UnitedHealthcare Community Plan
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We continue to ensure that all documents are updated for ICD-10 Terminology. Providers should be aware that ICD-9 content applies to dates of service prior to 10/1/2015. ICD-10 terminology and claims sets apply to dates of service 10/1/2015 and after, regardless of the status of the document. 

Please select the state where you practice.

UnitedHealthcare Community Plan Kansas Providers

UnitedHealthcare Community Plan of Kansas

We insure more pregnant moms, more children, and more aged, blind and persons with disabilities than anyone else. No one has a larger list of doctors and hospitals. We're a leader in working with community organizations to help the uninsured become insured, and the insured to get the best medical care possible. We're a leader in the effort to understand the social and cultural causes of disease. UnitedHealthcare has been in your community for years. We look forward to partnering with you.

UnitedHealthcare Community Plan Added to Electronic Payments & Statements (PDF 59.89 KB)

Issues Log

The Provider Issue Log is updated on a weekly basis and provides the status, resolution and timing of global issues impacting multiple providers. Click here (PDF 146.34 KB) to access the current Provider Issue Log (issues posted since 2015. 

Click here (PDF 679.43 KB) to access an archive of past issues (issues posted from 2012 through 2014).




Provider Advocate Contact Information

Providers may click here (PDF 118.09 KB) to access the HCBS Provider Advocate Territory Map to identify the Provider Advocate in your area.

United IDD Provider Billing Guidelines
Click here (PDF 129.58 KB) for the current guidelines.
Click here (PDF 196.56 KB) for Atypical Provider Billing Bulletin.

Billing Issues Related to NPI Number
Providers who are experiencing claim issues related to NPI number may click here (PDF 105.34 KB) for suggested steps to follow to help identify and correct the provider NPI issue.

 

UnitedHealthcare Provider Contact List

View details

UnitedHealthcare’s provider support teams are available to assist Kansas Providers. 

Call Center Support

Provider Services Call Center  

877-542-9235

Prior Authorization Call Center

866-604-3267

UHCOnline Customer Service (website assistance)

866-842-3278 Option 2

 

Physical Health Providers

Network Team for contracting/credentialing           

ks.net.mgmt@uhc.com

Provider Advocate Team

Kansas_PR_Team@uhc.com

 

Physical Health Provider Advocate Map (PDF 253.57 KB)

 

 

Behavioral Health/Substance Use Disorder Providers

Customer Care Professional Call Center

855-802-7095

Provider Relations Lead Monica Meek

Monica.meek@optum.com

Fax authorizations or provider concerns

855-268-9392

Sandra K Hashman-Evans, Executive Director

Sandra.hashman@optum.com; 913-333-4051

 

Nursing Facilities

Nursing Facility Provider Support Line

888-823-8751

Mona Hull, Provider Advocate Manager

Mona_hull@uhc.com; 612-642-7797

Michelle Cowen, Provider Advocate

michelle.cowen@optum.com; 913-323-1037

 

Nursing Facility Provider Advocate Map  (PDF 77.83 KB)

 

Home and Community Based Service Providers

 

HCBS Provider Support Team Email

Ksunited_longtermcare@uhc.com

Krista Hayes, Associate Director

kristahayes@uhc.com; 913-333-4013

Cynthia Henderson, Manager

cynthia_henderson@uhc.com; 913-802-5635

Eric Rholes, Provider Advocate, Northeast Kansas

eric.rholes@uhc.com; 913-333-4028

Melissa Shumaker, Provider Advocate, Southeast

melissa_shumaker@uhc.com; 417-553-3145

Jessica Cook, Provider Advocate, Southcentral/Southwest

jessica_cook@uhc.com; 763-283-4479

Jennifer Crawford, Provider Advocate, Northcentral/Northwest

Jennifer_crawford@uhc.com; 952-406-4096


Home and Community Based Services Provider Advocate Map  (PDF 118.09 KB)


Vision Providers

OptiCare Provider Support Center

866-921-7962

 

 

Pharmacy Providers

OptumRx Help Desk – for pharmacy claim
resolution

877-305-8952

OptumRx Network Management

800-613-3591

Jennifer Murff, Kansas Pharmacy Manager

Jennifer.Murff@uhc.com; 913-333-4002

 

Dental Providers

Provider Services Call Center

855-878-5372

 

Transportation Providers

LogistiCare Provider Support Line

866-697-0492 

 

Provider Administrative Guide

Click here to access the UnitedHealthcare Provider Administrative Guide.

