As a primary care physician, you can earn extra on top of fee-for-service payments. We’ve added more categories to our incentive program to help support you and your practice. Thank you for the care you provide to our UnitedHealthcare Community Plan members.
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.
Learn how our Application Programming Interface (API), Electronic Data Interchange (EDI) and UnitedHealthcare Provider Portal digital solutions can help you save time, reduce paper and get paid faster.
Easily manage your practice’s submission of claims, payment information, eligibility and benefits, prior authorization and more.
Need to register or modify your access within the UnitedHealthcare Provider Portal? Check out the:
Help patients find you by verifying your practice data in our provider directories. There are multiple ways to do this.
You now have more flexibility to access trainings on your time, search topics and get the resources you need.
Search for a care provider by plan name:
Search for Preferred Drug List by plan name:
Visit UHCCommunityPlan.com/MI for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.
Plan information is available for:
Member plan and benefit information can also be found at UHCCommunityPlan.com/MI and myuhc.com/communityplan.
Verify Medicaid Eligibility - State of MI expand_moreIMPORTANT: Must be signed in before clicking the link.
Join Our Network / Credentialing and Attestation expand_moreFor Credentialing and Attestation updates, contact the National Credentialing Center at 1-877-842-3210.
Learn how to join the Behavioral Health Network, review Community Plan Behavioral Health information, or submit demographic changes at Community Plan Behavioral Health.
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.
Medicaid Managed Care Rule expand_moreThe Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:
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.
PCP Membership Reports expand_moreThe best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare feature on the UnitedHealthcare Provider Portal, which allows you to:
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.
Reporting Health Care Fraud, Waste and Abuse expand_moreWhen 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.
UnitedHealthcare Dual Complete Special Needs Plans (SNP) offer benefits for people with both Medicare and Medicaid. These SNP plans provide benefits beyond Original Medicare, and may include transportation to medical appointments and vision exams. Members must have Medicaid to enroll.
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.
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.
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.