UnitedHealthcare Community Plan of Kentucky
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.
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State news, bulletins and alerts
- 04.01.2025 - Medicaid: View the genetic and molecular codes added to prior authorization requirements
- 02.19.2025 - Keep Rural Communities Healthy: The Role of HPV Vaccination Training
This webinar focuses on opportunities to increase HPV vaccination coverage with rural communities to prevent HPV cancers and is intended for an audience of healthcare providers, professionals serving rural communities, etc. The training provides an overview of HPV epidemiology and shares efforts by the St. Jude HPV Cancer Prevention Program, including the implementation of six priority action steps, and other strategies for improvement. Training takes around 60 minutes to complete. - 09.30.2024 - New External Independent Third Party Review Form Goes Live October 1, 2024
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Resources
Provider call center
Phone: 866-633-4449 available 8 a.m. – 6 p.m. Eastern Time (including federal holidays)
Provider Relations team
Email: kentucky_pr_team@uhc.com
Network Management team
To check the status of your credentialing application, Sign In with your One Healthcare ID. This allows you to access self-service tools or connect to a chat advocate for support. Please have the care provider’s full name, tax ID number and National Provider Identifier (NPI) number available.
Technical support
Phone: 866-209-9320
Behavioral health contact information
Phone: 800-888-2998
Online: providerexpress.com
Pharmacy services
Phone: 800-210-7628
Prior authorization:
- Phone: 844-336-2676, available 8am – 7pm Monday – Friday
- Fax: 858-357-2612
- Online: Submit through Cover My Meds, Surescripts, or CenterX ePA portals.
UnitedHealthcare Dental
Phone 877-897-4941
Online: uhcdental.com
MARCH Vision Care
Phone: 844-516-2724
Online Reference Guides: marchvisioncare.com
Contact Information: providers.eyesynergy.com
General inquiries:
Email: ky_provider_requests@uhc.com
Disclaimer: This email inbox is intended to be used solely for communications that do not contain unencrypted protected health information (PHI). Email messages and any documents containing PHI are protected by various state and federal laws including 45 C.F.R. Part 164. No emails or documentation should be sent to this inbox that contain PHI unless the communication is encrypted. Examples of PHI include a member’s name, date of birth, any detail regarding their medical condition including diagnoses and any other combination of identifiable information.
For questions about credentialing and attestation updates, connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.
Behavioral health providers
Learn how to join the behavioral health network, review behavioral health information or submit demographic changes at Community Plan Behavioral Health.
Medical providers including facility/hospital-based, group/practice and individually contracted clinicians
The state-specific requirements and process on how to join the UnitedHealthcare Community Plan network are found in the UnitedHealthcare Community Plan Care Provider Manuals.
Learn about requirements for joining our network.
If you have questions about KHIE or want to begin the connection process, please email us at KHIE@ky.gov, call us at 502-564-7992, ext. 2800 or visit the Kentucky Health Information Exchange page.
Healthy First Steps program
You can refer patients to a UnitedHealthcare maternity care manager through our Healthy First Steps program. This program will support them through their pregnancy. Your patient can get pregnancy and parenting support by calling 800-599-5985 (TTY 711).
We can help with:
- Finding a doctor for both mother and baby
- Learning about nutrition, fitness and safety
- Finding out what extra rewards she could be eligible for
- Learning about breastfeeding questions and resources in her area
Overview
The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:
- Promote quality of care
- Strengthen efforts to reform the delivery of care to individuals covered under Medicaid and Children’s Health Insurance Plans (CHIP)
- Strengthen program integrity by improving accountability and transparency
- 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/ky for current member plan information including sample member ID cards, provider directories, value-added benefits, dental plans, vision plans and more.
Plan information is available for:
- UnitedHealthcare Community Plan of Kentucky
Member dental plan and benefit information can be found at uhccommunityplan.com/ky and myuhc.com/communityplan.
Access a PDF Provider Directory by region:
CommunityCare
The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare feature on the UnitedHealthcare Provider Portal, which allows you to:
- Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the state in order to remain eligible to receive Medicaid benefits
- See a complete list of all members, or just members added in the last 30 days
- Export the roster to Microsoft Excel
- View most Medicaid and Medicare Special Needs Plans (SNP) members’ plans of care and health assessments
- Enter plan notes and view notes history (for some plans)
- Obtain HEDIS® information for your member population
- Access information about members admitted to or discharged from an inpatient facility
- Access information about members seen in an emergency department
For help using CommunityCare feature in the UnitedHealthcare Provider Portal, please see our user guide. If you’re not familiar with UnitedHealthcare Provider Portal, visit our portal resources page.
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 844-359-7736 or visit uhc.com/fraud to report any issues or concerns.
UnitedHealthcare Dual Complete® Special Needs Plan
UnitedHealthcare Dual Complete Special Needs Plans (DSNP) offer benefits for people with both Medicare and Medicaid. These DSNP plans provide benefits beyond Original Medicare, and may include transportation to medical appointments and vision exams. Members must have Medicaid to enroll.
Health Insurance Portability and Accountability Act (HIPAA) information
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 HCPCS and CPT®-4 codes.
Integrity of claims, reports and representations to the government
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.
Disclaimer
If UnitedHealth Group 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 Policies and Clinical Guidelines section at left.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CPT® is a registered trademark of the American Medical Association.