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.
UnitedHealthcare Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, and may include transportation to medical appointments and vision exams. Enrollees must have Medicaid to enroll.
Provider Services at 888-350-5608.
For providers who wish to join the network.
For DME providers who wish to join the network, send an email to: DMEPOSNetwork@UHC.com.
Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information, or submit demographic changes at Community Plan Behavioral Health.
Learn about requirements for joining our network.
UnitedHealthcare Community Plan determines and maintains its list of covered medications. This list applies to all UnitedHealthcare Community Plan of District of Columbia members.
The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:
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.
Visit UHCCommunityPlan.com/DC or current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.
Member plan and benefit information can also be found at UHCCommunityPlan.com/DC.
CareConductor
The best way for primary care professionals (PCPs) to manage District of Columbia UnitedHealthcare Community Plan and UnitedHealthcare Dual Complete member care is using the Care Conductor tool on the UnitedHealthcare Provider Portal, which allows PCPs to:
For more information about Care Conductor please log in to the UnitedHealthcare Provider Portal.
CommunityCare Enrollee Roster
The best way for primary care professionals (PCPs) to view and export the full District of Columbia UnitedHealthcare Community Plan and UnitedHealthcare Dual Complete member roster is using the CommunityCare feature on the UnitedHealthcare Provider Portal, which allows PCPs to:
For help using CommunityCare on the UnitedHealthcare Provider Portal, please see our CommunityCare Training.
If you’re new to the UnitedHealthcare Provider Portal, please visit UHCprovider.com/portal to register.
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. If you 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 at 1-844-359-7736 or visit uhc.com/fraud to report any issues or concerns.
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.
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.
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.