Quick Reference Guide. For health care professionals | Pennsylvania. UnitedHealthcare Dual Complete Select (HMO D-SNP). Effective Jan. 1, 2022.
Quick Reference Guide For health care professionals | Pennsylvania UnitedHealthcare Dual Complete® Select (HMO D-SNP) Effective Jan. 1, 2022 UnitedHealthcare Provider Portal PCP membership reports Member eligibility and benefits Claims/reconsiderations Prior authorization EDI* transactions Referrals Prescription coverage/pricing Prescription drug formulary Provider educational resources Facility/practice data updates Online UHCprovider.com/portal UHCprovider.com/portal UHCprovider.com/eligibility UHCprovider.com/claims UHCprovider.com/paan UHCprovider.com/edi UHCprovider.com/referral UHCprovider.com/precheckmyscript UHCprovider.com/dsnpformulary UHCprovider.com/training UHCprovider.com/mypracticeprofile Phone 1-800-600-9007 Behavioral health Submit a behavioral health referral: Online: providerexpress.com Phone: 1-800-290-4009 7 days a week, 8 a.m.-8 p.m., OctMar; M-F, Apr-Sept Virtual Visits: 1-800-290-4009 Appeals submission API: Submit appeals with attachments using our API solution. Get more information online at UHCprovider.com/api. Online: UHCprovider.com. Click "Sign In" in the top right corner. Model of care training Please complete the required annual Model of Care training at UHCprovider.com/training > Special Needs Plan Model of Care Training for Providers. PCA-1-21-02928-M&R-QRG_08252021 *Electronic Data Interchange Claims submission Payer ID: 87726 Electronic claims Claims can be filed as an EDI 837 transaction or by using Claims on UHCprovider.com/portal. Paper claims Please mail claims to: UnitedHealthcare Community Plan Pennsylvania P.O. Box 8207 Kingston, NY 12402-8207 Please submit claims within 90 days of service, or the time frame in your Participation Agreement. Other helpful resources For more information, please contact your dedicated Provider Advocate. If you do not have a dedicated Provider Advocate, please send an email to northeastprteam@uhc.com or visit UHCprovider.com/PA > Medicare. Member resources Members with questions can call the number on their member ID card. Non-members can call 1-855-277-4716 to see if they qualify. Key contacts for additional benefits Dental Phone: 1-844-275-8750 Monday-Friday, 8 a.m.-6 p.m. ET Online: UHCdentalproviders.com OTC+Healthy Food Benefit (Solutran) Phone: 1-833-853-8587 7 days a week, 8 a.m.-8 p.m., local time, excluding CMS Holidays Online: healthybenefitsplus.com/HWP Vision (March Vision) Phone: 1-844-916-2724 Monday-Friday, 8 a.m.-5 p.m. Online: marchvisioncare.com Transportation Phone: 1-866-418-9812 Monday-Friday, 8 a.m.-5 p.m. local time Online: modivcare.com Hearing Phone: 1-855-523-9355 Monday-Friday, 8 a.m.-8 p.m. CT Online: UHChearing.com Personal Emergency Response System Phone: 1-855-596-7612 Monday-Friday, 8 a.m.-8:30 p.m. ET; Saturday, 9 a.m.-5:30 p.m. ET Online: lifeline.philips.com/UHCMedicare Renew Active® Fitness Program Phone: 1-800-290-4009 7 days a week, 8 a.m.-8 p.m., Oct-Mar; M-F, Apr-Sept Online: UHCrenewactive.com Meal Delivery Phone: 1-855-428-6667 Monday-Friday, 7 a.m.-6 p.m. CT Online: momsmeals.com/care-transitions/ Virtual Medical Visits Phone: 1-800-290-4009 7 days a week, 24 hours a day Nurse Hotline Phone: 1-877-440-9407 7 days a week, 24 hours a day UnitedHealthcare® At Home Phone: 1-855-409-7073 Monday-Friday, 9 a.m.-5:30 p.m. local time Online: UHCathome.com Sample ID cards Member ID Health Plan (80840): 999-99999-99 Member ID: 999999999 Group Number: Member: SUBSCRIBER BROWN Payer ID: PCP Name: DR. PROVIDER BROWN PCP Phone: (999)999-9999 Rx Bin: Rx Grp: Rx PCN: 999999 XXXXXXXX 9999 Medicaid PCA-1-21-02928-M&R-QRG_08252021 Sample member ID cards for illustration only; actual information varies depending on payer, plan and other requirements. Not for distribution to retirees or beneficiaries. © 2021 United HealthCare Services, Inc. All Rights Reserved. CST33015_H3113-014-000 MedicareAdobe PDF Library 15.0