Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Kentucky

Welcome

For UnitedHealthcare Community Plan of Kentucky

UnitedHealthcare Community Plan of Indiana Homepage

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.”

Prior Authorization and Notification Resources

Current Policies and Clinical Guidelines

Provider Administrative Manual and Guides

For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.

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

If you have questions about KHIE or want to begin the connection process, please email us at KHIE@ky.gov, call us at 502-564-7992 EXT 2800 or find us online https://khie.ky.gov/Pages/index.aspx.

Overview

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.

Helpful Resources

Pediatric Care Network will provide delegated medical management services for UHC Community Plan Pediatric Care Network members including case management, utilization management and disease management. Resources are available for providers including reference guides, office forms, frequently asked questions and more.

View Pediatric Care Network Provider Resources

Reporting Fraud, Waste or Abuse to Us

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.  

Current News, Bulletins and Alerts

  • Bulletins and Newsletters

    Last Modified | 11.12.2020

    Recent news, alerts and bulletins offering important informational updates for Indiana Community Plan providers.

    Learn More
  • Last Modified | 07.27.2020

    Recent news, alerts and bulletins offering important informational updates for Kentucky Community Plan providers.

    Learn More
  • Last Modified | 04.03.2020

    Learn more about joining the UnitedHealthcare Provider Network, along with information on credentialing and recredentialing processes. We're always looking for health care professionals who share our commitment to providing plan members with quality, safe and cost-efficient care.

    Learn More
  • Last Modified | 03.18.2020

    In response to the COVID-19 public health emergency, UnitedHealthcare is expanding its telehealth policies effective immediately. We’re closely monitoring national and local updates from the Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services (CMS) and other outlets to adjust our policies as needed.

    Learn More
  • Last Modified | 03.18.2020

    Effective immediately, United Healthcare is expanding our policies around telehealth services for our Medicare Advantage, Medicaid, and Commercial membership, making it even easier for patients to connect with their health care provider.

    Learn More
Bulletins and Newsletters

Last Modified | 11.12.2020

Recent news, alerts and bulletins offering important informational updates for Indiana Community Plan providers.

Learn More
Bulletins and Newsletters

Last Modified | 07.27.2020

Recent news, alerts and bulletins offering important informational updates for Kentucky Community Plan providers.

Learn More
Join Our Network

Last Modified | 04.03.2020

Learn more about joining the UnitedHealthcare Provider Network, along with information on credentialing and recredentialing processes. We're always looking for health care professionals who share our commitment to providing plan members with quality, safe and cost-efficient care.

Learn More
Coronavirus (COVID-19) Telehealth Services Frequently Asked Questions

Last Modified | 03.18.2020

In response to the COVID-19 public health emergency, UnitedHealthcare is expanding its telehealth policies effective immediately. We’re closely monitoring national and local updates from the Centers for Disease Control and Prevention (CDC), Centers for Medicare & Medicaid Services (CMS) and other outlets to adjust our policies as needed.

Learn More
Provider Telehealth Policies

Last Modified | 03.18.2020

Effective immediately, United Healthcare is expanding our policies around telehealth services for our Medicare Advantage, Medicaid, and Commercial membership, making it even easier for patients to connect with their health care provider.

Learn More
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Accredited NCQA Health Plan Accredited NCQA Health Plan

HEDIS Medical Record Collection

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. View our updated HIPAA information for UnitedHealthcare Community Plan.

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. View our policy.

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.