercial, Medicare Advantage claim processing requirements, Special reporting requirements for certain claim types, Medical records standards and requirements, Commercial health services, wellness and behavioral health programs, Commercial and Medicare Advantage behavioral health information, UnitedHealth Premium® 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), Monitoring of network care providers and health care professionals, 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, Network Bulletin: Policy and protocol updates, 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 (CA Commercial only), Capitation and/or delegation, Delegated credentialing program, Capitation and/or delegation, Virtual Visits (Commercial HMO plans – CA only), 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, Contractual and financial responsibilities, Capitation and/or delegation supplement, Capitation reports and payments, 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, Prior authorization and notification requirements, 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, How to contact us - Oxford Level-Funded plans (NJ and CT) - 2021 UnitedHealthcare Administrative Guide, Our claims process - Oxford Level-Funded plans (NJ and CT) - 2021 UnitedHealthcare Administrative Guide, How to submit your reconsideration or appeal- Oxford Level-Funded plans (NJ and CT) - 2021 UnitedHealthcare Administrative Guide, Confidentiality of Protected Health Information (PHI), Preferred Care Partners, Prior authorizations and referrals, Preferred Care Partners, Clinical coverage review, Preferred Care Partners, Appeal and 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, Information regarding the use of this supplement, 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 and grievances, UnitedHealthcare West, California Quality Improvement Committee, UnitedHealthcare West, Member complaints and 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, United Healthcare Community Plan of Rhode Island, Search for Care Providers in the General UnitedHealthcare Plan Directory, View More Demographic Information Update Resources, Search the NexusACO Care Provider Directory, Optum Behavioral Health, EAP, Worklife & Mental Health Services, Optum's Complex Medical Centers of Excellence Provider Network, Search for a pharmacy in the OptumRx network, Relative Cost of Network Providers Referral Tool, Access the UnitedHealthcare General Provider Directory, Learn more about Relative Cost of Network Providers, UnitedHealthcare of California Ancillary Care Provider Referral Directory, Select the UnitedHealthcare of California Ancillary Care Provider Referral Directory of Your Choice, UnitedHealthcare West (SignatureValue) Commercial Physician Directory, Around The Clock Home Health Care Termination – Effective Dec. 16, 2019, Deere Premier Network Providers (Use ONLY for John Deere Group Number 709335), UnitedHealthcare Retiree Medicare Physician Directory. Using this Provider Directory To find a doctor, choose the county you want in the table of contents. Use the app to make demographic changes just one time, in one place – and get those updates into our systems more quickly. information in the online or paper directories. For the most up-to-date information … In addition, you'll find directories for mental health clinicians and facilities. Optum's Centers of Excellence networks are the gold standard in complex health care. Visit the State of Arizona site for more information on eligbility and enrollment. UnitedHealthcare … Brand and/or generic may be excluded from coverage. (Specialty is the area of medicine in which this doctor is highly trained. This Provider Directory lists participating providers in the UnitedHealthcare Health & Home Connection network. This means some of your patients will be switched to UnitedHealthcare Community Plan on Jan. 1st, 2021. The document below tells you what a real emergency is and provides a list of many urgent care centers that you can use. Llame al 1-800-905-8671 TTY 711. Starting on that date, please submit claims for these members to us. UHC Members should call the number on the back of their ID card, and non-UHC members can call 888-638-6613 TTY 711. If you don't already have this viewer on your computer, download it free from the Adobe website. ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities. This manual also includes important phone numbers and websites on the How to Contact Us page. UnitedHealthcare Connected™ for MyCare Ohio (Medicare-Medicaid Plan), UnitedHealthcare Connected™ (Medicare-Medicaid Plan), UnitedHealthcare Connected Benefit Disclaimer, UnitedHealthcare Senior Care Options (HMO SNP) Plan, General Provider and Facilities Directory, Non-Discrimination Language Assistance Notices. to Good Health! AHCCCS Complete Care assigned to UnitedHealthcare Community Plan will receive all of their behavioral health care from UnitedHealthcare Community Plan with the exception of the first 23 hours of crisis care. We have made every effort to ensure a correct listing, but errors can happen with a … PDF (Portable Document Format) files can be viewed with Adobe® Reader®. UnitedHealthcare Connected has a Model of Care approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2017 based on a review of UnitedHealthcare Connected’s Model of Care. Monday – Friday from 8 a.m. – 5 p.m.Â. UnitedHealthcare Dual Complete: Hawaii Members Matched with a Navigator. The doctor trains in this area of … Lower-cost options are available and covered. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. Search for a dental provider. Welcome to UnitedHealthcare Community Plan Providers listed in this directory are current as of the date listed on the cover. Your plan PROVIDER DIRECTORY This directory provides a list of your plan’s network providers. Machine Readable UnitedHealthcare Community Plan AZ Statewide Provider Directory, LabCorp – Find a LabCorp Patient Service Center Location. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. 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, Benefit enhancements for Rhode Island dual special needs plan (DSNP), 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, South Dakota UnitedHealthcare 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, TennCare Is Waiving Risk-Sharing Payments for 2019 Episodes of Care in Response to COVID-19, UnitedHealthcare Dual Complete: Tennessee Members Matched With a Navigator, 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, TX UnitedHealthcare Medicare Advantage Ally Special Needs, Texas UnitedHealthcare Medicare Advantage Plans, 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, Vermont UnitedHealthcare Medicare Advantage Plans, Virginia Erickson Advantage® Freedom/Signature Plans, 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, Benefit enhancements for Washington dual special needs plan (DSNP), Pregnancy Intention Screening: Family Planning for Social Change, UnitedHealthcare Dual Complete: Washington Members Matched With a Navigator, Community Plan Reimbursement Policies of Washington, West Virginia AARP® Medicare Advantage Plans, West Virginia Group Medicare Advantage Plans, Wisconsin AARP® Medicare Advantage Plans, Wisconsin UnitedHealthcare Medicare Advantage Assist plans, Benefit enhancements for Wisconsin dual special needs plan (DSNP), 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 2021 Administrative Guide, Quick reference guide 2021 Administrative Guide, Manuals and benefit plans referenced in the guide, Online/interoperability resources and how to contact us, Verifying eligibility, benefits and your network participation status, Healthcare plan identification (ID) cards, 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, Member dismissals initiated by a PCP (Medicare Advantage), Individual marketplace vs. small business health options program marketplace, UnitedHealthcare’s participation in Exchanges. 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