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.

Welcome to the UnitedHealthcare Community Plan Health Professionals area for Louisiana providers!


Here you will find the information, forms, manuals and links you need to conduct business with UnitedHealthcare Community Plan.


UnitedHealthcare Community Plan Behavioral Health Transition
Through our current partnership as a Bayou Health Managed Care Organization (MCO) with the Louisiana Department of Health and Hospitals (DHH) to provide Home and Community Based services to the regions Medicaid population; UnitedHealth Community Plan is extending its services to include the management of Behavioral Health Services. This Behavioral Health transition will take effect on December 1, 2015, and will benefit the individuals receiving services by integrating primary care and behavioral health services for improved care and care coordination of their physical and behavioral health needs.

URGENT ALERT: Certain Checks to Be Reissued This Week (PDF 34.68 KB)

Referral Requirement Change - Effective 2/1/2015 (PDF 23.48 KB)


You're invited!

LA Community Plan (Bayou Health) Provider Education Webinar UnitedHealthcare Physician, Office Managers and Staff. (PDF 44.53 KB)

Submit Claims for Dates of Service before Feb. 1 by July 31, 2015 (PDF 24.19 KB)

Down Syndrome Information (PDF 10.62 KB)

UnitedHealthcare Responds to Ebola Concerns (PDF 80.08 KB)


Are your Patients Prepared for Hurricane Season?

UnitedHealthcare Community Plan wants to help you make sure your patients are prepared for hurricane season and the resulting hazards such as storm surge, high winds, tornadoes, and flooding. Be sure to share these tips with your patients before disaster strikes:

  • Assemble an emergency preparedness kit including: food; water; extra cash; first aid supplies; a flashlight; a radio; a multi-purpose tool; medications and medical items; copies of personal documents; ID cards; cell phone with chargers; map of the area; an emergency blanket; emergency numbers; sanitation supplies such as disinfecting bleach; and other essential items. Consider the special needs of family members and supplement kits with items that fit your needs (such as baby supplies or pet food). Be sure to include your UnitedHealthcare Community Plan and Medicaid ID cards.
  • Identify ahead of time where to go if you are told to evacuate. Choose several places, such as a friend's home in another town, a motel or a shelter and have their phone numbers on hand. You may need to take unfamiliar routes if major roads are closed or clogged so be sure to have a map. Develop a plan for family communication in the event of an emergency and agree on evacuation routes so everyone knows what to do and where to go.
  • Listen to NOAA (www.noaa.gov) Weather Radio or local radio or TV stations for evacuation instructions. If advised to evacuate, do so immediately.You can find more information at https://lava.dhh.louisiana.gov/. There, you can sign up for text updates and even a smartphone application to help you plan. from Louisiana Governor's Off ice and the American Red Cross

Good to know:

  • Please encourage your patients to update their address and phone contact information with us regularly so we can reach them in case of an emergency. Members can do this by calling Member Services, 866-675-1607 (TTY: 711) or NurseLine, 877-440-9409.
  • If your office relocates or closes for an extended period, please contact us at 877-369-1302.
  • In case of a hurricane or other disaster, your patients can register on the American Red Cross Safe and Well website, redcross.org/SafeandWell, to let family and friends know about their welfare.Those without Internet access can call 1-866-GET-INFO.
  • Volunteers are critical in an emergency. First-responders and shelter volunteers play a crucial role by donating their time, skills and resources to those in need.
  • Visit lsms.org/site/emergencypreparedness for more information.
Contact Us

Behavioral Health Providers: For instructions on how to join the Behavioral Health Network, to review Community Plan Behavioral Health information, and to submit demographic changes, please click on the Behavioral Health link below.
Community Plan Behavioral Health

Provider Call Center



Claims Address

UnitedHealthcare Community Plan
300 Oxford Drive
Monroeville, PA 15146

Claims Mailing Address

UnitedHealthcare Community Plan
PO Box 31341
Salt Lake City, UT 84131-0341

Utlization Management Appeals Address

UnitedHealthcare Community Plan
Attn: Claims Administrative Apeals
PO Box 31364
Salt Lake City, UT 84131-0364

Claims Appeals Address

UnitedHealthcare Community Plan
Attn: Claims Administrative Apeals
PO Box 31364
Salt Lake City, UT 84131-0364

Fee Schedules
Grievance Process

UnitedHealthcare Community Plan maintains a grievance system for members that ensures receipt and prompt resolution of informal and formal member grievances and access to the state fair hearg process.

Filing a Member Grievance

A member, a representative of the member's choice, or a CCN-S provider, acting on behalf of the member with the member's written consent, may file a grievance with UnitedHealthcare Community Plan. Grievances may be filed orally by calling the toll-free number for our Member Services Call Center 866-675-1607 or in writing by mailing the grievance to our Regional Mail Operations (RMO) UnitedHealthcare P.O. Box 31364, Salt Lake City, UT 84131-0364. We route telephonic/verbal grievances through our technology that identifies call type and routes to other databases according to category. When the system identifies the call as a grievance, the information is logged into the system, and forwarded to a triage team who puts the information into our tracking system where a case file is created and populated. On receipt of a written grievance, appropriate personnel scan them into the tracking system and create a case file. Per our Member Grievance Policy, and on initial contact, we log and track criteria including member.


Provider Manual (PDF 2.78 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



BioScrip (offers nursing services)

 v also a National Home Infusion Provider for Medical Benefit medications


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


Walgreens Infusion Services (offers nursing services)

Cardiovascular/Heart Failure

Enzyme Deficiency

Gaucher’s Disease


Immune Globulin



CVS Caremark Specialty Pharmacy

Enzyme Deficiency

Gaucher’s Disease


Pulmonary Hypertension


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.

Provider Training Materials

Here, you find the links to our training materials:

UnitedHealthcare Community Plan's Training Materials and Quick Reference Guides that appear on this website apply to both contracted and non contracted providers. If you are not contracted with UnitedHealthcare Community Plan and are a specialist, ancillary provider, or a hospital that participates in the State of Louisiana Medicaid network, you are considered participating with us. The policies and processes that are included in the documents on this website are applicable to all providers, including our contracted PCPs.


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.