UnitedHealthcare Community Plan
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UnitedHealthcare Responds to Ebola Concerns (PDF 80.08 KB)

 

ALERT

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Contact Us

General Postal Mailing/Correspondence:

UnitedHealthcare Community Plan
P.O. Box 200089
Newark, NJ 07102

Claims Address:

Medicaid and NJ Familycare:
UnitedHealthcare Community Plan
P.O. Box 5250
Kingston, NY 12402-5250

UnitedHealthcare Dual Complete (Medicare):

UnitedHealthcare Dual Complete
P.O. Box 5250
Kingston, NY 12402-5250

Claims Appeal Address:

Part C Appeals and Grievance Department
UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131-0364

Part D Appeals and Grievance Department
Attn: CA124-0197
P.O. Box 6106
Cypress, CA 90630-9948

UM Appeals:

Medicaid and NJ Familycare:
UnitedHealthcare Community Plan
Attn: UM Appeals Coordinator
P.O. Box 31364
Salt Lake City, UT 84131

UnitedHealthcare Dual Complete (Medicare):
UnitedHealthcare Dual Complete
Attn: UM Appeals Coordinator
P.O. Box 31364
Salt Lake City, UT 84131

Provider Frequently Asked Questions (FAQs) New Jersey Medicare Advantage Dual Eligible
(PDF 402.79 KB)

PPACA PCP Medicaid Fee Increase Reimbursement - Update (PDF 47.33 KB) (New)

Provider Service Center:

Monday – Friday: 8 a.m. – 6 p.m.
888-362-3368

 

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

888-296-4513

 

Walgreens Infusion Services (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.