BREAKING NEWS: As of December 1, 2012 UnitedHealthcare Community Plan CAN Product Claims Payer ID will change to 87726. UnitedHealthcare Community Plan CHIP Product Claims Payer ID will remain 95378. Our ERA Payer ID will remain 95378 for both CAN and CHIP plans.
Welcome to the UnitedHealthcare Community Plan Health Professionals area for Mississippi providers.
Here you will find the information, forms, manuals and links you need to conduct business with UnitedHealthcare Community Plan.
Please choose your topic of interest, by selecting one of the navigation buttons on the left-hand side of the page, or select one of the topics or products below to reveal our Contact Information, Provider Administrative Manuals and Forms.
Readmission Policy (F7001) (PDF 44.94 KB)
To review the clinical criteria/guidelines used to conduct medical necessity reviews, please use this link: https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=ca174ccb4726b010VgnVCM100000c520720a____
See the list of our upcoming workshops here (PDF 222.27 KB) .
Clinical Information- UnitedHealthcare Medical Policies
UnitedHealthcare has developed Medical Policies, Drug Policies, and Coverage Determination Guidelines to assist us in administering health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.
For Medicare Medical Policies, please click here.
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. Click here (PDF 34.75 KB) to download our policy.
If UHG Medical 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.