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UnitedHealthcare MedicareAdvantage Plans in Indiana2022 quick reference guideNeed to contact us? Use this reference guidefor quick access to a variety of helpful resources.UnitedHealthcare Provider PortalThe UnitedHealthcare Provider Portal is your gateway to the UnitedHealthcare online tools.To sign in, go to UHCprovider.com, and click on the Sign In button in the top-right corner. You can: Check patient eligibility and benefits Use TrackIt to manage items that need your attention, including prior authorization requestsand claim submissions Submit and check referral status Get claims status and submit reconsideration and appeal requestsVisit UHCprovider.com/portal for more information. If you have technical questions, contactUnitedHealthcare Web Support at providertechsupport@uhc.com or call 866-842-3278, option 1,7 a.m.‒9 p.m. CT, Monday‒Friday.Claims submissionOnline: To submit claims using the UnitedHealthcare Provider Portal, please go to UHCprovider.comand click on the Sign In button in the top-right corner.Electronic: To submit claims by Electronic Data Interchange (EDI), please use Payer ID 87726.Learn more at UHCprovider.com/edi.Paper: Please submit paper claims to the address listed on the member’s ID card.Prior authorization requests and advance notificationFor more information, visit UHCprovider.com/priorauth.Online: Use the UnitedHealthcare Provider Portal at UHCprovider.com and click on the Sign In buttonin the top-right corner.Phone: Call the Provider Services number on the member’s ID card.My Practice ProfileThe My Practice Profile tool on the UnitedHealthcare Provider Portal at UHCprovider.com/mpp letsyou view, update and attest to the demographic information UnitedHealthcare members see for yourorganization. To review your participation status, explore the Provider Products section of the ProviderDemographic Details.PCA-2-21-03783-M&R-QRG 10192021
Telehealth (virtual visits) UnitedHealthcare Medicare Advantage members have coverage for telehealth with contractednetwork health care professionals for medical and behavioral/mental health care If you’re looking to deliver care virtually, we have resources, training, best practices andreimbursement policies at UHCprovider.com/telehealthYou’ll find our telehealth service protocols in the administrative guide at UHCprovider.com/guides.Behavioral and mental health servicesPlease refer to the member’s ID card for their behavioral and mental health provider phone number.Prescription medicationsoptumrx.comMail order Call 800-791-7658, Monday–Friday, 8 a.m.‒8 p.m. CT Fax 800-491-7997Oral drug prior authorization requestscovermymeds.com/epa/optumrx Call 800-711-4555, option 1 Fax 800-527-0531Injectable drug prior authorization requests Call 800-711-4555, option 2UnitedHealthcare Visionspectera.comRoutine vision care Call 800-638-3120, Monday–Friday, 7 a.m.–10 p.m., and Saturday, 8 a.m.–5:30 p.m. CT(Please submit out-of-network vision claims to the medical claims address listed on the back of the member’s ID card.)UnitedHealthcare Hearinguhchearing.comFor routine hearing services and plans offering hearing aids covered through UnitedHealthcareHearing, members must receive hearing aids from a UnitedHealthcare Hearing network provider.Contact UnitedHealthcare Hearing directly with any questions. Call 855-523-9355, Monday–Friday, 8 a.m.–8 p.m. CTUnitedHealthcare Dentaluhcdental.comRoutine dental care Call 877-816-3596, Monday–Friday, 7 a.m.–10 p.m. CT(Please submit out-of-network dental claims to UnitedHealthcare Dental at P.O. Box 30567, Salt Lake City, UT 84130.)Other resourcesYou’ll find information in the care provider administrative guide at UHCprovider.com/guides.If you can’t find the information you need on UHCprovider.com, call Provider Services at877-842-3210, 8 a.m.–8 p.m. ET, Monday–Friday.Questions?If you have questions, please contact your provider advocate, provider relations or networkmanagement representative at UHCprovider.com/contactus Network Contact.PCA-2-21-03783-M&R-QRG 10192021
