* The claim address on the back of the member’s ID card • For UnitedHealthcare Empire Plan, send to: P.O. Shared Decision-Making Program – Say Y.E.S. The benefit information is a brief summary, not a complete description of benefits. Medicaid UnitedHealthcare Community Plan / SC (formerly Unison) 25175 claims with DOS prior to 10-1-2013 Medicaid, CHIP only UnitedHealthcare Community Plan / IA, hawk-i (formerly AmeriChoice of Iowa) 87726 former payer id 95378 Medicaid, Dual SNP UnitedHealthcare Community Plan / AZ (formerly Arizona Physicians IPA and The plan is for AZ, CA, HI, MD, NE, NV, NJ, NY, NY EPP, OH, PA CHIP, RI and VA. Developmental, Autism Screenings, Blood Lead Level Testing, Newborn Hearing Testing, Early intervention, Standardized Developmental Screening Tools, Resources Pediatrics. Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare® Connected™ de MyCare Ohio (plan Medicare-Medicaid), comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al 1-844-445-8328 (TTY 711) de lunes a viernes de 7 a.m. a 8 p.m. (correo de voz disponible las 24 horas del día, los 7 días de la semana). UnitedHealthcare of the Midlands Inc. is a health insurance company incorporated in Iowa and Nebraska. Refer to NDC Claim Submission or call UnitedHealthcare EDI Support at 800-842-1109 for more information. Monday – Friday, 8 a.m. – 8 p.m. CST, TTY 711 for hearing impaired UnitedHealthcare Community Plan Member . Attn: Part D Standard Appeals information in the online or paper directories. The service is not an insurance program and may be discontinued at any time. Fax: (877) 960-8235, UnitedHealthcare Community Plan Hard-of-hearing: 711, 7 a.m. to 7 p.m. Monday through Friday Box 5250 Kingston, NY 12402-5250 Complete Claims A complete claim includes the following: • Patient’s name, date of birth, address and ID number. Need information about our Dual Special Needs plans for those who have Medicaid and Medicare? Contact UnitedHealthcare by phone, online or by mail. Hard-of-hearing: 711, 1-844-445-6330 TTY:711 Enrollment in the plan depends on the plan’s contract renewal with Medicare. Talk to your UnitedHealthcare representative for more details. To ask for a fair hearing, you or your representative should call UnitedHealthcare Community Plan at 1-888-887-9003 or send a letter to the health plan at: UnitedHealthcare Community Plan Attn: Fair Hearings Coordinator 14141 Southwest Freeway, Suite 800 Sugar Land, TX 77478 Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services. After your report is made, UnitedHealthcare works to detect, correct and prevent fraud , waste  and abuse  in the health care system. Kahului, HI  96732, 1-844-445-7036 32 Kinoole St, Ste 108 Resources for physicians, administrators and healthcare professionals, Community Plan Pharmacy Prior Authorization for Prescribers, Self Service for Revenue Cycle Management Companies, COVID-19 Testing, Treatment, Coding & Reimbursement, Prior Authorization and Ongoing Patient Care Updates, UnitedHealthcare Community Plan of Arizona Homepage, Pharmacy Resources & Physician Administered Drugs, UnitedHealthcare Community Plan of California Homepage, UnitedHealthcare Community Plan of Colorado Homepage, UnitedHealthcare Community Plan of Connecticut Homepage, UnitedHealthcare Community Plan of Delaware Homepage, UnitedHealthcare Community Plan of District of Columbia Homepage, UnitedHealthcare Community Plan of Florida Homepage, UnitedHealthcare Community Plan of Georgia Homepage, UnitedHealthcare Community Plan of Hawaii Homepage, UnitedHealthcare Community Plan of Indiana Homepage, UnitedHealthcare Community Plan of Iowa Homepage, UnitedHealthcare Community Plan of Kansas Homepage, UnitedHealthcare Community Plan of Kentucky Homepage, UnitedHealthcare Community Plan of Louisiana Homepage, UnitedHealthcare Community Plan of Maine Homepage, UnitedHealthcare Community