UnitedHealthcare Community Plan
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UnitedHealthcare Community Plan Nebraska Providers

Welcome to the UnitedHealthcare Community Plan area for Nebraska providers!

 

On this site you will find the information, forms, manuals and links you need to successfully partner with UnitedHealthcare Community Plan. We are committed to working with you and your staff to achieve the best possible health outcomes for our members.

Select one of the navigation buttons on the left to find what you’re looking for, or select one of our forms and resources below.

 

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

Contact Us

Hours of Operation: 8:00 am - 5:00 pm CST, 5 days a week
Provider Call Center: 866-331-2243

 

Mailing Address:
UnitedHealthcare Community Plan
2717 N 118th Street, Suite 300
Omaha, NE 68164

 

Claims Mailing Address:
UnitedHealthcare
PO Box 31365
Salt Lake City, UT 84131

 

Utilization Denial & Appeals Department Mailing Address:
National A&G Service Center
PO Box 31365
Salt Lake City, UT 84131

 

Claims Appeals Mailing Address:
UnitedHealthcare Community Plan Appeals-Maryland
PO Box 31365
Salt Lake City, UT 84131

UHC Provider Resources 

Forms
Prior Authorization Fax Request Form (PDF 112.88 KB)
Rx Solns Hemo Factor Enrollment Form (PDF 104.97 KB)

 

CPT (Current Procedural Terminology) Codes
Radiology Crosswalk Table (PDF 470.12 KB)
Radiology Prior Authorization List (PDF 240.27 KB)
Administrative Guide
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 through a network specialty pharmacy:

Network Specialty Pharmacy

Phone Number

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.

 

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.

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.

Magellan PCP Toolkit

Magellan offers an online toolkit designed to give medical practitioners the resources needed to identify potential behavioral health concerns and assist in making appropriate referrals.

To be directed to the Magellan PCP Toolkit please click here.