Sample ID cardsSample member ID cards for illustration only; actual information varies dependingon payer, plan and other requirements.PCA-2-21-03783-M&R-QRG 10192021
2022 plan overviewReferrals are not requiredCenters for Medicare& Medicaid Services(CMS) contractGroup 0749H2802-01000704007050074400745Clark, Dearborn, Floyd, Franklin,AARP Medicare Advantage Harrison, Jackson, Jefferson,Plan 1 (HMO-POS)Jennings, Ohio, Ripley, Scott,Switzerland, WashingtonH2802-01600739007400075500756AARP Medicare Advantage Jasper, La Porte, Lake, Newton, Porter,Plan 1 (HMO-POS)Pulaski, StarkeH2802-0180074200758Adams, Allen, Cass, De Kalb, Elkhart,Fulton, Grant, Huntington, Jay,AARP Medicare AdvantageKosciusko, Lagrange, Marshall,Plan 1 (HMO-POS)Miami, Noble, St. Joseph, Steuben,Wabash, Wells, WhitleyH2228-0196700167030AARP Medicare Advantage Adams, Allen, Huntington, Kosciusko,Focus Lutheran (PPO)Wells, WhitleyH2228-0206700774000Bartholomew, Benton, Blackford,Boone, Brown, Carroll, Clinton,Decatur, Delaware, Fayette, Fountain,Hamilton, Hancock, Hendricks, Henry,AARP Medicare AdvantageHoward, Johnson, Lawrence, Madison,Choice Plan 1 (PPO)Marion, Monroe, Montgomery, Morgan,Orange, Putnam, Randolph, Rush,Shelby, Tippecanoe, Tipton, Union,Warren, Wayne, WhiteH2228-0216702467026Crawford, Daviess, Dubois, Gibson,AARP Medicare AdvantageKnox, Martin, Perry, Pike, Posey,Choice Plan 1 (PPO)Spencer, Vanderburgh, WarrickH2228-0226701767034Plan nameand typeCountiesAARP Medicare Advantage Allen, De Kalb, Huntington, Lagrange,Profile Parkview (HMO-POS) Noble, Wabash, WhitleyAdams, Cass, Elkhart, Fulton, Grant,AARP Medicare AdvantageKosciusko, Marshall, Miami, St. Joseph,Plan 1 (HMO-POS)Steuben, WellsBartholomew, Benton, Blackford,Boone, Brown, Carroll, Clinton,Decatur, Delaware, Fayette, Fountain,Hamilton, Hancock, Hendricks,AARP Medicare AdvantageHenry, Howard, Jay, Johnson,Plan 1 (HMO-POS)Lawrence, Madison, Marion, Monroe,Montgomery, Morgan, Orange, Putnam,Randolph, Rush, Shelby, Tippecanoe,Tipton, Union, Warren, Wayne, WhitePCA-2-21-03783-M&R-QRG 10192021
Centers for Medicare& Medicaid Services(CMS) contractGroup numberAARP Medicare Advantage Jasper, La Porte, Lake, Newton,Choice Plan 1 (PPOPorter, Pulaski, StarkeH2228-06467171671729010190102Clark, Dearborn, Floyd, Franklin,AARP Medicare Advantage Harrison, Jackson, Jefferson,Choice (PPO)Jennings, Ohio, Ripley, Scott,Switzerland, WashingtonH2228-0656717390103AARP Medicare Advantage Clay, Greene, Owen, Parke, Sullivan,Choice (PPO)Vermillion, VigoH2228-06667175671769010590106Adams, Allen, Cass, De Kalb, Elkhart,Fulton, Grant, Huntington, Jay,AARP Medicare AdvantageKosciusko, Lagrange, Marshall, Miami,Choice Plan 2 (PPO)Noble, St. Joseph, Steuben, Wabash,Wells, WhitleyH2228-0807405590126Bartholomew, Benton, Blackford,Boone, Brown, Carroll, Clinton,Decatur, Delaware, Fayette, Fountain,Hamilton, Hancock, Hendricks, Henry,AARP Medicare AdvantageHoward, Johnson, Lawrence, Madison,Choice Plan 2 (PPO)Marion, Monroe, Montgomery, Morgan,Orange, Putnam, Randolph, Rush,Shelby, Tippecanoe, Tipton, Union,Warren, Wayne, WhiteH2228-08174056740579012790128AARP Medicare AdvantageAll countiesPatriot MA Only 019Clark, Crawford, Daviess, Dearborn,Dubois, Floyd, Franklin, Gibson,AARP Medicare Advantage Harrison, Jackson, Jefferson, Jennings,Choice Plan 2 (PPO)Knox, Martin, Ohio, Perry, Pike, Posey,Ripley, Scott, Spencer, Switzerland,Vanderburgh, Warrick, hcare DualComplete (PPO D-SNP)H0271-0056720090006Plan nameand typeCountiesAARP Medicare Advantage Jasper, La Porte, Lake, Newton, Porter,Choice Plan 2 (PPO)Pulaski, StarkeAll countiesPCA-2-21-03783-M&R-QRG 10192021 2021 United HealthCare Services, Inc. All Rights Reserved.
Profile Parkview (HMO-POS) Allen, De Kalb, Huntington, Lagrange, Noble, Wabash, Whitley H2802-007 00700 00746 AARP Medicare Advantage Plan 1 (HMO-POS) . Warren, Wayne, White H2228-081 74056 74057 90127 90128 AARP Medicare Advantage Patriot MA Only (PPO) All counties H2228-091 74064 90041 AARP Medicare Advantage
