UnitedHealthcare Community Plan of Arizona
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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Resources
ACC/DD/Dual Complete One Provider Call Center
800-445-1638, available from 8:00 a.m. - 5:00 p.m. MT
LTC Provider Call Center
800-293-3740, available from 8:00 a.m. - 5:00 p.m. MT
Arizona Therapy Provider Resolution Team
Email: netdevpubsec@optum.com for claims issues
Include “NPC (AZ)”/ Name/TIN/examples and a brief description of issue
Fee Schedules: myoptumhealthphysicalhealth.com > Tools and Resources > Fee Schedules
Therapy Provider Call Center: 800-873-4575
Mailing address
UnitedHealthcare Community Plan
1 East Washington, Suite 900
Phoenix, AZ 85004
Claims and medical records mailing address
UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290
Behavioral health claims and medical records mailing address
United Behavioral Health
PO Box 30760
Salt Lake City, UT 84130-0760
Provider claim disputes mailing address
UnitedHealthcare Community Plan
Attn: Provider Claim Disputes
1 East Washington, Suite 900
Phoenix, AZ 85004
UnitedHealthcare Dual Complete One (HMO-SNP) provider claim disputes mailing address
UnitedHealthcare Dual Complete
Attn: Provider Claim Disputes
PO Box 31364
Salt Lake City, UT 84131-0364
UnitedHealthcare Dual Complete One (HMO-SNP) Part C Member Appeals and Grievance department
Attn: CA124-0187
PO Box 6103
Cypress, CA 90630-0023
UnitedHealthcare Dual Complete One (HMO-SNP) Part D Member Appeals and Grievance department
Attn: CA124-0197
PO Box 61063
Cypress, CA 90630
If you have patients who have been affected by a closure of a resident facility or sober living house, please direct them to contact one of the following numbers:
- For closure of a residential facility or sober living home: Call 211, then press 7
- For immediate mental health assistance: Call 988
- For emergency services or protection if unsafe: Call 911
For more information about the credentialing process for network care providers, please read the AHCCCS Credentialing Tip Sheet. Learn more about Joining our network here.
Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.
Member dental plan and benefit information can be found at UHCcommunityplan.com/AZ and myuhc.com.
Dental practitioners who are currently serving Medicaid plans can access Community Plan dental information by logging into uhcdental.com under Medicaid.
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.
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.
Visit UHCcommunityplan.com/AZ for current member plan information including member handbooks, sample member ID cards, provider directories, dental plans, vision plans and more.
Plan information is available for:
- Arizona Complete Care/Medicaid
- Arizona Developmentally Disabled (DD)
- Arizona Long Term Care
Member plan and benefit information can also be found at UHCcommunityplan.com/AZ and myuhc.com/communityplan.
Member eligibility
Verify member eligibility through AHCCCS Online/State of Arizona.
The Division of Developmental Disabilities services are based on age and specific eligibility based on federal requirements and referral/application processes. See details.
CommunityCare
The best way for primary care providers (PCPs) to view and export the full 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 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 in the UnitedHealthcare Provider Portal, please see our user guide. If you’re not familiar with UnitedHealthcare Provider Portal, visit our portal resources page.
Reporting fraud, waster 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 844-359-7736 or visit uhc.com/fraud to report any issues or concerns.
How to report fraud, waste or abuse to the State of Arizona
The Office of Inspector General for the State of Arizona provides a way for members, plans, providers and the public to report all forms of suspected fraud, waste or abuse of the program. We encourage medical professionals and their staff to review the information available on the AHCCCS website.
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 UnitedHealth Group 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.