Maidawat nga pilyen iti pagilyan nu sadinoka nga agsansanay.

Welcome!

Welcome to the UnitedHealthcare Community Plan Health Professionals area for North Carolina providers! Here you will find the information, forms, manuals and links you need to conduct business with UnitedHealthcare Community Plan.

 

Dual Plan (RPPO-SNP) coming soon, learn more

 

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).

Reporting Fraud, Waste and Abuse

If you suspect another provider or member has committed fraud, waste or abuse, you have a responsibility and a right to report it.

Awagandakam iti: 1-866-675-1607 to report any issues or concerns. 

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.