- Provider Information
- Billing and Reference Guides
- Claims and Member Information
- Claim Reconsideration and Appeals
- Clinical Practice Guidelines
- Cultural Competency Library
- Electronic Data Interchange (EDI)
- Pharmacy Program
- Provider Forms
- Reimbursement Policy
- UnitedHealthcare Connected™
UnitedHealthcare Connected is available to individuals who are eligible for both Medicare and Medicaid in: Columbiana, Cuyahoga, Geauga, Lake, Lorain, Mahoning, Medina, Portage, Stark, Summit, Trumbull and Wayne counties.
UnitedHealthcare Connected is a partner in the state of Ohio’s integrated care delivery system for Medicare-Medicaid eligible enrollees called MyCare Ohio. UnitedHealthcare Connected is dedicated to improving quality and efficiency of care benefits for members through an individualized approach that focuses on seamless coordination of care while simultaneously easing the administrative burden for providers through assistance with higher acuity patients and claims simplification.
As an industry leader in population health management, we employ best practices to support your care plans to help members maintain and improve their health. We also support members who want to remain independent and live in the least restrictive environment possible through our comprehensive and integrated care management benefit programs.
We believe our benefits can help make coverage and care more connected, personal and flexible for everyone involved. UnitedHealthcare Connected seamlessly combines:
- Medicare Parts A and B
- Behavioral health
- Vision and dental
- Long-term care
- Home and community-based services
Our Mission for Providers and Members
To be the preeminent provider of state health care solutions for the aged, blind, and disabled, as well as those in need of long-term care and behavioral health care, who are Medicare-Medicaid enrollees.
We will accomplish this through:
- Support of Medicare and Medicaid services through coordinated or contractually integrated models.
- Relationships with best-in-class providers.
- Support of members’ choices to maintain independence and prevent functional decline through comprehensive and integrated care management programs.
- Provider incentives tied to quality measures.
UHC 1099 Assistance
Direct all tax questions to UHC 1099 Assistance at 1-866-343-0236. Please select from the following options:
#1 – Copy of 1099 Tax Form
#2 - Demographic Change
#3 - Payment History Report due to discrepancy on 1099 form
#4 - Speak to a Representative
See all the advantages that UnitedHealthcare Connected provides by selecting from the choices below.
Click on the arrow above to learn more about our experience.
UnitedHealthcare is an industry leader in providing comprehensive coverage to Medicare and Medicaid members that centers on person-centric care. Our expertise in coordinating physical health care services, long-term care and behavioral health services helps ensure this unique population has access to comprehensive care to address their often complex care needs.
- We’ve managed plans for both Medicare and Medicaid for nearly 30 years. Today, we serve more than 250,000 people who are Medicare and Medicaid eligible and one in five Americans who are covered by Medicare.
- We are a pioneer and national leader in developing and operating integrated managed care plans for acute and long-term care.
- We have more than 20 years of experience developing person-centered models of care that have improved quality, driven increased customer satisfaction and reduced unnecessary and costly utilization.
- Through our partnership with OptumHealth, a UnitedHealth Group company, we offer cutting-edge population management practices and comprehensive behavioral health services.
We are committed to helping our extensive provider network learn more about all aspects of this health plan by offering training opportunities and/or materials to support your participation in this network and to help you leverage the technology and tools developed to support your care of our members.
Click on the arrow above to view provider training.
ICD-10 TRAINING (PDF 899.22 KB)
MyCare Ohio Plan Information
Member Enrollment Frequently Asked Questions (PDF 155.01 KB) - Passive enrollment, the member's options and important contact information.
2016 MyCare Ohio Provider Training Deck (PDF 4.2 MB)
Online Training Sessions help you learn more about Claim Submission, Care Coordination, Plan Benefits and Prior Authorizations.
Training Aids for Electronic Transactions
Customized for MyCare Ohio providers, training aids were developed to assist you in filing claims, verifying member eligibility, checking status of a claim and handling paper claim payments.
EDI via UnitedhealthcareOnline.com - Learn how to perform electronic transactions using our website:
- Quick Reference Guides - individual guides with step-by-step instructions for each transaction.
- Tutorials for EDI - Learn by viewing recorded tutorials for each transaction.
