UnitedHealthcare Community Plan
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To learn more about UnitedHealthcare Community Plan, please contact your Provider Advocate or view our On Demand programs on UHC On Air. 

Instructions for Accessing UHC On Air Videos

To access UHC On Air:

  1. Sign in to UnitedHealthcareOnline.com using your Optum ID.
  2. Click on the UHC On Air app on your Link dashboard.
  3. Select the UHC News Now channel on UHC On Air, then select one of the DSNP programs to view.
Instructions to Register for LINK

For help with Link self-service tools, including access support and quick reference guides, please visit unitedhealthcareonline.com.

Please select the state where you practice.

UnitedHealthcare Community Plan Michigan Providers

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

 

Contact Us

Medicaid/Healthy Michigan/Children Special Health Care Services (CSHCS)

Provider Call Center

 

800-903-5253
Monday-Friday  8:30 a.m. – 5:30 p.m. EST

 

Claims Mailing Address

 

UnitedHealthcare Community Plan
P.O. Box 30991
Salt Lake City, UT 84130-0991

Payer ID: 95467
 

Member and Provider Complaints and Appeals Address

 

UnitedHealthcare Community Plan
Attn: Complaint and Appeals 
P.O. Box 30991
Salt Lake City, UT 84130-0991

 

Overbilling and Refund Address

 

UnitedHealthcare Community Plan
P.O. Box 740804
Atlanta, GA 30374

 

Dental - Healthy Michigan Plan Only

UHC Dental Provider Services

To verify eligibility, benefits, obtain claim and prior authorization status
855-918-2265

 

 

Interactive Voice Response (IVR)

available 24 hours a day, 7 days a week

 

 

 

Claims Mailing Address

 

UnitedHealthcare MI Dental
P.O. Box 1317
Milwaukee, WI 53201

 

Prior Authorizations

 

UnitedHealthcare MI Dental
P.O. Box 1484
Milwaukee, WI 53201

 

Claims Dispute for Providers

 

UnitedHealthcare MI Dental
Attn_ Appeals Department
P.O. Box 1337
Milwaukee, WI 53201

 

Correspondence regarding your participation, contractual issues, dentist changes or office changes

 

UnitedHealthcare Dental
Provider Relations
6220 Old Dobbin Lane
Columbia, MD 20045

 

Overbilling and Refund Address

 

UnitedHealthcare Community Plan
P.O. Box 740804
Atlanta, GA 30374

 

MIChild

Provider Call Center

 

800-903-5253
Monday-Friday  8:30 a.m. – 5:30 p.m. EST

 

Claims Mailing Address

 

UnitedHealthcare Community Plan
P.O. Box 30991
Salt Lake City, UT 84130-0991

Payer ID: 95467
 

Member and Provider Complaints and Appeals Address

 

UnitedHealthcare Community Plan
Attn: Complaint and Appeals 
P.O. Box 30991
Salt Lake City, UT 84130-0991

 

Overbilling and Refund Address

 

UnitedHealthcare Community Plan
P.O. Box 740804
Atlanta, GA 30374

 

 

 

Provider Credentialing Information

Join Our Network

UnitedHealthcare Community Plan encourages qualified physicians and health care professionals to consider applying to join our participating provider network. Call 1-877-842-3210 to learn more. 

 

 

Specialty Pharmacy

Medical Injectables

Click on the arrow above to view information about medical injectables.

Specialty pharmacy medications covered under the member’s medical benefit may be provided through a various sources ‒ home infusion provider, outpatient facility, physician, or specialty pharmacy.

If you don’t want to buy-and-bill a specialty pharmacy medication that is covered under the member’s medical benefit, you may order it through one of the following network specialty pharmacies:

Network Specialty Pharmacy

Phone Number

BriovaRx

866-815-5338

BioScrip (offers nursing services)

• Also serves as a national home infusion provider for medical benefit medications

866-788-7710


The following specialty pharmacies also provide certain types of specialty medications:

Network Specialty Pharmacy

Medication Category

Phone Number

Accredo (offers nursing services)

Immune Globulin

Pulmonary Hypertension


800-803-2523

 

Option Care (offers nursing services)

Immune Globulin

Makena

866-827-8203

CVS Caremark Specialty Pharmacy

Pulmonary Hypertension

800-237-2767


Coverage of a requested medication depends on the member’s benefits. and availability of a specific drug from a network specialty pharmacy.

Upon request, a specialty pharmacy can deliver the medication to your office or another site such as the member’s home.

Medications obtained through a Specialty Pharmacy will be directly billed to the patient’s health plan.

Provider Links

 

file

 

Looking for a network care provider?

