Welcome to the Home for Care Provider Resources

For UnitedHealthcare Community Plan of Maryland

Welcome

For UnitedHealthcare Community Plan of Maryland

Skip left navigation

UnitedHealthcare Community Plan of Maryland Homepage

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 menu on the left to quickly find what you're looking for. Be sure to check back frequently for updates.

Hours of Operation: 8:00 am - 6:00 pm EST
Provider Call Center: 877-842-3210
Member Services Number: 800-318-8821 (TTY 711),  Monday-Friday, 8:00 am to 7:00 pm EST

Mailing Address:
UnitedHealthcare Community Plan
6220 Old Dobbin Lane
Columbia, MD  21045

Claims Mailing Address:
UnitedHealthcare Community Plan
PO Box 31365
Salt Lake City, UT 84131 

Utilization Denial & Appeals Department 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: 
Contact the National Credentialing Center at 1-877-842-3210.

Additional Resources

Facility/Hospital-Based Providers, Group/Practice Providers and Individually-Contracted Clinicians

The state-specific requirements and process on how to join the UnitedHealthcare Community Plan network is found in the UnitedHealthcare Community Plan Care Provider Manuals.

Learn about requirements for joining our network.

Visit UHCCommunityPlan.com/MD for current member plan information including provider directories, dental plans, vision plans and more.

View a sample member ID card here: Member ID card

Plan information is available for:

  • Maryland HealthChoice

Member plan and benefit information can also be found at UHCCommunityPlan.com/MD and myuhc.com

Referrals are required for most specialty services.

The links below provide more information on our referral requirements including how to submit online referrals.

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.  

Helpful Resources

Reporting Fraud, Waste or Abuse to Us

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.

Current News, Bulletins and Alerts

Skilled Nursing Facility Stays Frequently Asked Questions (FAQs) for UnitedHealthcare Community Plan of Maryland

Last Modified | 09.12.2019

Per Maryland Department of Health and Mental Hygiene’s (DHMH) Transmittal (PT 15-17), effective Jan. 1, 2017, we extended the allowable time for skilled nursing facility inpatient stays from 30 to 90 days. Facilities still need to follow UnitedHealthcare Community Plan policies regarding transfer and prior authorization requirements.

Learn More
DUR Educational Newsletter: Opioid and Buprenorphine Use for Treating Opioid Use Disorder

Last Modified | 08.16.2019

Buprenorphine and full opioid agonists should not be used together to treat opioid use disorder.

Learn More
Care Provider Quick Reference Guide - UnitedHealthcare Community Plan of Maryland

Last Modified | 08.15.2019

This reference guide provides you with quick access to local and national resources.

Learn More
View More News
UHC On Air text above stylized monitor.

UHC On Air gives you in-depth program information and meaningful updates from UnitedHealthcare 24/7and from any device.

Learn More

HEDIS Medical Record Collection

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 Healthcare Common Procedure Coding System (HCPCS) and CPT-4 codes. View our updated HIPAA information for UnitedHealthcare Community Plan.

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. View our policy.

Disclaimer

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.