UnitedHealthcare Community Plan of Maryland
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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Resources
Hours of operation: 8 a.m.–6 p.m. ET
Provider call center: Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.
Member services: 800-318-8821 (TTY 711), Monday–Friday, 8 a.m.–7 p.m. ET
Mailing address:
UnitedHealthcare Community Plan
10175 Little Patuxent Parkway
Columbia, MD 21044
Claims mailing address:
UnitedHealthcare Community Plan
PO Box 31365
Salt Lake City, UT 84131
Utilization management denial and appeals mailing address:
UM Denial & Appeals Department
PO Box 31365
Salt Lake City, UT 84131
Claims appeals mailing address:
UnitedHealthcare Community Plan Appeals – Maryland
PO Box 31365
Salt Lake City, UT 84131
Credentialing updates:
For questions about credentialing and attestation updates, connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.
Facility/hospital-based providers, group/practice providers and individually contracted clinicians
You can find the state-specific requirements and process on how to join the UnitedHealthcare Community Plan network in the UnitedHealthcare Community Plan Care Provider Manuals.
Learn about requirements for joining our network.
Search for a care provider by plan name:
Search for Preferred Drug List by plan name:
Visit the Maryland Community Plan page for current member plan information including provider directories, dental plans, vision plans and more.
Plan information is available for:
- Maryland HealthChoice
Member plan and benefit information can also be found at myuhc.com/communityplan.
Referrals are required for most specialty services.
We offer several digital tools to help you verify, manage and submit eligibility and referral activity.
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.
CommunityCare
The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare feature in 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 on the UnitedHealthcare Provider Portal, please see our quick reference 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 (D-SNP) offer benefits for people with both Medicare and Medicaid. These D-SNP 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 UnitedHealthcare 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.