EDI via Trading Partners - Learn more about electronic transactions available through software vendors, clearinghouses, or billing companies:
- Checklist for assessing your EDI needs
- Claim submission methods and connections
- Payer list for UnitedHealthcare, our affiliates and strategic alliances
- Understanding Claim Status EDI transactions
- Understanding Eligibility & Benefit EDI transactions
- Useful tips for electronic claim submissions
A comprehensive resource for physicians and health care professionals to obtain information related to their practice and care of UnitedHealthcare Community Plan members.
Optum Cloud Dashboard
Cloud-bases online resource for physicians and health care professionals:
- Optum Cloud Dashboard Login
- Learn more about Optum Cloud Dashboard, its features and functionality.
- Live webinars on Optum Cloud Dashboard Registrations are offered twice a month.
- Communications are being sent to UnitedHealthcareOnline.com password owners and users to register for Optum Cloud Dashboard. When you receive the email, please follow the instructions, using the resources provided for more information.
- Once you register for Optum Cloud Dashboard, you will login at this site to access online resources. If you login at UnitedHealthcareOnline.com, you will be redirected to Optum Cloud Dashboard.
- From Optum Cloud Dashboard, select the UnitedHealthcare app (labeled UHC) to go to UnitedHealthcareOnline.com.
Training & Education - including live webinars, on-demand videos and slide presentation for UnitedHealthcareOnline.com and Optum Cloud Dashboard
Click the Resources link below to view important sources of support and information for our UnitedHealthcareConnected for MyCare Ohio providers.
Integration of Medicare and Medicaid programs eliminates the need to coordinate care separately for these two health benefits programs. We'd like to partner with you to coordinate care and compensation, so you can focus on the health of your patients and the health of your practice.
Click on the arrow above to read more.
Connecting care and services for a healthier practice.
UnitedHealthcare Connected helps you spend more time with patients and less time on administrative tasks. Complete integration of Medicare and Medicaid benefits means you no longer have to worry about coordinating the two programs.
We do that for you. Instead of spending time figuring out which program covers what benefits, and who can deliver them, we manage all the details and logistics for you.
Our goal is to increase efficiency, minimize your administrative burden and better leverage all available resources to help you deliver the best possible care.
Your expertise and input is important to the success of UnitedHealthcare Connected and we look forward to our partnership to improve care for members who are eligible for Medicare-Medicaid health benefits.
A single source for all you need.
With UnitedHealthcare Connected, you'll have greater flexibility to deliver the right care each patient requires. Whether they need medication compliance counseling, substance abuse treatment, nutrition counseling or other support services, just call us.
Our care coordinators include social workers and aging experts who will put the necessary resources in place.
Save time and administrative costs.
You'll have one business partner who is accountable for complete care coordination and compensation. That simplifies billing and coding for your services, which are all tracked with one UnitedHealthcare member ID number.
Working together will help save you time and administrative costs, while increasing the efficiency of care. And we're developing innovative compensation and incentive models so that quality care and efficiency are rewarded.
Special attention for community behavioral health centers.
The UnitedHealthcare Connected approach to care can be a significant change for many behavioral health care providers. UnitedHealthcare’s experience in contracting with numerous medical, long-term care and community behavioral health systems in other states will help ensure that the transition is easy to understand and to implement.
We are working diligently to streamline procedures and payment processes. Our clinical staff will work with you to ensure easy access to our providers and promote your services as a seamless part of our plan. And we'll conduct face-to-face and web-based training sessions to solve any issues together.
We look forward to partnering with you. If you would like more information, please contact us.
We recognize that arranging care and services for your loved one takes a lot of time and effort. You play such a vital role, and we want that to continue for their well-being. It’s just as important though for us to help take care of you as well as the person in your care.
Click on the arrow above to view more information.
Connected care can mean a better quality of life for the person in your care.
We recognize that arranging care and services for your loved one takes a lot of time and effort. You play a vital role, and we want that to continue for their well-being. It’s just as important though for us to help take care of you as well as the person in your care.
A team to help you access care.
UnitedHealthcare Connected members and their caregivers have access to a dedicated care team to help them navigate the entire health care system. The personal care team will:
- Develop a comprehensive plan of care to support their physician’s care plan.
- Coordinate Medicare and Medicaid benefits.
- Arrange for community support services to help improve overall quality of life. This may include adding ramps for members with a physical disability, meal delivery or identifying resources for those who have trouble paying utility bills.
Our comprehensive provider network includes a variety of general and specialty doctors, therapists and nurses who are highly skilled in working with people with complex care needs.
