- Provider Information
- Billing and Reference Guides
- Claims and Member Information
- Claim Reconsideration and Appeals
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete® ONE
- Electronic Data Interchange (EDI)
- Pharmacy Program
- Provider Administrative Manual
- Provider Education
- Provider Forms
- Reimbursement Policy
National Drug Codes Requirement for UnitedHealthcare Community Plan
Medicaid Managed Care Rule Presentation (PDF 90.71 KB)
American Disabilities Act ADA
American Disabilities Act (ADA) Provider Training (PDF 439.7 KB)
Managed Long-Term Care Services and Supports (MLTSS)
The MLTSS program focuses on serving frail, elderly, and disabled individuals. The program combines traditional health care benefits (doctor visits, hospital stays, labs) with long-term services and supports with help in a home or community setting with daily living activities such as:
- Care Management
- Home and Vehicle Modifications
- Home Meal Delivery
- Mental Health & Addiction Services
- Personal Emergency Response System (PERS)
- Adult Day Care
- Respite Care
- Personal Care.
For more information about the MLTSS program click here.
MLTSS Provider Training
UnitedHealthcare Community Plan of New Jersey provides trainings to all MLTSS providers. If you are a MLTSS provider, please reference training presentations below to learn more about the program specifics and requirements.
UnitedHealthcare Community Plan of New Jersey MLTSS Provider Orientation (PDF 1.47 MB)
UnitedHealthcare Community Plan of New Jersey Adult and Pediatric Day Care Provider Orientation (PDF 1.16 MB)
MLTSS Presentation for Skilled Nursing Facility (SNF) and Special Care Nursing Facility (SCNF) Providers (PDF 1.66 MB)
UnitedHealthcare Community Plan MLTSS ICD-10 Orientation (PDF 1.26 MB)
MLTSS Contracting and Credentialing
Becoming a Provider
If you are interested in becoming a participating MLTSS provider, please email NJ_MLTSS_CRED@UHC.com for more information or to request a credentialing application. Please include the name of the facility and the words “Credentialing Application” on the subject line.
If you are a participating MLTSS provider, please remember to send us your recredentialing documents annually to ensure we have your most current complete required documentation. All forms and documents can be emailed to NJ_MLTSS_CRED@UHC.com.
Please include the name of the facility and the words “Recredentialing Application” on the subject line. Documents can also be mailed to:
UnitedHealthcare Community Plan
283-289 Market Street 12th Floor, Ste. 1202
Newark, NJ 07102
Attn: MLTSS Credentialing
All documentation, inquires, and communication related to MLTSS credentialing and recredentialing information can be emailed to NJ_MLTSS_CRED@UHC.com.
If you are a participating MLTSS provider and have questions, please call (888) 702-2168.
Fluoride Varnish Training Tool
Smiles For Life is a National Oral Health Curriculum Educational Training Tool for our participating PCPs to take Coursework 6 & 7 Modules in their understanding of the Fluoride Varnish Program. Click here.
New Jersey Smiles Directory
General and Pediatric Dentistry for Children 5 and Under. Click here (PDF 298.55 KB).