UnitedHealthcare Community Plan
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UnitedHealthcare Community Plan Rhode Island Providers

Welcome to the UnitedHealthcare Community Plan Health Professionals area for Rhode Island providers.

Here, you will find the information and links you need to conduct business with UHC Community Plan.  Choose your topic of interest by selecting one of the left navigation buttons.

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 view our Contact Information and Forms.

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

 

Contact Us

Click on the arrow above to view our contact information. 

Provider Call Center

877-842-3210
24 hours a day, 7 days a week and holidays

Postal Mailing Address

UnitedHealthcare Community Plan
475 Kilvert Street
Warwick, RI 02886
ATTN: Medicaid Program
 

Utlization Management Appeals Address   

UnitedHealthcare Community Plan
P.O. Box 31364
Salt Lake City, Utah 84131
 

Report Health Care Fraud, Waste and Abuse: 844-359-7736 or uhc.com/fraud

 

Provider Administrative Manual

Rhode Island Provider Manual (PDF 3.15 MB)

Quick Reference Guide for the UnitedHealthcare Administrative Guides (PDF 112.23 KB)

 

 

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. 

Medical Injectables Information

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

Specialty pharmacy medications covered under the member's medical benefit may be obtained through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.

If you don't want to buy and bill a specialty pharmacy medication 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 (nursing services)

Enzyme Deficiency

Gaucher's Disease

Immune Globulin

Pulmonary Hypertension

800-803-2523

 

Option Care (nursing services)

Cardiovascular/Heart Failure

Enzyme Deficiency

Gaucher's Disease

Hemophilia

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 benefit, and availability of a specific drug from a network specialty pharmacy may vary.

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

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

 

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

UnitedHealthcare Medicare Advantage Coverage Summaries

For policy guidance for Medicare Advantage plan members, view the UnitedHealthcare Medicare Advantage Coverage Summaries Manual and corresponding policy update bulletins here

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.