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For UnitedHealthcare Community Plan of New Jersey


For UnitedHealthcare Community Plan of New Jersey

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UnitedHealthcare Community Plan of New Jersey 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 on the left to quickly find what you're looking for. Be sure to check back frequently for updates.”

Provider Service Center

888-362-3368, available Monday – Friday from 6:00 a.m. – 6:00 p.m.

Claims Address

Medicaid and NJ Familycare

UnitedHealthcare Community Plan
P.O. Box 5250
Kingston, NY 12402-5250
Payer ID: 86047 

UnitedHealthcare Dual Complete ONE

UnitedHealthcare Dual Complete® ONE
P.O. Box 5250
Kingston, NY 12402-5250
Payer ID: 86047

Claims Appeal Address

Part C Appeals and Grievance Department
UnitedHealthcare Community Plan
Attn: Complaint and Appeals Department
P.O. Box 31364
Salt Lake City, UT 84131-0364

Part D Appeals and Grievance Department
Attn: CA124-0197
P.O. Box 6106
Cypress, CA 90630-9948

UM Appeals

Medicaid and NJ Familycare

UnitedHealthcare Community Plan
Attn: UM Appeals Coordinator
P.O. Box 31364
Salt Lake City, UT 84131

UnitedHealthcare Dual Special Needs (HMO SNP)

UnitedHealthcare Dual Complete One
Attn: UM Appeals Coordinator
P.O. Box 31364
Salt Lake City, UT 84131

All Providers

For Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.

Credentialing and Recredentialing for Managed Long-Term Care Services and Supports (MLTSS) Providers

All documentation, inquires, and communication related to MLTSS credentialing and recredentialing information can be emailed to us at NJ_MLTSS_CRED@uhc.com.

  • If you are a participating MLTSS provider, you need to send us your recredentialing documents each year to ensure we have your most current complete required documentation.
  • All forms and documents can be emailed to NJ_MLTSS_CRED@uhc.com. Include the name of the facility and the words “Recredentialing Application” in the subject line.
  • Documents can also be mailed to:
    • UnitedHealthcare Community Plan
      Attn: MLTSS Credentialing
      283-289 Market Street 12th Floor, Suite 1202
      Newark, NJ 07102

Behavioral Health Providers

Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information, or submit demographic changes at Community Plan Behavioral Health.

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

Managed Long-Term Care Services and Supports (MLTSS) Providers

If you are interested in becoming a participating MLTSS provider, please email NJ_MLTSS_CRED@UHC.com for more information or to request a credentialing application. Include the name of the facility and the words “Credentialing Application” in the subject line.

Visit UHCCommunityPlan.com/NJ for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.

Plan information is available for:

  • New Jersey FamilyCare
  • New Jersey Managed Long Term Services and Supports (MLTSS) Pharmacy Program

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

Care Provider Search

Search for a care provider by plan name:


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

Medicare Physician Fee Schedule Status Indicator - Reimbursement Policy - UnitedHealthcare Medicare Advantage

Last Modified | 07.20.2018

This policy describes reimbursement for Evaluation and Management (E/M) services (99201–99499) reported by nonphysician health care professionals.

Learn More
PreCheck My Script: Manage Prescribers Quick Reference Guide

Last Modified | 09.28.2018

For provider support staff with multiple prescribers in the office, you can add up to 20 prescribers to your account. Adding a prescriber allows you to submit electronic prior authorizations on their behalf, as well as view their submitted prior authorization history and saved prior authorizations.

Learn More
Link Security: User ID and Password Management Overview

Last Modified | 09.28.2018

The Link Security app (formerly User ID & Password Management) allows password owners and ID administrators to add, change or deactivate users’ access to Link apps. Access can be limited by app, tax ID number (TIN), specialties and more.

Learn More
PreCheck MyScript: A Visual Overview of PreCheck MyScript Features

Last Modified | 09.28.2018

With PreCheck MyScript, you can run a pharmacy trial claim and get real-time prescription coverage detail for your patients who are UnitedHealthcare benefit plan members. If a medication requires prior authorization, you can request it right within the app. No need to call or fax your request — you can do it all online!

Learn More
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Current News, Bulletins and Alerts

(PCM) Medical Care Coordination: Private Duty Nursing for United Healthcare Community Plan of New Jersey (UHCCP)

Last Modified | 09.12.2019

UnitedHealthcare Community Plan (UHCCP) will coordinate PDN care to its members that meet NJ Administrative Code (N.J.A.C 10:60) medical necessity criteria.

Learn More
UPDATE: Delayed Until Further Notice - Updated Speech, Occupational and Physical Therapy Prior Authorization Requirements and Site of Service Medical Necessity Reviews for New Jersey

Last Modified | 09.06.2019

We’re now delaying the implementation of the prior authorization requirement updates and site of service reviews for speech, occupational and physical therapy services for UnitedHealthcare Community Plan of New Jersey members until further notice.

Learn More
B.4.15 Hysterectomy and Sterilization Procedures and Consent Form - UnitedHealthcare Community Plan of New Jersey

Last Modified | 09.05.2019

Federally prescribed documentation regulations for hysterectomies are extremely rigid. SpecificMedicaid requirements must be met and documented on the Hysterectomy

Learn More
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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.

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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.


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.