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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

General Postal Mailing/Correspondence:

UnitedHealthcare Community Plan
P.O. Box 200089
Newark, NJ 07102

Claims Address:

Medicaid and NJ Familycare:
UnitedHealthcare Community Plan
P.O. Box 5250
Kingston, NY 12402-5250

UnitedHealthcare Dual Complete (Medicare):
UnitedHealthcare Dual Complete
P.O. Box 5250
Kingston, NY 12402-5250

Claims Appeal Address:

Medicaid and NJ Familycare:
UnitedHealthcare Community Plan
Attn: Claims Administrative Appeals
P.O. Box 5250
Kingston, NY 12402-5250

UnitedHealthcare Dual Complete (Medicare):
UnitedHealthcare Dual Complete
Attn: Claims Administrative Appeals
P.O. Box 5250
Kingston, NY 12402-5250

UM Appeals:
Medicaid and NJ Familycare:
UnitedHealthcare Community Plan
Attn: UM Appeals Coordinator
P.O. Box 31364
Salt Lake City, UT 84131

UnitedHealthcare Dual Complete (Medicare):
UnitedHealthcare Dual Complete
Attn: UM Appeals Coordinator
P.O. Box 31364
Salt Lake City, UT 84131

Provider Service Center:
Monday – Friday: 8 a.m. – 6 p.m.
888-362-3368

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____

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.

You can provide feedback directly to Medicare through their Complaint Form about your Medicare health plan.

As part of our brand changeover to UnitedHealthcare Community Plan, we're improving our websites. But we're not quite done yet. So for now, we're sending you to our old website for the information you need. Rest assured that it's up-to-date and correct, even if it may not be as pretty as the UnitedHealthcare Community Plan website you'll be going to soon. Thanks for your understanding.