What can we do to make the UnitedHealthcare Provider Manuals better for you? Click here to provide feedback.

 

 

To learn more about the Dual Special Needs Plan (DSNP), please contact your Provider Advocate or view our DSNP programs on UHC On Air. 

To access UHC On Air:

  1. Sign in to UnitedHealthcareOnline.com using your Optum ID.
  2. Click on the UHC On Air app on your Link dashboard.
  3. Select the UHC News Now channel on UHC On Air, then select one of the DSNP programs to view.
Please select the state where you practice.
UnitedHealthcare Community Plan Kansas Providers

UnitedHealthcare Community Plan of Kansas

We insure more pregnant moms, more children, and more aged, blind and persons with disabilities than anyone else. No one has a larger list of doctors and hospitals. We're a leader in working with community organizations to help the uninsured become insured, and the insured to get the best medical care possible. We're a leader in the effort to understand the social and cultural causes of disease. UnitedHealthcare has been in your community for years. We look forward to partnering with you.

 

Medicaid Managed Care Rule External FAQs (PDF 64.57 KB)
Medicaid Managed Care Rule Presentation
(PDF 90.71 KB)
UnitedHealthcare Community Plan Added to Electronic Payments & Statements
(PDF 59.89 KB)

 

Kontakte Nou

UnitedHealthcare's provider support teams are available to assist Kansas Providers.

View the UnitedHealthcare Community Plan Contact List (PDF 81.3 KB) 


Provider Advocate Contact Information

Provider / Hospital Advocate Team Contact Information (PDF 535.92 KB)
Skilled Nursing Facilities Provider Advocate Map
(PDF 107.51 KB)


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

Issues Log

The Provider Issue Log is updated on a weekly basis and provides the status, resolution and timing of global issues impacting multiple providers. 

Access the current Provider Issue Log (issues posted since 2015)

 

Jwenn yon doktè 

Access our online provider search tool  

Provider Directories  

Eastern Kansas Provider Directory (PDF 3.04 MB) - posted 3.22.2018
Nothern Kansas Provider Directory (PDF 2.49 MB) - posted 3.22.2018
Southern Kansas Provider Directory (PDF 3.27 MB) - posted 3.22.2018
Western Kansas Provider Directory (PDF 1.99 MB) - posted 3.22.2018
Home and Community Based Service (HCBS) Provider Directory (PDF 3.25 MB) - posted 3.22.2018

 

Prior Authorization

UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan
UnitedHealthcare Medicare Prior Authorization Requirements - Effective 4/1/2018 (PDF 293.21 KB)

Plan Kominotè UnitedHealthcare
UnitedHealthcare Community Plan Prior Authorization KS - Effective 4/1/2018 (PDF 208.25 KB)

UnitedHealthcare Medicare Prior Authorization Requirements - Effective 1/1/2018  (PDF 282.37 KB)

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

UnitedHealthcare Community Plan Prior Authorization KS - Effective 10/1/2017 (PDF 220.79 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 KS - Effective 7/1/2017 (PDF 212.77 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 4/1/2017 (PDF 211.71 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 KS - Effective 1/1/2017 (PDF 204.28 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 10/1/2016 (PDF 212.19 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 7/1/2016 (PDF 207.52 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 5/1/2016 (PDF 197.52 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 1/1/2016 with attachment (PDF 190.74 KB)

UnitedHealthcare Community Plan Prior Authorization KS - Effective 1/1/2016 (PDF 197.61 KB)

 

 

Medical Injectables

Specialty pharmacy medications covered on the Medical Benefit may be provided through a variety of channels – home infusion provider, outpatient facility, physician, or specialty pharmacy.

Specialty pharmacy medications covered under the member’s medical benefit may be obtained through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.

If you don’t want to buy and bill a specialty pharmacy medication covered under the member’s medical benefit, you may order it through the following network specialty pharmacy:

Network Specialty Pharmacy

Nimewo Telefòn

BriovaRx

855-427-4682

The following specialty pharmacies also provide certain types of specialty medications:

Network Specialty Pharmacy

Medication Category

Nimewo Telefòn

Accredo (nursing services)

Enzyme Deficiency

Gaucher's Disease

Immune Globulin

Pulmonary Hypertension

800-803-2523

 

Option Care (nursing services)

Enzyme Deficiency

Gaucher's Disease

Hemophilia

Immune Globulin

Makena

866-827-8203

CVS Caremark Specialty Pharmacy

Pulmonary Hypertension

800-237-2767


Coverage of a requested medication depends on the member’s benefit, and availability of a specific drug from a network specialty pharmacy may vary.

Upon request, a specialty pharmacy can deliver the medication to your office or another site such as a member’s home.

Medications obtained through a specialty pharmacy will be directly billed to the patient’s health plan.

Provider Notice Archives 

DME Notice for Pharmacies (PDF 90.14 KB) 

 

Disclosure Forms

Disclosure Forms are required for all contracted providers. If you are already a network provider and have not submitted your completed disclosure form, please email the form to ks.disclosure.forms@uhc.com

Medicaid Provider Assistance 

Kansas Department of Health and Environment's Division of Health Care Finance and the Kansas Foundation for Medical Care (KFMC) are working together to assist Medicaid providers in Kansas with implementing health information technology and the Medicaid EHR Incentive Program (Meaningful Use). The documents available at the links below describe the services offered and eligibility criteria.

Medicaid Meaningful Use Incentives (PDF 134.14 KB)

Technical Assistance with Health Information Technology (PDF 453.42 KB)

 

HPV Home

http://www.cdc.gov/hpv/index.html

The HPV Home site is the CDC website for the public and health care professionals. Healthcare professional information includes:
• CME opportunities
• Fact Sheets and schedules
• Tools and materials for your office
• Information to provide to parents (English/Spanish)
• Recommendations for leading the conversation about HPV

HPV for Clinicians CE
http://www.cdc.gov/hpv/hcp/continuing-ed.html

The HPV Clinicians for CE link is a CDC website with free, credit courses on HPV infection, cancers and vaccinations. The courses include guidance on how to have an effective conversation with parents about HPV vaccinations.

You Are The Key to Cancer Prevention! Vacinate!  http://www.kansasaap.org/wordpress/chapter/kaap-webinars/hpv-webinar/

You Are the Key to Cancer Prevention! Vacinate! is presented as a web-on-demand video with pre-test and post-test. 

Physicians: 
The Kansas Chapter, American Academy of Pediatrics is accredited by the Kansas Medical Society to provide continuing medical education for physicians.

The Kansas Chapter, American Academy of Pediatrics designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

 

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. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.
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

Integrity of Claims, Reports, and Representations to the Government

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).

Disclaimer

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.