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UnitedHealthcare Community Plan New York Providers

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Provider Call Center

866-362-3368


 

Postal Mailing Address

Planong Pangkomunidad ng UnitedHealthcare
77 Water Street, 14th Floor
New York, NY 10005

Claims Mailing Address

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

Utilization Management Appeals Address   

Planong Pangkomunidad ng UnitedHealthcare
PO Box 31364
Salt Lake City, UT 84131-0364
Fax: (801) 994-1082

Claims Appeals Mailing Address

Part C Appeals or Grievances:
Planong Pangkomunidad ng UnitedHealthcare
Paunawa: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131-0364
Fax: (801) 994-1082

 

Medicare Part D Grievances:
Planong Pangkomunidad ng UnitedHealthcare
Paunawa: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131
Fax: (801) 994-1082

Medicare Part D Appeals:
Planong Pangkomunidad ng UnitedHealthcare
Paunawa: Part D Standard Appeals
P.O. Box 6103
Cypress, CA 90630-9998
Fax: (877) 960-8235

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

 

Prior Authorization

UnitedHealthcare Outpatient Injectable Chemotherapy Prior Authorization Program Overview (PDF 72.85 KB)

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

Planong Pangkomunidad ng UnitedHealthcare
UnitedHealthcare Community Plan Prior Authorization NY - Effective 4/1/2018 (PDF 249.88 KB)

UnitedHealthcare Community Plan Prior Authorization NY - Effective 1/1/2018 (PDF 246.84 KB)

UnitedHealthcare Medicare Prior Authorization Requirements - Effective 1/1/2018  (PDF 282.37 KB)

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

UnitedHealthcare Community Plan Prior Authorization NY - Effective 10/1/2017 (PDF 256.23 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 NY - Effective 7/1/2017 (PDF 251.62 KB)

UnitedHealthcare Community Plan Prior Authorization NY - Effective 4/1/2017 (PDF 235 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 NY - Effective 1/1/2017 (PDF 224.57 KB)

UnitedHealthcare Community Plan Prior Authorization NY - Effective 10/1/2016 (PDF 226.25 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification / Prior Authorization Requirements -  Effective 10/1/2016 (PDF 277.31 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification/Prior Authorization Requirements - Effective 7/1/2016 (PDF 266.74 KB)  

UnitedHealthcare Community Plan Prior Authorization NY - Effective 7/1/2016 (PDF 205.74 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification/Prior Authorization Requirements - Effective 5/1/2016 (PDF 251.42 KB)

UnitedHealthcare Community Plan Prior Authorization List NY - Effective 5/1/2016 (PDF 216.31 KB)

UnitedHealthcare Community Plan Prior Authorization NY - Effective 1/1/2016 (PDF 220.19 KB)

UnitedHealthcare Medicare Solutions Notification/Prior Authorization List - Effective 1/1/16 (PDF 250.02 KB)

UnitedHealthcare Medicare Solutions Notification/Prior Authorization List - Effective 1/1/16 (PDF 249.77 KB)

 

Provider Training Materials

Quick Reference Guide for the UnitedHealthcare Administrative Guides (PDF 112.23 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

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.