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Provider Call Center

866-815-5334
8 a.m. – 5 p.m. CST (except State designated holidays)

Provider Relations Team

Missouri_PR_Team@uhc.com

 

Network Management Team

866-574-6088
mo_network_mgmt@uhc.com
 
 

Postal Mailing Address

UnitedHealthcare Community Plan of Missouri
13655 Riverport Drive
Maryland Heights, MO 63043
 

Claims Mailing Address

Planong Pangkomunidad ng UnitedHealthcare
PO Box 5240
Kingston, NY 12402-5240
 

Appeals Address   

UnitedHealthcare Community Plan of Missouri
Attention: Provider Dispute
P.O. Box 31364
Salt Lake City, Utah 84131-0364
 

Additional Information

Kalusugan sa Pag-uugali
Optum Behavioral Health
866-815-5334
https://www.providerexpress.com/content/ope-provexpr/us/en.html

Pangangalaga sa Ngipin
UnitedHealthcare Dental
855-934-9818
https://uhcpwp.sciondental.com/PWP/Landing

Member Transportation
Medical Transportation Management
866-292-0359
https://www.mtm-inc.net/

Pangangalaga sa Paningin
March Vision Care
844-616-2724
https://marchvisioncare.com/


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

 

Provider Medicaid Enrollment 

Effective January 1, 2018, all providers servicing Missouri Medicaid members must be enrolled with Missouri HealthNet. Use the application form below that best applies to your situation.

Individual Provider Enrollment
Missouri HealthNet Individual Providers Application 

Organizational Provider Enrollment
Missouri HealthNet Large Provider Organization Application


Medicaid Managed Care Rule External Frequently Asked Questions
(PDF 64.57 KB)
Medicaid Managed Care Rule Presentation
(PDF 90.71 KB)

 

Prior Authorization

To request prior authorization for Pediatric Care Network (PCN) members, contact PCN at 1-877-347-9367. 

Prior Authorization Fax Request Form (PDF 72.36 KB)

UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan

UnitedHealthcare Medicare Plan Prior Authorization Requirements - Effective 4/1/2018 (PDF 293.21 KB)

Planong Pangkomunidad ng UnitedHealthcare

UnitedHealthcare Community Plan Prior Authorization MO - Effective 4/1/2018 (PDF 138.08 KB)

 

 

Issue Log

The Provider Issue Log is updated on a weekly basis and provides the status, resolution and timing of global issues impacting multiple providers.

View Current Provider Issue Log (PDF 119.12 KB)

 

Pediatric Care Network (PCN)

Pediatric Care Network will provide delegated medical management services for UHC Community Plan Pediatric Care Network members including case management, utilization management and disease management. Resources are available for providers including reference guides, office forms, frequently asked questions and more.

View Pediatric Care Network Provider Resources

 

 

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. 

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.