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UnitedHealthcare Community Plan Mississippi Providers

Welcome to the UnitedHealthcare Community Plan Health Professionals area for Mississippi providers.

Here you will find the information, forms, manuals and links you need to conduct business with UnitedHealthcare Community Plan.

Please choose your topic of interest, by selecting one of the navigation buttons on the left-hand side of the page, or select one of the topics or products below to reveal our Contact Information, Prior Authorizations, Coverage Guidelines, Policies and more. 

 

Provider Training

MSCAN Autism Spectrum Disorder Services Program - Provider Orientation (PPTX 14.11 MB)

Optum would like to cordially invite you, your clinical and administrative staff,  to attend a  Provider Orientation for the MississippiCAN Autism Spectrum Disorder Services Program.  We will hold a telephonic Provider Orientation that will address a host of topics that will benefit you as you provide services and work within the Optum MS CAN Autism Network.  Our telephonic Provider Orientation is scheduled for November 9th at 2:00 EST. You can attend by calling into our conference line at 1-763-957-6400, Meeting ID# 828 814 373. 

You may find related materials in advance of this meeting at the following location:

https://www.providerexpress.com/content/ope-provexpr/us/en/clinical-resources/autismABA/abaCAMediCal11.html

After the orientation, please feel free to contact your Network Manager, Deborah Sills, at Deborah.Sills@optum.com.

Makipag-ugnayan sa Amin

Contract, Demographic, and Network Related Issues: (800) 557-9933

Claims or Service Related Questions: (800) 557-9933

Hours of Operation (Call Center): 8 am - 6 pm CST

Report Health Care Fraud, Waste and Abuse: 844-359-7736 or uhc.com/fraud


Postal Mailing Address:
UnitedHealthcare
795 Woodlands Parkway
Suite 301
Ridgeland, MS  39157

Claims Mailing Address: 
P.O. Box 5032
Kingston, NY  12402-5032

Prior Authorizations


UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 10/1/2017 (PDF 230.06 KB)


(PDF 230.06 KB)UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 10/1/2017 (PDF 235.59 KB)

UnitedHealthcare Medicare Prior Authorization Requirements - Effective 10/1/2017 (PDF 286.74 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 7/1/2017 (PDF 218.24 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 7/1/2017 (PDF 226.79 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 7/1/2017 (PDF 300.09 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 4/1/2017 (PDF 200.13 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 4/1/2017 (PDF 207.51 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 5/1/2017 (PDF 299.55 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 1/1/2017 (PDF 306.96 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 4/1/2017 (PDF 300.79 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 1/1/2017 (PDF 200.03 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 1/1/2017 (PDF 206.71 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 10/1/2016 (PDF 205.14 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 10/1/2016 (PDF 209.24 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 7/1/2016 (PDF 217.95 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 7/1/2016 (PDF 194.81 KB)

UnitedHealthcare Community Plan Prior Authorization - MS CAN - effective 5/1/2016 (PDF 195.31 KB)

UnitedHealthcare Community Plan Prior Authorization - MS CHIP - Effective 5/1/2016 (PDF 190.5 KB)

UnitedHealthcare Community Plan Prior Authorization - MS CAN - Effective 1/1/2016 (PDF 202.93 KB)

UnitedHealthcare Community Plan Prior Authorization - MS CHIP - Effective 1/1/2016 (PDF 180.68 KB)

Prior Authorization CAN (PDF 206.93 KB) - Effective December 7, 2015

Prior Authorization CHIP (PDF 181.17 KB) - Effective December 7, 2015

Advance Notification Requirements for Mississippi CAN – Effective March 1, 2015 (PDF 201.32 KB)
Advance Notification Requirements for Mississippi CHIP – Effective March 1, 2015 (PDF 181.85 KB)

MS CAN Prior Authorization (PDF 19.71 KB)

 

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. Ang mga patakaran at alituntunin na ito ay ibinibigay para sa mga layunin ng pagbibigay-impormasyon, at hindi bumubuo ng isang payong medikal.
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

Integridad ng Mga Claim, Ulat, at Pagkakatawan sa Pamahalaan

Iniaatas ng UnitedHealth Group ang pagsunod sa mga batas pederal at batas ng estado na nagbabawal sa pagsusumite ng mga huwad na claim kaugnay sa mga pederal na programa ng pangangalaga sa kalusugan, kabilang na ang Medicare at 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. Upang makita ang mga na-update na pagbabago sa patakaran, piliin ang seksyon ng Bulletin sa kaliwa.