AmeriHealth Caritas Members Transitioning to Community Plan
Starting Dec. 1, 2017, UnitedHealthcare Community Plan will begin servicing IA Health Link members who were previously managed by AmeriHealth Caritas. If a member doesn’t present their new UnitedHealthcare Community Plan member ID card, please verify eligibility using their Medicaid State ID number. You may verify by calling the Eligibility and Verification Information System (ELVS) at 800-338-7752 or by signing in to their web portal here. You may also call UnitedHealthcare’s Provider Services at 888-650-3462. More information about the transition can be viewed on our Bulletins page. You can also use our tool for looking up in-network providers.
- Provider Information
- Billing and Reference Guides
- Claims and Member Information
- Claim Reconsideration and Appeals
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete (HMO-SNP) Program
- Electronic Data Interchange (EDI)
- Pharmacy Program
- Provider Administrative Manual
- Provider Forms
- Provider Training
- Reimbursement Policy
Provider Claim Review Processes
To view up to date Claim Reconsideration information go to UnitedHealthcareOnline.com.
Claim Administrative Disputes/Appeals
A formal claim dispute is a comprehensive review of the disputed claim or claims, and may involve a review of additional administrative or medical records by a clinician or other personnel.
UnitedHealthcare Community Plan generally completes the review within 30 calendar days. However, depending on the nature of the review, a decision may take up to 60 days from the receipt of the claim dispute documentation.
Please allow 10 business days from this submission to enable us to begin processing the review before calling our Provider Services call center to request a status update.