Share Link	http://www.uhccommunityplan.com/health-professionals/TX/provider-information
From Email Address *
To Email Address *

(OR copy and paste the link into your own email.)

Provider Information

Welcome to the UnitedHealthcare Community Plan Health Professionals area for Texas 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.

Contact Us (CHIP)

Provider Call Center	888-887-9003 Monday-Friday 8 a.m. – 5 p.m. CST
Postal Mailing Address	UnitedHealthcare Community Plan 9702 Bissonnet Suite 2200W Houston, TX 77036-8000
Claims Mailing Address	UnitedHealthcare Community Plan PO Box 5270 Kingston, NY 12402-5270
Member and Provider Complaints and Appeals Address	UnitedHealthcare Community Plan Attn: Complaint and Appeals Dept. PO Box 31364 Salt Lake City, UT 84131-0364
Overbilling and Refund Address	UnitedHealthcare Community Plan PO Box 740800 Atlanta, GA 30374

Contact Us (STAR)

Provider Call Center	888-887-9003 Monday-Friday 8 a.m. – 5 p.m. CST
Mailing Address	UnitedHealthcare Community Plan 9702 Bissonnet Suite 2200W Houston, TX 77036-8000
Claims Mailing Address	UnitedHealthcare Community Plan PO Box 5270 Kingston, NY 12402-5270
Member and Provider Complaints and Appeals Address	UnitedHealthcare Community Plan Attn: Complaint and Appeals Dept. PO Box 31364 Salt Lake City, UT 84131-0364
Overbilling and Refund Address	UnitedHealthcare Community Plan PO Box 740800 Atlanta, GA 30374

Contact Us (STAR+PLUS)

Provider Call Center	888-887-9003 Monday-Friday, 8 a.m. – 5 p.m. CST
Postal Mailing Address	UnitedHealthcare Community Plan 9702 Bissonnet Suite 2200W Houston, TX 77036-8000
Claims Mailing Address	UnitedHealthcare Community Plan CLAIMS PO Box 31352 Salt Lake City, UT 84131-0352
Provider Appeals and Complaints Address	UnitedHealthcare Community Plan Attn: Complaint and Appeals Dept. PO Box 31364 Salt Lake City, UT 84131-0364
Overbilling and Refund Address	UnitedHealthcare Community Plan PO Box 740800 Atlanta, GA 30374

Manuals

CHIP Provider Administrative Manual (PDF 1.51 MB)
STAR Provider Administrative Manual (PDF 10.13 MB)
STAR+PLUS Provider AdministrativeManual (PDF 3.41 MB)
STAR, STAR+PLUS, CHIP Pharmacy Provider Manual (PDF 372.57 KB)

Training Presentations

Register for Scheduled Provider Trainings - May - December 2013 (PDF 72.76 KB)
Register for Scheduled Provider Trainings (PDF 73.12 KB) - April - May 2013
Educational Offerings April and May 2013 (PDF 72.45 KB)
Rehabilitative Services Authorization FAQs (PDF 150.38 KB)
Ancillary Training Guide (PDF 1.22 MB)
Weight Management Value (PDF 683.59 KB)

UnitedHealthcare Provider Educational Training Guide (PDF 1.33 MB)
UnitedHealthcare Provider Educational Training Guide for STAR (PDF 1.47 MB)
UnitedHealthcare Provider Educational Training Guide for STAR+PLUS (PDF 1.73 MB)
UnitedHealthcare Provider Educational Training Guide for CHIP (PDF 1.18 MB)
UnitedHealthcare Provider Educational Training Guide for Long Term Support Services
(PDF 402.3 KB)UnitedHealthcare Provider Training Guide for Comprehensive Outpatient Rehab and Outpatient Rehab Facility (PDF 1.32 MB)

Helpful Links

UnitedHealthcare® Online
https://www.unitedhealthcareonline.com/b2c/CmaAction.do?viewKey=PreLoginMain&forwardToken=PreLoginMain

The Texas Health and Human Services Commission (HHSC)
http://www.hhsc.state.tx.us/

Texas Medicaid & Healthcare Partnership (provider page)
http://www.tmhp.com/Pages/Medicaid/Medicaid_home.aspx

Texas Department of Aging and Disability Services (DADS)
http://www.dads.state.tx.us/

Centers for Medicare and Medicaid Services (CMS)
http://www.cms.gov/

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.