UnitedHealthcare Community Plan
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Reconsiderations, Appeals and Complaints

Following is some basic information about our guidelines for filing reconsiderations, appeals and complaints with UnitedHealthcare Community Plan.

 

Reconsiderations

You have multiple options to file a request to have a claim payment reconsidered. You can submit a request online at UnitedHealthcareOnline.com > Claims & Payments > Claims Reconsideration.

 

Or, complete the Claims Reconsideration form at UHCCommunityPlan.com > For Health Care Professionals > Texas > Provider Forms > Claim Reconsideration Form.  Mail to:

UnitedHealthcare Community Plan

P.O. Box 31350

Salt Lake City, UT 84131-0350

 

Provider Complaints & Appeals

As a care provider, you can file a complaint with UnitedHealthcare Community Plan regarding any aspect of the health plan. You can access the Provider Complaint/Grievance Form at UHCCommunityPlan.com > For Health Care Professionals > Texas > Provider Forms > Provider Complaint/Grievance Form. You can submit the completed form in one of the following ways:

 

Mail: Complaints and Appeals

UnitedHealthcare Community Plan

Attn:  Complaint and Appeals

P.O. Box 31364

Salt Lake City, UT 84131-0364

 

Email:  americhoice_appeals@uhc.com

 

Fax: 801-994-1082

 

You may also submit a complaint online at UnitedHealthcareOnline.com > Tools & Resources >

UnitedHealthcare Community Plan Resources > Texas > Attachment Submission Process for Texas Community Plan.

 

For assistance, call Customer Service at 888-887-9003.

 

 

The Health and Human Services Commission

You also have the right to submit a complaint to the Texas Health and Human Services Commission (HHSC) Provider Resolution Services. Written complaints can be submitted via regular mail or email:

 

The Texas Health and Human Services Commission

Provider Complaints

Health Plan Operations, H320

P. O. Box 85200

Austin, TX 78708

 

Email: HPM_Complaints@hhsc.state.tx.us         

 

 

For more information about protocols for provider complaints and appeals, access our provider manuals at UHCCommunityPlan.com > For Health Care Professionals > Texas > Provider Manuals. Thank you.