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.
COVID-19 Resources for Providers
- Important Information from UnitedHealthcare onCOVID-19
Prior Authorization and Notification Resources
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Current Policies and Clinical Guidelines
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Provider Administrative Manual and Guides
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UnitedHealthcare Community Plan of Oklahoma SoonerSelect ContentComing Soon
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Contact Us
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Provider Services Call Center:
Phone: 800-301-5547
Hours of Operation: 8 a.m. – 5 p.m. CT, Monday - Friday,
Provider Advocate Team:
To check the status of your credentialing application,Sign Inwithyour One Healthcare ID. This allows you to access self-servicetools or connect to a chat advocate for support.Please have the care provider’s full name, Tax ID, and National Provider Identifier (NPI) available.
Behavioral Health Services:
Phone: 800-888-2998
Online: Providerexpress.com
Pharmacy Services:
Phone: 800-813-4713 (OptumRx)
Online: Professionals.optumrx.com
Prior Auth Phone: 800-310-6826
Non-Emergent Transportation Services:
Phone: 877-718-4215
MARCH Vision Care:
Phone: 844-796-2724
Online Reference Guides: marchvisioncare.com
Online: providers.eyesynergy.com
Nurseline (available anytime):
Phone: 866-744-6341
Claims Address:
UnitedHealthcare Claims
P.O. Box 5290
Kingston, NY 12402-5290
Multilingual/Telecommunication Device for the Deaf (TDD) Services:
Phone: 888-265-1078 (members)
Phone: 800-301-5547 (providers)
TDD 711
Technical Support:
Phone: 866-209-9320
Credentialing and Attestation
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For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
Join Our Network
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For more Information on the Oklahoma Health Care Authority Enrollment Requirements for enrolling in SoonerCare, please visit -https://oklahoma.gov/ohca/providers/provider-enrollment.html
We appreciate your interest in Joining our network. - We have 4 easy steps to join our network
Get Started
Member Information: Current Medical Plans, ID Cards, Provider Directories, Dental & Vision Plans
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For more information about the SoonerSelect program, please visit:https://oklahoma.gov/ohca/soonerselect.html
UnitedHealthcare Community Plan website will have more information available by 7/1/2021
Visit UHCCommunityPlan.com/OKfor 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 atUHCCommunityPlan.com/OKandmyuhc.com/communityplan.
Medicaid Managed Care Rule
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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.
Reporting Health Care Fraud, Waste and Abuse
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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.Ifyou 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 at1-844-359-7736or visituhc.com/fraud to report any issues or concerns.
PCP Membership Reports
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CommunityCare
The best way for primary care providers (PCPs) to view and export thefull member roster is using the CommunityCare feature on 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 MedicareSpecial 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 ourQuick Reference Guide.If you’re not familiar with UnitedHealthcare Provider Portal, go toUHCprovider.com/portal.
CommunityCare Overview
UnitedHealthcare Dual Complete® Special Needs Plan
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.
Learn more about the Dual Special Needs Program
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.
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 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.
