Search

print Print

UnitedHealthcare Community Plan of Washington 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.

To submit and manage your prior authorizations, please sign in to the UnitedHealthcare Provider Portal.

Sign in

Are you a member looking for health plan or provider information?

Sign in to myuhc.com

Prior Authorization and Notification Resources

Learn More

Current Policies and Clinical Guidelines

Learn More

Provider Administrative Manual and Guides

Learn More
Expand All add_circle_outline
Collaborative Care Model

Overview

The University of Washington’s Collaborative Care Model is an integrated, evidence-based approach that aims to bring together primary care providers and behavioral health care providers to deliver care to eligible members. The Collaborative Care Model gives the PCP access to additional care management support and regular psychiatric consultation for members receiving behavioral health treatment. The Washington State Health Care Authority and UnitedHealthcare Community Plan are encouraging care providers to learn more about how they may integrate this model into their practice.

Interested? The first step is to submit an attestation – Washington State Health Care Authority form 13- 0017 – to become an approved collaborative care provider for UnitedHealthcare Community Plan members. Email the form to us at WAcollaborativecare@uhc.com. After that, one of our Transformation Advocates will contact you.

Helpful Resources 

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.

UnitedHealthcare is here to help your practice successfully transition to the integrated managed care (IMC) clinical care model.

If you have any questions, please contact the clinical practice performance consultants at WACollaborativeCare@uhc.com.

For more training and educational resources, please click here.

Motivational Interviewing Training

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. Provider groups and facilities in Washington who employ both medical and behavioral health providers and wish to contract for Medicaid should contact Washington Network Management by Signing In with your One Healthcare ID to access our Network Help and Support chat and start the process. Include “Request for Participation in Behavioral and Medical Contracting” in the information shared with the chat advocate. 

Note: this is for provider groups and facilities who have both medical and behavioral health providers only. If you are a hospital, facility, group or individual that practices only behavioral health or only medical health, please refer to the instructions found under "Get Started". 

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/WA for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.

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

UnitedHealthcare Community Plan of Washington

UnitedHealthcare Dual Complete® Special Needs Plan

The Partnership Access Line (PAL) is a mental health consultation resource available to all primary care providers to help practices deliver more effective mental health care for any child they see, regardless of insurance. PAL also includes PAL for Moms, which is focused on support for postpartum depression.   Learn more about PAL and upcoming care provider training on the Seattle Children’s website, Washington Partnership Access Line - Seattle Children's (seattlechildrens.org).

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
  • 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 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.

Go to CommunityCare Now
CommunityCare Overview

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.  

WISe is a voluntary service that takes a team approach to meeting the needs of children and youth. It provides intensive mental health services to support you and your family in meeting your goals. 

UnitedHealthcare Dual Complete® Special Needs Plan

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.

Learn more about the Dual Special Needs Program

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.

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 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.