We share your commitment to helping low-income elderly and people with disabilities live healthier lives. We want to work with you to build the strongest possible network of services and supports for these individuals. Together, we can create a model of efficiency, effectiveness and compassion.
Click on the arrow above to learn more.
Together, we can help shape the future of care in Ohio.
Big change brings big opportunities. Organizations like yours are vital to a healthy community. We want to work with you to build the strongest possible network of services for the low-income elderly and people with disabilities. By working together, and sharing ideas and expertise, we can help create a model of efficiency, effectiveness and compassion.
A trusted partner.
All successful partnerships are built on trust and respect. We are committed to working with you to promote the wellbeing and protect the best interests of the people you serve. And through our advisory council, you can have a direct voice and the opportunity to make suggestions that will improve our health plan in Ohio.
Ask us. We're happy to help.
Many community organizations are facing increasing budget challenges. That can make it difficult to assemble all the resources you need to further your mission. Or, it may limit what you can offer to those you serve. UnitedHealthcare can provide a wide range of technical supports and assistance to organizations of all types and sizes.
Whether you need help solving issues with claims and billing, writing applications for grants and funding, providing health-related educational materials, or delivering health and nutrition programs at your facility, just ask. We're eager to partner with you.
We look forward to working with you. If you would like to learn more, please contact us.
You are an expert at caring for the frail, elderly and people with disabilities. You understand their unique needs, and you have effective programs to care for them. Our partnership will be the foundation for a higher level of care for members.
Click on the arrow above to read more.
UnitedHealthcare Connected means working together to serve people better.
You are an expert at caring for the frail, elderly and people with disabilities. You understand their unique needs, and you have effective programs to care for them.
Our partnership will be the foundation for a higher level of care for members. That’s why we’d like to work side-by-side with you to help give the people of Ohio a higher level of care and to serve more people, more effectively.
The full benefit of our combined expertise.
Like you, we are firm believers in the value of home- and community-based services (HCBS). In fact, UnitedHealthcare has long been integrally involved in the movement to care for people at home. That goes back to 1989, when we helped Arizona pioneer its program to find HCBS as alternatives to nursing home care.
Over the last 20 years, we've managed HCBS and long-term care programs in seven states including Massachusetts, New Mexico and Tennessee. We want to use our knowledge and best practices to help you strengthen and enhance your plan of care and service offerings.
Save time and administrative costs.
UnitedHealthcare Connected integrates all Medicare and Medicaid benefits into one plan. That's not only better for those you serve, it's also easier and more efficient for you.
You'll enjoy faster communication and greater efficiency having just one business partner who is accountable for complete care coordination.
Having just one entity responsible for compensation also helps reduce the complexity and duplication of administrative work - saving you time, while lowering your administrative costs.
Opportunities for increased growth.
Partnering with community organizations has always been our business model, making you an integral part of our work. And, as our member base grows, the opportunities for you to expand and serve more people can increase too, just as it has for our physicians, specialists and other healthcare professionals and service partners in communities throughout the country.
We look forward to working with you. If you would like to learn more, please contact us.
Here you’ll find links to important sources of support and information for our UnitedHealthcare Connected for MyCare Ohio providers.
If you are looking for a particular resource that you didn’t find, please email our Integrated Care Delivery System (ICDS) team at: ICDSProvider@uhc.com
Click on the arrow above to view more resources.
CommunityCareOnline Health Care Management Tool (PDF 186.45 KB)
Contact / Resource Information (PDF 179.57 KB)
Home- and Community-Based Services Quick Reference Guide (PDF 297.58 KB)
How to Complete a Paper Claim Form (CMS-1500) (PDF 433.01 KB)
Independent Care Providers: TU Modifier Claim Submission Instructions (PDF 95.87 KB)
Ohio Home- and Community-Based Services (HCBS) Provider Credentialing Application (PDF 71.68 KB)
Payment Requirements for Non-Contracted Providers During Transition of Care (PDF 351.62 KB)
UnitedHealthcare ConnectedTM for MyCare Ohio Medicare-Medicaid Product Provider Administrative Manual (PDF 926.26 KB)
Preferred Drug List (PDL)
PDL Formulary Look Up
Find a Pharmacy
Pharmacy Prior Authorization Form/Submission
State Supported Resources
MyCare Ohio - Integrating Medicare & Medicaid Benefits
Ohio Medicaid resource for Health Plan Assignment and Provider Fee Schedule
Ohio Medicaid Consumer Information