UnitedHealthcare Community Plan of Tennessee

The best way for primary care professionals (PCPs) to manage Tennessee UnitedHealthcare Community Plan and UnitedHealthcare Dual Complete member care is using the Care Conductor tool on the UnitedHealthcare Provider Portal, which allows PCPs to:

• View a member’s plan of care and health assessment
• Enter plan notes and view notes history for some plans

For more information about Care Conductor, sign in to the UnitedHealthcare Provider Portal.

CommunityCare

The best way for primary care professionals (PCPs) to view and export the full Tennessee UnitedHealthcare Community Plan and UnitedHealthcare Dual Complete member roster is using the CommunityCare feature on the UnitedHealthcare Provider Portal, which allows PCPs to:

• See a complete list of all members, or members added in the last 30 days
• Export the roster to Excel
• Access information about patients admitted to or discharged from an inpatient facility
• Access information about patients seen in an Emergency Department

For help using CommunityCare on the UnitedHealthcare Provider Portal, please see our CommunityCare Training.

If you’re new to the UnitedHealthcare Provider Portal, please visit our portal registration page.

Provider Services

Call 800-690-1606, Monday–Friday, 8 a.m.–6 p.m. ET.

Mailing addresses 

Postal mailing address
UnitedHealthcare Community Plan
10 Cadillac Drive, Suite 200
Brentwood, TN  37027

Claims address
UnitedHealthcare Community Plan
P.O. Box 5220
Kingston, NY 12402

Utilization Management Appeals address
UnitedHealthcare Community Plan
P.O. Box 5220
Kingston, NY 12402

Part C Claims Appeals and Grievance Department
UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131-0364

Part D Appeals and Grievance Department
Attn: CA124-0197
P.O. Box 6106
Cypress, CA 90630-9948

If you have questions for the Applied Behavior Analysis (ABA) Utilization Management team:

• Call the Customer Service on the back of the member ID card
• Email tn_medicaid_aba@uhc.com

If you'd like to join the network, contact our provider relations or network strategy team at TN–uhccp_bhnetwork@uhc.com.

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.

Integrity of claims, reports and representations to the government

UnitedHealthcare 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 TennCare's policy related to fraud and the Federal and State False Claims Act.

To report fraud, waste or abuse concerns, you can call 800-690-1606 (UnitedHealthcare Community Plan tipline) or 800-433-3982 (Division of TennCare & Office of Inspector General). Or, you can report fraud, waste and abuse concerns at the EthicsPoint - UnitedHealthcare Fraud, Waste and Abuse Hotline.

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 844-359-7736 or visit uhc.com/fraud to report any issues or concerns.

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. 

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 the Tennessee Community Plan page for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.

Plan information is available for:

• UnitedHealthcare Community Plan – TennCare

Member plan and benefit information can also be found at myuhc.com/communityplan.

Member rights and responsibilities

The UnitedHealthcare Community Plan member rights and responsibilities can be found in the Provider Manual. Member rights and responsibilities are distributed to new members upon enrollment. On an annual basis, members are referred to their handbook to review them.

Search for a provider

• UnitedHealthcare Community Plan of Tennessee
• UnitedHealthcare Dual Complete® (HMO SNP) and UnitedHealthcare Dual Complete® ONE (HMO SNP)

Referral provider listings by region

• Referral Provider Listing - East 
• Referral Provider Listing - Middle 
• Referral Provider Listing - West 
  
• Referral Provider Listing - Home and Community Based Services Providers

Need to make a change to your provider or facility directory information? 

Visit the provider data updates and attestation page

TennCare

UnitedHealthcare Community Plan members can access and manage their TennCare benefit information online with TennCare Connect.

Resources

• TennCare Kids / EPSDT Coding Program overview
• TennCare Kids
• Tennessee Chapter of the American Association of Pediatrics (TNAAP)
  
  

Immunization Schedules

• Child / adolescent
• Adult

COVID-19 vaccine information and resources

• Get the latest COVID-19 vaccine information and FAQs from the TN Department of Health
• TennCare: COVID-19 Prevention and Response Guidance