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

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, Provider Administrative Manuals and Forms.

UnitedHealthcare Community Plan Added to Electronic Payments & Statements (PDF 59.89 KB)

Provider Call Center

877-651-6677
24/7 Customer Service;
8 a.m. – 5 p.m. for Member Advocates

Postal Mailing Address

UnitedHealthcare Community Plan
10701 W. Research Drive
Wauwatosa, WI 53226

Claims Mailing Address

UnitedHealthcare Community Plan
PO Box 5280
Kingston, NY 12402-5280

Utilization Management Appeals Address   

UnitedHealthcare Community Plan
P.O. Box 31364
Salt Lake City, Utah 84131-0364

Claims Appeals Mailing Address

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

 

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

Additional Information

UnitedHealthcare Behavioral Health
PO Box 30757
Salt Lake City, Utah 84130-0757

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

Prior Authorization

UnitedHealthcare Outpatient Injectable Chemotherapy Prior Authorization Program Overview (PDF 72.31 KB)

UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan
UnitedHealthcare Medicare Prior Authorization Requirements - Effective 1/1/2018 (PDF 282.37 KB)

UnitedHealthcare Community Plan
UnitedHealthcare Community Plan Prior Authorization WI - Effective 1/1/2018 (PDF 198.31 KB)

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

UnitedHealthcare Community Plan Prior Authorization WI - Effective 10/1/2017 (PDF 213.58 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 WI Effective 7/1/2017 (PDF 208.81 KB)

UnitedHealthcare Community Plan Prior Authorization WI - Effective 4/1/2017 (PDF 208.51 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 WI - Effective 1/1/2017 (PDF 208.73 KB)

UnitedHealthcare Community Plan Prior Authorization WI - Effective 10/1/2016 (PDF 210.02 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification / Prior Authorization Requirements -  Effective 10/1/2016 (PDF 277.31 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification/Prior Authorization Requirements - Effective 7/1/2016 (PDF 266.74 KB)

UnitedHealthcare Community Plan Prior Authorization WI - Effective 7/1/2016 (PDF 189.28 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification/Prior Authorization Requirements - Effective 5/1/2016 (PDF 251.42 KB)

UnitedHealthcare Community Plan Prior Authorization List WI - Effective 5/1/2016 (PDF 191.3 KB)

UnitedHealthcare Community Plan Prior Authorization List - Effective 12/7/2015 (PDF 199.15 KB)

UnitedHealthcare Medicare Solutions Notification/Prior Authorization List - Effective 1/1/16 (PDF 249.77 KB)

Advanced Notification Requirements for Wisconsin (PDF 196 KB) - 6/1/2015

Advanced Notification Requirements for Wisconsin (PDF 297 KB) - 10/1/2014

 

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.