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UnitedHealthcare Community Plan
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Provider Information

You don't have time to spare: that's why we put all the documents you need in one place.

Use the navigation items on the left to find what you're looking for fast.

Contact Us

Hours of Operation: 8:00 am - 5:00 pm CST, 5 days a week
Provider Call Center: 866-331-2243

 

Mailing Address:
UnitedHealthcare Share Advantage
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:
UnitedHealthcare Community Plan Appeals-Maryland
PO Box 31365
Salt Lake City, UT 84131

Forms

Prior Authorization Fax Request Form (PDF 89.35 KB)
Rx Solns Hemo Factor Enrollment Form (PDF 85.68 KB)

 

CPT (Current Procedural Terminology) Codes
Radiology Crosswalk Table (PDF 197.58 KB)
Radiology Prior Authorization List (PDF 202.63 KB)

Administrative Guide

Physician, Health Care Professional, Facility and Ancillary Provider Administrative Guide (PDF 1.59 MB)

UnitedHealthcare Community Plan Provider Welcome Kit - Nebraska (PDF 1.25 MB)

Prior Authorization List (PDF 56.57 KB)

Medical Injectables

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____

 

 

State of Nebraska Medical Necessity:
http://dhhs.ne.gov/medicaid/Pages/Nebraska-Medicaid-Medical-Necessity.aspx



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.

Disclaimer

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.