UnitedHealthcare Community Plan of Nebraska Homepage

We know you don't have time to spare, so we put all the UnitedHealthcare Community Plan resources you need in one place. Use the navigation on the left to quickly find what you're looking for. Be sure to check back frequently for updates.

Hospital Inpatient Nursing Facility Level of Care Per Diem Rate

• Hospital Inpatient Nursing Facility Level of Care Health Plan Advisory
• Hospital Inpatient Nursing Facility Level of Care Payment Q&A

Information about the End of Continuous Medicaid Coverage

• Important Notice: Help your patients avoid a lapse in their Medicaid coverage
  Your Heritage Health (Medicaid) patients may need to renew their coverage. If not, they could lose their eligibility.

Prior Authorization and Notification Resources

Current Policies and Clinical Guidelines

Provider Administrative Manual and Guides

Provider Call Center

866-331-2243, available Monday - Friday from 7:00 am - 6:00 pm CST (6:00 am - 5:00 pm MST)

Mailing Address

UnitedHealthcare Community Plan
2717 N 118th Street, Suite 300
Omaha, NE 68164

Claims Mailing Address

UnitedHealthcare
PO Box 31365
Salt Lake City, UT 84131

Utilization Denial & Appeals Department Mailing Address

National A&G Service Center
PO Box 31365
Salt Lake City, UT 84131
Claims Appeals Mailing Address

UnitedHealthcare Community Plan Appeals
PO Box 31365
Salt Lake City, UT 84131

Provider Advocates

For questions about Credentialing and Attestation updates, connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.

Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.

Nebraska Medicaid and Long-Term Care (MLTC) has expanded Medicaid coverage under the Heritage Health Adult (HHA) Expansion program. The HHA program expands Medicaid coverage to adults, ages 19–64, whose income is at or below 138% of the federal poverty level. Heritage Health Adult members are enrolled in managed care plans through the existing Heritage Health program and are eligible for the same benefit package. This includes comprehensive medical, behavioral health and prescription drug coverage as well as vision services, dental services and over-the-counter (OTC) medication benefits.

The Nebraska Department of Health and Human Services (DHHS) also has information on the Medicaid expansion available at dhhs.ne.gov.

The Known Issues Log is a current list of open and closed known global claims issues. For questions related to open issues, reach out to your Provider Advocate or call Provider Services at 866-331-2243.

Visit UHCCommunityPlan.com/NE for current member plan information including sample member ID cards, provider directories, dental plans, vision plans and more.

Plan information is available for:

• UnitedHealthcare Community Plan - Heritage Health

Member plan and benefit information can also be found at UHCCommunityPlan.com/NE and myuhc.com/communityplan.

Overview

The Centers for Medicare & Medicaid Services (CMS) established the Medicaid Managed Care Rule to:

• Promote quality of care
• Strengthen efforts to reform the delivery of care to individuals covered under Medicaid and Children’s Health Insurance Plans (CHIP)
• Strengthen program integrity by improving accountability and transparency

Enhance policies related to program integrity With the Medicaid Managed Care Rule, CMS updated the type of information managed care organizations are required to include in their care provider directories.

CommunityCare

The best way for primary care providers (PCPs) to view and export the full member roster is using the CommunityCare feature on the UnitedHealthcare Provider Portal, which allows you to:

• Identify Medicaid recipients who need to have their Medicaid recertification completed and approved by the state in order to remain eligible to receive Medicaid benefits
• See a complete list of all members, or just members added in the last 30 days
• Export the roster to Microsoft Excel
• View most Medicaid and Medicare Special Needs Plans (SNP) members’ plans of care and health assessments
• Enter plan notes and view notes history (for some plans)
• Obtain HEDIS information for your member population
• Access information about members admitted to or discharged from an inpatient facility
• Access information about members seen in an emergency department

For help using CommunityCare feature on the UnitedHealthcare Provider Portal, please see our Quick Reference Guide. If you’re not familiar with UnitedHealthcare Provider Portal, visit our Portal Resources page.