As of January 1st, 2018 UnitedHealthcare Community Plan will no longer provide Medicaid and Long Term Care coverage in Delaware. For questions about 2018 services, members can call their new Health Plan Member Service’s phone number, it is on their ID card. If members have questions related to any services prior to January 1, 2018, members can call United Healthcare Community Plan member services at 1-877-877-8159.
This change doesn’t affect UnitedHealthcare Medicare, including Institutional Special Needs Plan (I-SNP) and Dual Complete Plan (DSNP) or UnitedHealthcare Commercial Plan members.
Healthcare Providers can continue to call Provider Services at 1-800-600-9007. For questions regarding behavioral health, please call 1-877-614-0484. For questions regarding Dental, please call 1-855-609-5152.
- Provider Information
- Behavioral Health Resources
- Claim Reconsideration and Appeals
- Claims and Member Information
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete (HMO SNP) Program
- Electronic Data Interchange (EDI)
- Medicare Part D Educational Materials
- Pharmacy Program
- Reimbursement Policy
Dual Complete (HMO SNP) Program
Effective January 1, 2017 UnitedHealthcare Community Plan of Delaware launches a new Dual Special Needs Plan (DSNP) – UnitedHealthcare Dual Complete (HMO SNP), in New Castle County.
A Special Needs Plan is a Medicare Advantage (MA) coordinated care plan that provides targeted care and services to individuals with unique needs. Dual Special Needs Plans are plans for members eligible for Medicare and Medicaid.
Dual Special Needs Plans must:
- Follow CMS regulations and cover all Medicare Part A (hospital stay) and Part B (doctor’s office) benefits, and must include Medicare Part D (pharmacy) coverage.
- Offer clinical programs and special expertise to serve the target population.
UnitedHealthcare Dual Complete program will reimburse claims, according to your UnitedHealthcare contractual Medicare fee schedule.
This page is dedicated to information specific to the Dual Complete program. Look here for provider resources including administrative guide, quick reference guide, provider directory, policies and news related to the Dual Compete program.
Dual Complete Provider Quick Reference Guide (PDF 750.9 KB)
DNSP Frequently Asked Questions (PDF 272.99 KB)
Coverage Summaries and Reimbursement Policies
Link and UHCprovider.com
Use Link to perform secure transactions such as checking member eligibility and benefits, managing claims and requesting prior authorization. To access Link, sign in to UHCprovider.com using your Optum ID.
If you don’t have an Optum ID, go to UnitedHealthcareOnline.com and select “New User” to begin registration.
To learn more about using Link, please visit UHCprovider.com > Tools & Resources > Health Information Technology > Link