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, Provider Administrative Manuals and Forms.
Use Payer ID 87726 instead of 95378 for Claim Submissions
Claims submitted to payer ID 95378 will be subject to enhanced pre-adjudication review beginning on or after June 21, 2014.
Other health plans that currently use payer ID 95378 must transition to payer ID 87726 by June 21, 2014. You may be gin using payer ID 87726 immediately. Members will receive an updated member ID card with the new payer ID.
Please refer to the following chart for details:
|UnitedHealthcare Community Plan – Mississippi CHIP||
If you submit claims to payer ID 95378 after June 21, 2014, they will be subject to the enhanced review.
For more information about tracking your electronic claims, please visit: UnitedHealthcareOnline.com > Tools & Resources > EDI Education for Electronic Transactions
> Quick Tips for Electronic Claims > Tracking Your Electronic Claims.
If you have any questions about these changes, please ask your provider advocate or call the number listed for the plan in the chart above.
To review the clinical criteria/guidelines used to conduct medical necessity reviews, please use this link: https://www.unitedhealthcareonline.com/b2c/CmaAction.do?channelId=ca174ccb4726b010VgnVCM100000c520720a____
Contract, Demographic, and Network Related Issues: (800) 557-9933
Claims or Service Related Questions: (800) 557-9933
Hours of Operation (Call Center): 8AM - 6PM
Postal Mailing Address:
795 Woodlands Parkway
Ridgeland, MS 39157
Claims Mailing Address:
P.O. Box 5032
Kingston, NY 12402-5032
Prior Authorization CAN (PDF 206.93 KB) - Effective December 7, 2015
Prior Authorization CHIP (PDF 181.17 KB) - Effective December 7, 2015
MS CAN Prior Authorization (PDF 19.71 KB)
UnitedHealthcare has developed Medical Policies, Medical Benefit Drug Policies and Coverage Determination Guidelines to assist us in administering health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.
View the guidelines.
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.
View our policy (PDF 38.15 KB).
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.