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UnitedHealthcare Community Plan Iowa Providers

Welcome to Iowa Providers!

We are committed to working with you and your staff to achieve the best health outcomes for our members.  

On this website, you can find information specific to our health plan. Select the navigational tabs to the left or a link below for our policies, forms, manuals, processes, news and alerts.

Our provider portal is designed to streamline your business transactions with us.

 

Medicaid Managed Care Rule External FAQs (PDF 64.57 KB)
Medicaid Managed Care Rule Presentation
(PDF 90.71 KB)

 

 

Contact Us

Provider Services Call Center: 888-650-3462
It takes ONE call to help you with:

  • Member eligibility
  • Prior authorization
  • Language interpreter
  • Scheduling rides for a member
  • Referrals to specialists
  • Behavioral Health referral
  • Claims corrections
  • Reach a Community-based Case Manager

Hours of Operation: 7:30 a.m. – 6 p.m.

Mailing Address

UnitedHealthcare Community Plan
1089 Jordan Creek Parkway, Suite 320
West Des Moines, IA 50266

 

Claims Mailing Address

UnitedHealthcare
Attn: Claims
P.O. Box 5220
Kingston, NY 12402-5220

 

Claims Appeals and Disputes

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

 

Pharmacy Contact Information

Prior authorizations, call: 800-310-6826
Fax prior authorizations to: 866-940-7328

 

  • Eligibility and Benefits Center
  • Claims Management
  • Claims Reconsideration
  • Provider Data Management

To access Link, go to UHCprovider.com and select Link in the upper right hand corner. Sign in using your Optum ID. You will be redirected to Link after sign-in.

If you don’t have an Optum ID or need help remembering your ID or password, don’t worry – the Link sign-in screens will guide you through the process.

 

  • Eligibility and Benefits Center
  • Claims Management
  • Claims Reconsideration
  • CommunityCare
  • Provider Data Management

To access Link, sign in to UnitedHealthcareOnline.com using your Optum ID. You will be redirected to Link after sign-in. If you don’t have an Optum ID or need help remembering your ID or password, don’t worry – the Link sign-in screens will guide you through the process.

We’ve got a lot to offer and invite you to join our network of service providers, whether you are:

*Already serving UnitedHealthcare commercial and/or Medicare members and ready to add our network

*New to UnitedHealthcare and UnitedHealthcare Community Plan

*New or already familiar with managed care

To reach a contracting representative, please call 888-650-3462.

The Clinical Practice Consultant program supports provider’s efforts to help members overcome barriers to health care. As part of this initiative, the dedicated Clinical Practice Consultant (CPC) will work with providers to help manage the clinical requirements involved with meeting Healthcare Effectiveness Data and Information Set (HEDIS) and other quality measures.

Clinical Practice Consultant (CPC) Map (PDF 243.5 KB) - 4.20.2018

 

If the care provider is unable to contact a Community-Based Case Manager (CBCM) or has a situation that they are unable to resolve with the CBCM, please contact the MCM for further assistance.

Manager of Case Manager (MCM) Regional Map (PDF 434.57 KB) - 5.15.2018 

 

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.

 

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