Plan of Maryland Homepage, UnitedHealthcare Community Plan of Massachusetts Homepage, UnitedHealthcare Community Plan of Michigan Homepage, UnitedHealthcare Community Plan of Mississippi Homepage, UnitedHealthcare Community Plan of Missouri Homepage, UnitedHealthcare Community Plan of Nebraska Homepage, UnitedHealthcare Community Plan of New Jersey Homepage, UnitedHealthcare Community Plan of New York Homepage, UnitedHealthcare Community Plan of North Carolina Homepage, UnitedHealthcare Community Plan of Ohio Homepage, UnitedHealthcare Community Plan of Oklahoma Homepage, UnitedHealthcare Community Plan of Pennsylvania Homepage, UnitedHealthcare Community Plan of Rhode Island Homepage, UnitedHealthcare Community Plan of Tennessee Homepage, UnitedHealthcare Community Plan of Texas Homepage, UnitedHealthcare Community Plan of Virginia Homepage, UnitedHealthcare Community Plan of Washington Homepage, UnitedHealthcare Community Plan of West Virginia Homepage, UnitedHealthcare Community Plan of Wisconsin Homepage, Administrative Guide for Commercial, Medicare Advantage and DSNP, Specialty Pharmacy and Medicare Advantage Pharmacy, Neighborhood Health Partnership Supplement, UnitedHealthOne Individual Plans Supplement, Claims and Payments | UnitedHealthcare Community Plan of New York, Pharmacy Resources and Physician Administered Drugs, UnitedHealthcare Dual Complete® Special Needs Plans, Advance Notification and Plan Requirement Resources, Clinical Pharmacy Prior Authorization, Notification and Medical Necessity Requirements - Commercial, Clinical Program Drug Step Therapy - Commercial, Arizona Community Plan Pharmacy Prior Authorization Forms, Colorado Community Plan Pharmacy Prior Authorization Forms, Florida Community Plan Pharmacy Prior Authorization Forms, Hawaii Community Plan Pharmacy Prior Authorization Forms, Louisiana Community Plan Pharmacy Prior Authorization Forms, Maryland Community Plan Pharmacy Prior Authorization Forms, Michigan Community Plan Pharmacy Prior Authorization Forms, Mississippi Community Plan Pharmacy Prior Authorization Forms, Nebraska Community Plan Pharmacy Prior Authorization Forms, New Jersey Community Plan Pharmacy Prior Authorization Forms, New York Community Plan Pharmacy Prior Authorization Forms, Ohio Community Plan Pharmacy Prior Authorization Forms, Pennsylvania Community Plan Pharmacy Prior Authorization Forms, Rhode Island Community Plan Pharmacy Prior Authorization Forms, Texas Community Plan Pharmacy Prior Authorization Forms, Virginia Community Plan Pharmacy Prior Authorization Forms, Washington Community Plan Pharmacy Prior Authorization Forms, Drug Lists, Supply Limits and Specialty Pharmacy, Genetic and Molecular Lab Testing Notification/Prior Authorization, Prior Authorization for Outpatient Therapeutic Radiopharmaceuticals, Medicare Advantage Prior Authorization for Chemotherapy and Related Cancer Therapies, Prior Authorization for Chemotherapy and Related Cancer Therapies, Prior Authorization and Notification Program Summary, Retiring Admission Notification Fax Numbers, We've Retired Fax Numbers Used for Medical Prior Authorization Requests, Submitting Admission Notification, Prior Authorization Requests and Advance Notification, Revenue Cycle Management Self-Service Glossary, Self Service for Revenue Cycle Management Companies Frequently Asked Questions, Electronic Payment Solutions Rolling out in 2020, Clinical Pharmacy and Specialty Drugs Prior Authorization Programs - Commercial, Community Plan Pharmacy Prior Authorization Forms, Specialty Pharmacy – Medical Benefit Management (Provider Administered Drugs), Healthcare Professional Education and Training, Important Concepts in Integration: Coordination of Care, California Ancillary Service Care Providers, Care Provider Best Practices for Paperless Letter Delivery. 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