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UnitedHealthcare Community Plan Nebraska Providers

Welcome to the UnitedHealthcare Community Plan area for Nebraska providers!

 

On this site you will find the information, forms, manuals and links you need to successfully partner with UnitedHealthcare Community Plan. We are committed to working with you and your staff to achieve the best possible health outcomes for our members.

This website provides a current summary of health services and drug coverage provided by UnitedHealthcare Community Plan of Nebraska, Jan. 1, 2017, to Dec. 31, 2017. A detailed description of the benefits can be found in the Member Handbook.

Select one of the navigation buttons on the left to find what you’re looking for, or select one of our forms and resources below.

 

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

Provider Call Center

866-331-2243

Hours of Operation
7:00 am - 8:00 pm CST (6:00 am - 7:00 pm MST), Monday - Friday

 

Mailing Address

Planong Pangkomunidad ng UnitedHealthcare
2717 N 118th Street, Suite 300
Omaha, NE 68164

 

Claims Mailing Address

UnitedHealthcare
PO Box 31365
Salt Lake City, UT 84131

 

Utilization Denial & Appeals Department Mailing Address

National A&G Service Center
PO Box 31365
Salt Lake City, UT 84131

 

Claims Appeals Mailing Address

UnitedHealthcare Community Plan Appeals
PO Box 31365
Salt Lake City, UT 84131

 

Pharmacy Contact Information

Rx Claims Processing Technical Assistance: Contact the OptumRx Help Desk at
877-231-0131, 24 hours a day, 7 days a week.

Pharmacy Prior Authorization Assistance: Contact our Pharmacy Prior Authorization line at 800-310-6826.

Medical DME Questions: Contact our Provider Service Center at 866-331-2243. 

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

UnitedHealthcare Provider Resources

UnitedHealthcare Corporate website

Nebraska Provider Advocate Contact Sheet (PDF 55.06 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.