View our online Provider Directory

Childhood Immunization and Well Child Visits

UnitedHealthcare has identified a performance improvement team to improve Child Immunization and Well Child Visit rates. Click here for detail information.

HEDIS

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by health plans to measure performance on important dimensions of care and service. Click the guides below to view HEDIS in a Box Quick Reference Guides:

     - PCP All Preventive 
     - PCP All Disease Management 
     - Preventive Child Adolescent  
     - Women's Health for OBGyns

Mental Health

Find out more about depression management and primary care by clicking here.

Obesity Management

Click here to view Key facts about obesity in the United States.

PCP Developmental Surveillance and Screening
Click here to find out about the implementation of standardized developmental screenings through Assuring Better Child Health and Development (ABCD) Academy.

Behavioral Health Service Models

Please visit the following links to view information about evidence-based behavioral health service models for primary care providers.

Screening, Brief Intervention, and Referral to Treatment (SBIRT): Opportunities for Implementation and Points for Consideration

Substance Abuse and Mental Health Services Administration (SAMHSA)/Health Resources and Services Administration (HRSA): A Quick Start Guide to Behavioral Health Integration for Safety-Net Primary Care Providers

 

Provider Links

Childhood Immunization and Well Child Visits

 

UnitedHealthcare has identified a performance improvement team to improve Child Immunization and Well Child Visit rates. Click here for detail information.

 

HEDIS

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by health plans to measure performance on important dimensions of care and service. Click the guides below to view HEDIS in a Box Quick Reference Guides:

     - PCP All Preventive 
     - PCP All Disease Management 
     - Preventive Child Adolescent  
     - Women's Health for OBGyns

Mental Health

 

Find out more about depression management and primary care by clicking here.

 

 

Obesity Management

 

Click here to view Key facts about obesity in the United States.

 

PCP Developmental Surveillance and Screening
Click here to find out about the implementation of standardized developmental screenings through Assuring Better Child Health and Development (ABCD) Academy.

 

Provider Toolkits

 

The Alliance for immunizations in Michigan (AIM) publishes a Provider Toolkit annually with support from Michigan health plans. The Providers Immunization Toolkit for Children & Adults is a resource guide containing the most current standards of practice, forms, & vaccination methodologies for immunization in Michigan. To find out more, click here.

 

Provider Chlamydia Toolkit

 

There is a national increase in the rate of chlamydia.  In an effort to increase the rate at which sexually active women ages 16 to 25 are routinely screened for this sexually transmitted disease, we offer our provider partners a Chlamydia Toolkit.  The Chlmydia Toolkit provides clinical guidelines for the treatment of chlamydia, links to policies and procedures for adoption by your practice to improve routine screening and many more valuable references.  Please visit the following link to download a copy. 

 

https://www.stratishealth.org/pip/documents/Chlamydia_Toolkit.pdf

Quality Improvement Program

 

The purpose of the Quality Improvement Program is to achieve desired performance outcomes. UnitedHealthcare Community Plan's Building the Bridge to Excellence QI Program is guided by important objectives. Find out more by clicking here.

 

Smoking Cessation

 

UnitedHealthcare Community Plan's Smoking Cessation Program is supported by both behavioral modification and pharmaceutical assistance to effect maximum support for members who are ready to quit. Click here for details.

 

 

Provider Links

Childhood Immunization and Well Child Visits

 

UnitedHealthcare has identified a performance improvement team to improve Child Immunization and Well Child Visit rates. Click here for detail information.

 

 

HEDIS

 

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by health plans to measure performance on important dimensions of care and service. Click the guides below to view HEDIS in a Box Quick Reference Guides:

 

     - PCP All Preventive 
     - PCP All Disease Management 
     - Preventive Child Adolescent  
     - Women's Health for OBGyns

 

 

Mental Health

 

Find out more about depression management and primary care by clicking here.

 

 

Obesity Management

 

Click here to view Key facts about obesity in the United States.

PCP Developmental Surveillance and Screening
Click here to find out about the implementation of standardized developmental screenings through Assuring Better Child Health and Development (ABCD) Academy.

Provider Toolkits

The Alliance for immunizations in Michigan (AIM) publishes a Provider Toolkit annually with support from Michigan health plans. The Providers Immunization Toolkit for Children & Adults is a resource guide containing the most current standards of practice, forms, & vaccination methodologies for immunization in Michigan. To find out more, click here.

