UnitedHealthcare Community Plan of Florida 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.
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State news, bulletins and alerts
- 05.01.2025 - Expanded member benefits help make health care better for everyone
- 04.01.2025 - Earn $100 incentive with SBIRT
- 04.01.2025 - Medicaid: View the genetic and molecular codes added to prior authorization requirements
- 10.31.2024 - Medicaid: Changes to reimbursement rules for diabetic supplies
- 08.02.2024 - Medicaid: AHCA will terminate unregistered provider IDs Sept. 1
- 05.29.2024 - Medicaid: HearUSA to begin serving MMA members in July
- 05.16.2024 - Explore the benefits of implementing SBIRT in your office
- 05.01.2024 - Avoid overpayment. Learn how HRA applies to out-of-pocket costs
- 01.24.2024 - Medicaid: Elevated lead levels found in applesauce products
- 01.01.2024 - Medicaid: 2024 taxonomy rule changes
- 01.01.2024 - Medicaid: Increased OBRAF incentive
- 11.01.2023 - Radiation therapy prior authorization requirement
- 09.22.2023 - MPIP Incentive payments and Qualified Provider Designation Questions - Contact your Provider Advocate
News your way
Get news related to your role, specialty, health plan and state. When you subscribe to Network News, you can update your preferences to select what news you receive and how often.
Resources
Behavioral health providers
Learn how to join the behavioral health network, review Community Plan behavioral health information or submit demographic changes at Community Plan Behavioral Health.
Facility/hospital-based providers, group/practice providers and individually contracted clinicians
The state-specific requirements and process on how to join the UnitedHealthcare Community Plan network is found in the UnitedHealthcare Community Plan Care Provider Manuals.
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.
Visit UHCCommunityPlan.com/FL for current plan names, overview of eligibility information, doctor look-up and more.
Member health waivers
If you are a provider of a member whose health was previously cared for under one of the following waivers, please contact Provider Services for extra help understanding your full benefit program:
- Project Aids Care (PAC) waiver
- Traumatic Brain Injury (TBI) or Spinal Cord Injury (SCI) waiver
- Adult Cystic Fibrosis (ACF) waiver
You can reach our Provider Services team by calling the number on the back of your member ID card or referencing the contact numbers below:
- Managed Medical Assistance (MMA): Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal
- Long-term care (LTC): 800-791-9233
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.
Search for a care provider
- UnitedHealthcare Community Plan (Medicaid MMA)
- UnitedHealthcare Dual Complete® LP Plan 1 (HMO SNP)
- UnitedHealthcare Dual Complete® RP - FL
- UnitedHealthcare Dual Complete®RP ONE (Regional PPO SNP)
- UnitedHealthcare Health & Home Connection (long-term care)
Search for a Dentist
Dental: Provides all Medicaid dental services for children and adults. All people on Medicaid must enroll in a dental plan.
If you’re ready to join or just want to know more, call and speak to a Medicaid choice counselor at 877-711-3662.
TTY/TDD users, please call 866-467-4970. You can also enroll online at flmedicaidmanagedcare.com/dental/dentalplaninformation
Need to make a change to your provider or facility directory information?
When you report a situation that could be considered fraud, you’re doing your part to help save money for the health care system and prevent personal loss for others. If you suspect another provider or member has committed fraud, waste or abuse, you have a responsibility and right to report it.
Taking action and making a report is an important first step. After your report is made, we will work to detect, correct and prevent fraud, waste and abuse in the health care system.
Call us at 844-359-7736 or visit uhc.com/fraud to report any issues or concerns.
Resources
- Florida Statewide Medicaid Managed Care Behavioral Analysis Program quick reference guide
- Florida Statewide Medicaid Managed Care quick reference guide - This reference guide provides a list of the departments at UnitedHealthcare that may be helpful in assisting with coordination and authorization of services that a member may need
- Continuity of Care - UnitedHealthcare Community Plan members transitioning to a new plan or provider can still see their current provider for up to 60 days. This ensures a smooth transition and uninterrupted medical treatment.
Health Insurance Portability and Accountability Act (HIPAA) information
HIPAA standardized both medical and non-medical codes across the health care industry and under this federal regulation, local medical service codes must now be replaced with the appropriate HCPCS and CPT®-4 codes.
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.
Disclaimer
If UnitedHealth Group 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 Policies and Clinical Guidelines section at left.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).
CPT® is a registered trademark of the American Medical Association.