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.
We are committed to delivering services that are culturally appropriate and sensitive to meet our member’s needs. Per legislation passed in 2024, interpretation services billed by providers will be a covered service retroactive to July 1, 2024, in line with guidance from Nebraska Medicaid and Long-Term Care.
Billing guidance for interpretation services will align to Nebraska Medicaid and Long-Term Care direction.
As per legislative mandate, this advisory is being issued to notify Medicaid providers that the Prenatal Plus Program (PPP) will be implemented January 1, 2025.
Provider Call Center
866-331-2243, available Monday - Friday from 7:00 am - 6:00 pm CST (6:00 am - 5:00 pm MST)
Mailing Address
UnitedHealthcare Community Plan
2717 N 118th Street, Suite 300
Omaha, NE 68164
Claims Mailing Address
UnitedHealthcare
PO Box 31365
Salt Lake City, UT 84131
Utilization Denial & Appeals Department Mailing Address
National A&G Service Center
PO Box 31365
Salt Lake City, UT 84131
Claims Appeals Mailing Address
Appeals
UnitedHealthcare Community Plan Appeals
PO Box 31365
Salt Lake City, UT 84131
For questions about Credentialing and Attestation updates, connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.
Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.
Health care professionals seeking initial credentialing with any managed care organization for Nebraska Medicaid should use the newly implemented centralized credentialing process along with a NCQA-certified centralized verification organization (CVO).
The CVO, Verisys, conducts 1 streamlined verification process for all 3 Nebraska managed care organizations (MCOs). A centralized credentialing system helps reduce administrative tasks by eliminating the need to perform a unique credentialing process with each MCO. However, providers are required to submit an individual application for each MCO if they wish to credential with.
Recredentialing using the new process is underway. You’ll receive a mailed letter from Verisys. It should arrive 6 months prior to your recredentialing due date. The CVO performs recredentialing every 3 years.
Who’s required to participate
Who’s excluded
Care providers out of scope for centralized credentialing need to follow UnitedHealthcare credentialing guidelines.
Step 1:
If you choose not to use CAQH, you can submit a paper application to Verisys:
Step 2:
Step 3:
Step 4:
Sign in to the provider portal with your One Healthcare ID. This allows you to access self-service tools and you can connect with us by visiting our contact resources. Please have the care provider’s full name, tax ID number (TIN) and national provider identifier (NPI) number available.
Nebraska Medicaid and Long-Term Care (MLTC) has expanded Medicaid coverage under the Heritage Health Adult (HHA) Expansion program. The HHA program expands Medicaid coverage to adults, ages 19–64, whose income is at or below 138% of the federal poverty level. Heritage Health Adult members are enrolled in managed care plans through the existing Heritage Health program and are eligible for the same benefit package. This includes comprehensive medical, behavioral health and prescription drug coverage as well as vision services, dental services and over-the-counter (OTC) medication benefits.
Resources
The Nebraska Department of Health and Human Services (DHHS) also has information on the Medicaid expansion available at dhhs.ne.gov.
The Known Issues Log is a current list of open and closed known global claims issues. For questions related to open issues, reach out to your Provider Advocate or call Provider Services at 866-331-2243.
| Open Issues | |||
|---|---|---|---|
| Description | Impacted provider type | Resolution status | Estimated completion date |
| No open issues. | |||
Nebraska Title V Program Overview
Overview of Nebraska’s Title V Maternal and Child Health (MCH) Program, including goals, funding, and services for women, children, and youth with special health care needs
Title V Needs Assessment Summary and Priorities
Details the five-year needs assessment process and outlines Nebraska’s current MCH priority areas, including access to care, behavioral health, and chronic disease prevention
2025 Title V Block Grant Application and Annual Report
Central hub for lead poisoning prevention resources, including testing guidelines, risk assessment tools, and educational materials for healthcare providers
Nebraska DHHS Lead Program (Provider Resources)
Tools and guidance for providers on lead screening, testing, and follow-up care
Nebraska Blood Lead Testing Plan (PDF)
Outlines Nebraska’s statewide strategy for blood lead screening, including testing recommendations for children ages 2–6 and follow-up protocols
Visit UHCCommunityPlan.com/NE for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.
Plan information is available for:
Member plan and benefit information can also be found at UHCCommunityPlan.com/NE and myuhc.com/communityplan.
The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:
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.
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:
For help using CommunityCare feature on the UnitedHealthcare Provider Portal, please see our quick reference guide. If you’re not familiar with UnitedHealthcare Provider Portal, visit our Portal resources page.
Search for a care provider by plan name:
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.
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.
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.
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.
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.