Ensure PCP assignment to avoid reimbursement denial

To support your patient population management and patient relationship-building efforts, UnitedHealthcare Community Plan of New York (UHCCP) requires our members to comply with the primary care provider (PCP) assignment listed on their ID card.

What this means for you

For primary care services, our members must visit a PCP in the same practice (same Tax ID) as the PCP listed on their ID card. If you provide primary care services for a UHCCP member who is not assigned to a PCP in your practice (same Tax ID), you may not receive reimbursement for those services.

It’s important to confirm eligibility and ensure that the UHCCP member is assigned to a PCP in your practice prior to scheduling an appointment or treating the patient. You can confirm eligibility by signing in to the UnitedHealthcare Provider Portal.

If a UnitedHealthcare member is scheduled for a primary care visit at your site but is not assigned to one of your PCPs, the member can call 1-800-493-4647 and request to switch PCPs at any time prior to the appointment.