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UnitedHealthcare Community Plan Mississippi Providers

Welcome to the UnitedHealthcare Community Plan Health Professionals area for Mississippi providers.

Here you will find the information, forms, manuals and links you need to conduct business with UnitedHealthcare Community Plan.

Please choose your topic of interest, by selecting one of the navigation buttons on the left-hand side of the page, or select one of the topics or products below to reveal our Contact Information, Prior Authorizations, Coverage Guidelines, Policies and more. 

 

Provider Training

MSCAN Autism Spectrum Disorder Services Program - Provider Orientation (PPTX 14.11 MB)

Optum would like to cordially invite you, your clinical and administrative staff,  to attend a  Provider Orientation for the MississippiCAN Autism Spectrum Disorder Services Program.  We will hold a telephonic Provider Orientation that will address a host of topics that will benefit you as you provide services and work within the Optum MS CAN Autism Network.  Our telephonic Provider Orientation is scheduled for November 9th at 2:00 EST. You can attend by calling into our conference line at 1-763-957-6400, Meeting ID# 828 814 373. 

You may find related materials in advance of this meeting at the following location:

https://www.providerexpress.com/content/ope-provexpr/us/en/clinical-resources/autismABA/abaCAMediCal11.html

After the orientation, please feel free to contact your Network Manager, Deborah Sills, at Deborah.Sills@optum.com.

Makiyinnuman Kadakami

Contract, Demographic, and Network Related Issues: (800) 557-9933

Claims or Service Related Questions: (800) 557-9933

Hours of Operation (Call Center): 8 am - 6 pm CST

Report Health Care Fraud, Waste and Abuse: 844-359-7736 or uhc.com/fraud


Postal Mailing Address:
UnitedHealthcare
795 Woodlands Parkway
Suite 301
Ridgeland, MS  39157

Claims Mailing Address: 
P.O. Box 5032
Kingston, NY  12402-5032

Prior Authorizations


UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 10/1/2017 (PDF 230.06 KB)


(PDF 230.06 KB)UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 10/1/2017 (PDF 235.59 KB)

UnitedHealthcare Medicare Prior Authorization Requirements - Effective 10/1/2017 (PDF 286.74 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 7/1/2017 (PDF 218.24 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 7/1/2017 (PDF 226.79 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 7/1/2017 (PDF 300.09 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 4/1/2017 (PDF 200.13 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 4/1/2017 (PDF 207.51 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 5/1/2017 (PDF 299.55 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 1/1/2017 (PDF 306.96 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 4/1/2017 (PDF 300.79 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 1/1/2017 (PDF 200.03 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 1/1/2017 (PDF 206.71 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 10/1/2016 (PDF 205.14 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 10/1/2016 (PDF 209.24 KB)

UnitedHealthcare Community Plan Prior Authorization MS CAN - Effective 7/1/2016 (PDF 217.95 KB)

UnitedHealthcare Community Plan Prior Authorization MS CHIP - Effective 7/1/2016 (PDF 194.81 KB)

UnitedHealthcare Community Plan Prior Authorization - MS CAN - effective 5/1/2016 (PDF 195.31 KB)

UnitedHealthcare Community Plan Prior Authorization - MS CHIP - Effective 5/1/2016 (PDF 190.5 KB)

UnitedHealthcare Community Plan Prior Authorization - MS CAN - Effective 1/1/2016 (PDF 202.93 KB)

UnitedHealthcare Community Plan Prior Authorization - MS CHIP - Effective 1/1/2016 (PDF 180.68 KB)

Prior Authorization CAN (PDF 206.93 KB) - Effective December 7, 2015

Prior Authorization CHIP (PDF 181.17 KB) - Effective December 7, 2015

Advance Notification Requirements for Mississippi CAN – Effective March 1, 2015 (PDF 201.32 KB)
Advance Notification Requirements for Mississippi CHIP – Effective March 1, 2015 (PDF 181.85 KB)

MS CAN Prior Authorization (PDF 19.71 KB)

 

UnitedHealthcare Community Plan Medical & Drug Policies and Coverage Determination Guidelines

UnitedHealthcare has developed Medical Policies, Medical Benefit Drug Policies and Coverage Determination Guidelines to assist us in administering health benefits. Dagitoy a pagalagadan ken pagannurotan ket maipaay para ti panangipakaammo a ranta, ken saan a mangbukel ti medikal a balakad.
View the guidelines

UnitedHealthcare Medicare Advantage Coverage Summaries

For policy guidance for Medicare Advantage plan members, view the UnitedHealthcare Medicare Advantage Coverage Summaries Manual and corresponding policy update bulletins here

Integridad ti Claims, Reports, ken Panangibagi iti Gobyerno

UnitedHealth Grupo ket dawatenna ti panagtungpal kadagiti dawdawaten ti pederal ken paglintegan ti estado nga mangiparit ti panagsumite ti palso a claims a maikamang iti pederal a programa ti pannakasalwad ti salun-at, pakairamanan ti Medicare ken Medicaid. 
View our policy (PDF 38.15 KB).

Panangilibak

If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. Tapno makita ti pakaaamo a panagbalbaliw ti pagalagadan, pilien ti Pagwarnakan a seksiyon iti kanigid.