HPV Home

http://www.cdc.gov/hpv/index.html

The HPV Home site is the CDC website for the public and health care professionals. Healthcare professional information includes:
• CME opportunities
• Fact Sheets and schedules
• Tools and materials for your office
• Information to provide to parents (English/Spanish)
• Recommendations for leading the conversation about HPV

HPV for Clinicians CE
http://www.cdc.gov/hpv/hcp/continuing-ed.html

The HPV Clinicians for CE link is a CDC website with free, credit courses on HPV infection, cancers and vaccinations. The courses include guidance on how to have an effective conversation with parents about HPV vaccinations.

You Are The Key to Cancer Prevention! Vacinate!  http://www.kansasaap.org/wordpress/chapter/kaap-webinars/hpv-webinar/

You Are the Key to Cancer Prevention! Vacinate! is presented as a web-on-demand video with pre-test and post-test. 

Physicians:   The Kansas Chapter, American Academy of Pediatrics is accredited by the Kansas Medical Society to provide continuing medical education for physicians.

The Kansas Chapter, American Academy of Pediatrics designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

 

Find A Doctor 

Click here to access Find A Doctor, our online provider search tool.  

Access a pdf Provider Directory:  
     Eastern third of Kansas (PDF 1.31 MB) 
     Middle third of Kansas (PDF 1.84 MB) 
     Western third of Kansas (PDF 616.38 KB)
     HCBS Provider Directory (PDF 1.18 MB)

Medical Injectables

Specialty pharmacy medications covered on the Medical Benefit may be provided through a variety of channels – home infusion provider, outpatient facility, physician, or specialty pharmacy.

For physicians who do not want to buy-and-bill a specialty pharmacy medication that is covered on the Medical Benefit, they may choose to source it through a network specialty pharmacy:

Network Specialty Pharmacy

Phone Number

OptumRx

866-218-7398

BioScrip (offers nursing services)

• also a National Home Infusion Provider for Medical Benefit medications

866-788-7710

The following specialty pharmacies may also provide specific categories of specialty pharmacy medications:

Network Specialty Pharmacy

Medication Category

Phone Number

Accredo (offers nursing services)

Enzyme Deficiency

Gaucher's Disease

Immune Globulin

Pulmonary Hypertension


800-803-2523

 

Option Care (offers nursing services)

Cardiovascular/Heart Failure

Enzyme Deficiency

Gaucher's Disease

Hemophilia

Immune Globulin

Makena

866-827-8203

CVS Caremark Specialty Pharmacy

Enzyme Deficiency

Gaucher's Disease

Makena

Pulmonary Hypertension

800-237-2767

Coverage of the requested drug is dependent on the member's benefits, and the availability of a specific drug from a network specialty pharmacy may vary.

The Specialty Pharmacy can deliver the medication to the healthcare practitioner's office or another site (ex. patient's home) upon request, and the Specialty Pharmacy will bill the patient's health plan directly.

 

Disclosure forms

Disclosure Forms are required for all contracted providers. If you are already a network provider and have not submitted your completed disclosure form, please email the form to ks.disclosure.forms@uhc.com

Provider Notice Archives

Kansas Department of Health and Environment's Division of Health Care Finance and the Kansas Foundation for Medical Care (KFMC) are working together to assist Medicaid providers in Kansas with implementing health information technology. The documents available at this link describe the services offered and eligibility criteria.

KDHEMU Notice Faxable (PDF 143.32 KB)

KDHEMU Notice For Stakeholder Newsletters (PDF 142.57 KB)

 

UnitedHealthcare Community Plan Medical Policies and Coverage Determination Guidelines

 

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 38.15 KB) to download our policy.