Provider Chlamydia Toolkit

 

There is a national increase in the rate of chlamydia.  In an effort to increase the rate at which sexually active women ages 16 to 25 are routinely screened for this sexually transmitted disease, we offer our provider partners a Chlamydia Toolkit.  The Chlmydia Toolkit provides clinical guidelines for the treatment of chlamydia, links to policies and procedures for adoption by your practice to improve routine screening and many more valuable references.  Please visit the following link to download a copy. 

 

https://www.stratishealth.org/pip/documents/Chlamydia_Toolkit.pdf

Quality Improvement Program

The purpose of the Quality Improvement Program is to achieve desired performance outcomes. UnitedHealthcare Community Plan's Building the Bridge to Excellence QI Program is guided by important objectives. Find out more by clicking here.

Smoking Cessation

UnitedHealthcare Community Plan's Smoking Cessation Program is supported by both behavioral modification and pharmaceutical assistance to effect maximum support for members who are ready to quit. Click here for details.

 

 

Provider Toolkits

The Alliance for immunizations in Michigan (AIM) publishes a Provider Toolkit annually with support from Michigan health plans.

The Providers Immunization Toolkit for Children & Adults is a resource guide containing the most current standards of practice, forms, & vaccination methodologies for immunization in Michigan. To find out more, click here (PDF 18.92 KB).

 

Provider Chlamydia Toolkit

There is a national increase in the rate of chlamydia. In an effort to increase the rate at which sexually active women ages 16 to 25 are routinely screened for this sexually transmitted disease, we offer our provider partners a Chlamydia Toolkit. 

The Chlmydia Toolkit provides clinical guidelines for the treatment of chlamydia, links to policies and procedures for adoption by your practice to improve routine screening and many more valuable references. Download the Chlmydia toolkit

 

Quality Improvement Program

The purpose of the Quality Improvement Program is to achieve desired performance outcomes. UnitedHealthcare Community Plan's Building the Bridge to Excellence QI Program is guided by important objectives. Find out more by clicking here (PDF 20.41 KB).

 

Smoking Cessation

UnitedHealthcare Community Plan's Smoking Cessation Program is supported by both behavioral modification and pharmaceutical assistance to effect maximum support for members who are ready to quit. Click here (PDF 62.99 KB) for details.

 

Provider Links

Childhood Immunization and Well Child Visits

 

UnitedHealthcare has identified a performance improvement team to improve Child Immunization and Well Child Visit rates. Click  here (PDF 19.71 KB) for detail information.

 

 

HEDIS

 

The Healthcare Effectiveness Data and Information Set (HEDIS®) is a tool used by health plans to measure performance on important dimensions of care and service. Click the guides below to view HEDIS in a Box Quick Reference Guides:

 

     -  PCP All Preventive (PDF 3.26 MB) 
     -  PCP All Disease Management (PDF 1.1 MB) 
     -  Preventive Child Adolescent (PDF 1.66 MB)  
     -  Women's Health for OBGyns (PDF 1.58 MB)

 

 

Mental Health

 

Find out more about depression management and primary care by clicking  here (PDF 18.98 KB).

 

 

Obesity Management

 

Click here (PDF 21.46 KB) to view Key facts about obesity in the United States.

PCP Developmental Surveillance and Screening
Click here (PDF 22.21 KB) to find out about the implementation of standardized developmental screenings through Assuring Better Child Health and Development (ABCD) Academy.

Provider Toolkits

The Alliance for immunizations in Michigan (AIM) publishes a Provider Toolkit annually with support from Michigan health plans. The Providers Immunization Toolkit for Children & Adults is a resource guide containing the most current standards of practice, forms, & vaccination methodologies for immunization in Michigan. To find out more, click here (PDF 18.92 KB).

Provider Chlamydia Toolkit

 

There is a national increase in the rate of chlamydia.  In an effort to increase the rate at which sexually active women ages 16 to 25 are routinely screened for this sexually transmitted disease, we offer our provider partners a Chlamydia Toolkit.  The Chlmydia Toolkit provides clinical guidelines for the treatment of chlamydia, links to policies and procedures for adoption by your practice to improve routine screening and many more valuable references.  Please visit the following link to download a copy. 

 

https://www.stratishealth.org/pip/documents/Chlamydia_Toolkit.pdf

Quality Improvement Program

The purpose of the Quality Improvement Program is to achieve desired performance outcomes. UnitedHealthcare Community Plan's Building the Bridge to Excellence QI Program is guided by important objectives. Find out more by clicking here (PDF 20.41 KB).

Smoking Cessation

UnitedHealthcare Community Plan's Smoking Cessation Program is supported by both behavioral modification and pharmaceutical assistance to effect maximum support for members who are ready to quit. Click  here (PDF 62.99 KB) for details.

 

 

 

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

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.