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UnitedHealthcare Community Plan of Idaho

Last update:  June 3, 2025

We know providers 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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State news, bulletins and alerts

  • 06.03.2025 - If you are a Federally Qualified Health Center (FQHC), rural health clinic (RHC), hospital, primary care provider, specialist or ancillary provider submitting claims to Idaho Medicaid Plus (IMPlus) as a secondary payer, please be aware that your network status may display as out of network. However, secondary claims from out-of-network providers will still be accepted and reimbursed. This policy does not apply to providers billing IMPlus as the primary payer.
  • 05.29.2025 – Available now! Register for the UnitedHealthcare Provider Portal and enroll in a virtual payment option.

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Prior authorization and notification

Access prior authorization and notification information.

Current policies and clinical guidelines

Guidelines for our quality and health management programs. 

Provider Administrative Manual and Guides

Helpful information on topics such as prior authorization, processing claims and protocols.

Claims and payments

Online tools and resources to help you manage your practice’s claim submission and payment.

Provider forms and references

Stay up to date with forms, reference guides that are important to your practice.

Pharmacy resources and physician-administered drugs

Find pharmacy information related to prescription drugs.

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Idaho IMPlus Provider Services 

Phone: 855-857-9753

One Healthcare ID support

Phone: 855-819-5909

For questions about credentialing and attestation updates, connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.

Behavioral health providers

Learn how to join the behavioral health network, review behavioral health information or submit demographic changes at Community Plan Behavioral Health.

Medical providers including facility/hospital-based, group/practice, individual clinicians, and ancillary providers

The state-specific requirements and process on how to join the UnitedHealthcare Community Plan network are 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.

Member plan and benefit information can also be found on our UnitedHealthcare Community Plan member page.

 

Provider directories

Visit the Idaho Department of Health and Welfare website to enroll as a Idaho Medicaid provider.

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.  

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.