We know you don't have time to spare, so we put all the UnitedHealthcare Community Plan resources you need in one place. Use the navigation on the left to quickly find what you're looking for. Be sure to check back frequently for updates.
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Contact Us
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Provider Services Call Center:
Phone: 866-633-4449 available 8 a.m. – 6 p.m. Eastern Time (including Federal holidays)
Provider Relations:
Email: kentucky_pr_team@uhc.com
Network Management Resource Team
To check the status of your credentialing application,Sign Inwithyour One Healthcare ID. This allows you to access self-servicetools or connect to a chat advocate for support.Please have the care provider’s full name, Tax ID, and National Provider Identifier (NPI) available.
Phone: 877-842-3210
Mailing Address:
UnitedHealthcare Community Plan of Kentucky
9100 Shelbyville Rd., Suite 270
Louisville, KY 40222
Technical Support:
Phone: 866-209-9320
Behavioral Health Services
Phone: 800-888-2998
Online: Providerexpress.com
Pharmacy Services:
Phone: 800-569-4147 (MedImpact)
Prior Auth:
Phone: 844-336-2676, available 8am – 7pm Monday – Friday, EST
Fax: 858-357-2612
Online:Submit through Cover My Meds, Surescripts, or CenterX ePA portals.
UnitedHealthcare Dental:
Phone 877-897-4941
Online:uhcdental.com
MARCH Vision Care:
Phone: 844-516-2724
Online Reference Guides: marchvisioncare.com
Contact Information: providers.eyesynergy.com
General Inquiries:
may be sent to ky_provider_requests@uhc.com
Disclaimer: This email inbox is intended to be used solely for communications that do not containunencrypted Protected Health Information (PHI). Email messages and any documentscontaining PHI are protected by various state and federal laws including 45 C.F.R. Part164. No emails or documentation should be sent to this inbox that contain PHI unless the communication is encrypted. Examples of PHI include a member’s name, date of birth, any detail regarding their medical condition including diagnoses and any other combination of identifiable information.
Credentialing and Attestation
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For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
Join Our Network
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Behavioral Health Providers
Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information, or submit demographic changes atCommunity Plan Behavioral Health.
Facility/Hospital-Based Providers, Group/Practice Providers and Individually-Contracted Clinicians
The state-specific requirements and process on how to join the UnitedHealthcare Community Plan networkis found in the UnitedHealthcare Community Plan Care Provider Manuals.
Learn about requirements forjoining our network.
Kentucky Health Information Exchange
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If you have questions about KHIE or want to begin the connection process, please email us at KHIE@ky.gov, call us at 502-564-7992 EXT 2800 or find us online https://khie.ky.gov/Pages/index.aspx.
Medicaid Managed Care Rule
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Overview
The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:
- Promote quality of care
- Strengthen efforts to reform the delivery of care to individuals covered under Medicaid and Children’s Health Insurance Plans (CHIP)
- Strengthen program integrity by improving accountability and transparency
Enhance policies related to program integrity With the Medicaid Managed Care Rule, CMS updated the type of information managed care organizations are required to include in their care provider directories.
Member Information: Current Medical Plans, ID Cards, Provider Directories, Dental & Vision Plans
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Visit UHCCommunityPlan.com/KYfor current member plan information including sample member ID cards, provider directories, value-added benefits, dental plans, vision plans and more.
Plan information is available for:
- UnitedHealthcare Community Plan of Kentucky
Member dental plan and benefit information can be found at UHCCommunityPlan.com/KY andmyuhc.com/communityplan.
Access a PDF Provider Directory by Region:
PCP Membership Reports
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CommunityCare
The best way for primary care providers (PCPs) to view and export thefull member roster is using the CommunityCare feature on the UnitedHealthcare Provider Portal, which allows you to:
- Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the state in order to remain eligible to receive Medicaid benefits
- See a complete list of all members, or just members added in the last 30 days
- Export the roster to Microsoft Excel
- View most Medicaid and MedicareSpecial Needs Plans (SNP) members’ plans of care and health assessments
- Enter plan notes and view notes history (for some plans)
- Obtain HEDIS information for your member population
- Access information about members admitted to or discharged from an inpatient facility
- Access information about members seen in an emergency department
For help using CommunityCare feature on the UnitedHealthcare Provider Portal, please see ourQuick Reference Guide.If you’re not familiar with UnitedHealthcare Provider Portal, go toUHCprovider.com/portal.
CommunityCare Overview
Provider Manual
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- Kentucky Provider Manual: Physician, Health Care Professional, Facility and Ancillary
Reporting Health Care Fraud, Waste and Abuse
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Reporting Fraud, Waste or Abuse to Us
When you report a situation that could be considered fraud, you’re doing your part to help save money for the health care system and prevent personal loss for others.Ifyou suspect another provider or member has committed fraud, waste or abuse, you have a responsibility and a right to report it.
Taking action and making a report is an important first step.After your report is made, we will work to detect, correct and prevent fraud, waste, and abuse in the health care system.
Call us at1-844-359-7736or visituhc.com/fraud to report any issues or concerns.
Health Insurance Portability and Accountability Act (HIPAA) Information
HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes.
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.
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.
