UnitedHealthcare Community Plan
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NOTICE: Iowa Medicaid care providers must re-enroll with the Iowa Medicaid Enterprise (IME) by Oct. 31, 2017 to continue being reimbursed for services by UnitedHealthcare. For additional information, call IME Provider Services at 800-338-7909.

 

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UnitedHealthcare Community Plan Iowa Providers

Welcome to UnitedHealthcare Community Plan’s resource site for Iowa providers

We are committed to working with you and your staff to achieve the best health outcomes for our members.  

On this website, you can find information specific to our health plan. Select the navigational tabs to the left or a link below for our policies, forms, manuals, processes, news and alerts.

Our provider portal is designed to streamline your business transactions with us.

 

Contact Us

Provider Services Call Center: 888-650-3462
It takes ONE call to help you with:

  • Member eligibility
  • Prior authorization
  • Language interpreter
  • Scheduling rides for a member
  • Referrals to specialists
  • Behavioral Health referral
  • Claims corrections
  • Reach a Community-based Case Manager

Hours of Operation: 7:30 a.m. – 6 p.m.

Click here to view more contact information

Mailing Address

UnitedHealthcare Community Plan
1089 Jordan Creek Parkway, Suite 320
West Des Moines, IA 50266

 

Claims Mailing Address

UnitedHealthcare
Attn: Claims
P.O. Box 5220
Kingston, NY 12402-5220

 

Claims Appeals and Disputes

UnitedHealthcare Community Plan
P.O. Box 31364
Salt Lake City, UT 84131

 

Pharmacy Contact Information

Prior authorizations, call: 800-310-6826
Fax prior authorizations to: 866-940-7328

 

Link: Your Gateway to UnitedHealthcare's Online Tools
  • Eligibility and Benefits Center
  • Claims Management
  • Claims Reconsideration
  • CommunityCare
  • Provider Data Management

To access Link, sign in to UnitedHealthcareOnline.com using your Optum ID. You will be redirected to Link after sign-in. If you don’t have an Optum ID or need help remembering your ID or password, don’t worry – the Link sign-in screens will guide you through the process.

 

  • Eligibility and Benefits Center
  • Claims Management
  • Claims Reconsideration
  • CommunityCare
  • Provider Data Management

To access Link, sign in to UnitedHealthcareOnline.com using your Optum ID. You will be redirected to Link after sign-in. If you don’t have an Optum ID or need help remembering your ID or password, don’t worry – the Link sign-in screens will guide you through the process.

Join Our Network

We’ve got a lot to offer and invite you to join our network of service providers, whether you are:

*Already serving UnitedHealthcare commercial and/or Medicare members and ready to add our network

*New to UnitedHealthcare and UnitedHealthcare Community Plan

*New or already familiar with managed care

To reach a contracting representative, please call 888-650-3462.

Provider Advocate Look Up

Behavioral Health Network Manager Map (PDF 131.51 KB) - 6.6.2016

Health Homes Transformation Consultants Map (PDF 438.99 KB) - 8.8.2017

Home- and Community-Based Services (HCBS) Provider Advocate Map (PDF 497.66 KB) - 8.28.2017

Physician/Ancillary Advocate Map  (PDF 470.15 KB) - 8.28.2017

Skilled Nursing Facility/NF Advocate Map (PDF 495.67 KB) - 8.31.2017

Clinical Practice Consultant (CPC) Lookup

Clinical Practice Consultant (CPC) Map (PDF 209.27 KB) - 9.18.2017

The Clinical Practice Consultant program supports provider’s efforts to help members overcome barriers to health care. As part of this initiative, the dedicated Clinical Practice Consultant (CPC) will work with providers to help manage the clinical requirements involved with meeting Healthcare Effectiveness Data and Information Set (HEDIS) and other quality measures.

 

 

UnitedHealthcare Community Plan Medical & Drug Policies and Coverage Determination Guidelines

UnitedHealthcare has developed Medical Policies, Medical Benefit 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.
View the guidelines

UnitedHealthcare Medicare Advantage Coverage Summaries

For policy guidance for Medicare Advantage plan members, view the UnitedHealthcare Medicare Advantage Coverage Summaries Manual and corresponding policy update bulletins 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. 
View our policy (PDF 38.15 KB).

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.

 

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