UnitedHealthcare Community Plan
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Find a Physician




Please select the state where you practice.

UnitedHealthcare Community Plan
Texas Providers


Here you will find the information, forms, manuals and links you need to conduct business with UnitedHealthcare Community Plan.

Please choose your topic of interest by selecting one of the navigation buttons on the left-hand side of the page, or select one of the topics below.

 

Contact Us

Select a plan below for contact information (call center, mailing address and more).

 

Customer Service:  888-887-9003

Provider Relations: 888-303-6162 or providerservicestx@uhc.com

Customer Service for Long Term Services and Supports:  888-787-4107  or uhc_cp_prov_relations@uhc.com

STAR Kids Service Coordination Hotline:  877-352-7798

STAR+PLUS Service Coordination Hotline: 800-349-0550

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


Nurseline

  • CHIP:  800-850-1267
  • STAR: 800-535-6714
  • STAR+PLUS: 877-839-5407
  • Dual Eligible Members: 877-596-3258

 

 

UnitedHealthcare Connected (Medicare-Medicaid Plan)

Click on the arrow above to view contact information for UnitedHealthcare Connected (Medicare-Medicaid Plan). 

 

Texas Medicare-Medicaid Plan Logo

Provider Call Center

888-887-9003
Monday-Friday, 8 a.m. – 6 p.m. CST 

Postal Mailing Address

UnitedHealthcare Community Plan
14141 Southwest Freeway
Suite 800
Sugar Land, TX 77478
 

Medical Claims Mailing Address UnitedHealthcare Connected
P.O. Box 31352Salt Lake City, UT 84131-0352
 
Provider Grievances Address           

UnitedHealthcare Connected
PO Box 31364
Salt Lake City, UT 84131-0364
 

Overbilling and Refund Address

UnitedHealthcare Community Plan
PO Box 740804
Atlanta, GA 30374

Service Delivery Areas

Harris County, Texas

CHIP

Click on the arrow above to view contact information for CHIP.

TX Chip logo

Provider Call Center

 

888-887-9003
Monday-Friday  8 a.m. – 6 p.m. CST

 

Postal Mailing Address

 

 

UnitedHealthcare Community Plan
14141 Southwest Freeway
Suite 800
Sugar Land, TX 77478

 

Claims Mailing Address

 

 

UnitedHealthcare Community Plan
PO Box 5270
Kingston, NY 12402-5270

 

Member and Provider
Complaints and Appeals Address

 

 

UnitedHealthcare Community Plan
Attn:  Complaint and Appeals Dept.
PO Box 31364
Salt Lake City, UT 84131-0364

 

Overbilling and Refund Address

 

UnitedHealthcare Community Plan
PO Box 740804
Atlanta, GA 30374

 

Service Delivery Areas Jefferson and Harris
STAR

Click on the arrow above to view contact information for STAR.

Texas Star Logo

Provider Call Center

 

888-887-9003
Monday-Friday  8 a.m. – 6 p.m. CST

Mailing Address

UnitedHealthcare Community Plan
14141 Southwest Freeway
Suite 800
Sugar Land, TX 77478
 

Claims Mailing Address

UnitedHealthcare Community Plan
PO Box 5270
Kingston, NY 12402-5270
 

Member and Provider Complaints and Appeals     
Address 

UnitedHealthcare Community Plan
Attn:  Complaint and Appeals Dept.
PO Box 31364
Salt Lake City, UT 84131-0364
 

Overbilling and Refund Address

UnitedHealthcare Community Plan
PO Box 740804
Atlanta, GA 30374

Service Delivery Areas Jefferson, Harris and Hidalgo
STAR+PLUS

Click on the arrow above to view contact information for STAR+PLUS.


TX Star Plus Logo
Provider Call Center

888-887-9003
Monday-Friday, 8 a.m. – 6 p.m. CST

Postal Mailing Address

UnitedHealthcare Community Plan
14141 Southwest Freeway
Suite 800
Sugar Land, TX 77478

Claims Mailing Address

UnitedHealthcare Community Plan
CLAIMS
PO Box 31352
Salt Lake City, UT 84131-0352

Provider Appeals and Complaints Address           

UnitedHealthcare Community Plan
Attn: Complaint and Appeals Dept.
PO Box 31364
Salt Lake City, UT 84131-0364

Overbilling and Refund Address

UnitedHealthcare Community Plan
PO Box 740804
Atlanta, GA 30374

Service Delivery Area

Jefferson, Harris, Nueces,
Travis and Central Medicaid
|Rural Service Area (MRSA)
and Northeast MRSA

 

STAR Kids

Click on the arrow above to view contact information for STAR Kids.

Texas Star Kids Logo

Provider Call Center

888-887-9003
Monday-Friday, 8 a.m. – 6 p.m. CST 

Postal Mailing Address

UnitedHealthcare Community Plan
14141 Southwest Freeway
Suite 800
Sugar Land, TX 77478
 

Medical Claims Mailing Address

UnitedHealthcare Community Plan
PO Box 5290
Kingston, NY 12402-5290
 

Provider Appeals and Complaints Address           

UnitedHealthcare Community Plan
Attn: Complaint and Appeals Dept.
PO Box 31364
Salt Lake City, UT 84131-0364
 

Overbilling and Refund Address

UnitedHealthcare Community Plan
PO Box 740804
Atlanta, GA 30374

Service Delivery Areas

Jefferson, Harris, Hidalgo
Medicaid Rural Service Area (MRSA Central) and MRSA Northeast

 

Join Our Network

Learn more about our network (PDF 364.56 KB). - Posted 3.28.2016

 

Messages from Texas Health and Human Services Archive

Click on the arrow above to view the messages from Texas Health and Human Services from 2016 and earlier. 

 

Provider Manuals

CHIP, STAR, and STAR+PLUS Administrative Guide (PDF 1.28 MB) - 2.13.2017

Nursing Facility Provider Manual (PDF 970.3 KB)

STAR Kids Provider Manual (PDF 730.67 KB)

UnitedHealthcare Connected (Medicare-Medicaid Plan) Provider Manual (PDF 782.77 KB) - 3.14.2016

 

Prior Authorization Archive

Click on the arrow above to view the prior authorization archive. 

UnitedHealthcare Community Plan Prior Authorization TX CHIP - Effective 4/1/2017 (PDF 219.45 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR - Effective 4/1/2017 (PDF 239.82 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR Kids - Effective 4/1/2017 (PDF 229.98 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR+PLUS - Effective 4/1/2017 (PDF 203.78 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)

Prior Authorization TX CHIP - Effective 1/1/2017 (PDF 218.73 KB)

Prior Authorization TX STAR - Effective 1/1/2017 (PDF 218.24 KB)

Prior Authorization TX STAR Kids - Effective 1/1/2017 (PDF 227.58 KB)

Prior Authorization TX STAR+PLUS - Effective 1/1/2017 (PDF 203.46 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR -Effective 10/1/2016 (PDF 218.7 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR PLUS - Effective 10/1/2016 (PDF 203.13 KB)

UnitedHealthcare Community Plan Prior Authorization TX CHIP - Effective 10/1/2016 (PDF 216.01 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR Kids - Effective 10/1/2016 (PDF 226.16 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification / Prior Authorization Requirements -Effective 10/1/2016 (PDF 277.31 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR - Effective 7/1/2016 (PDF 196.79 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR PLUS - Effective 7/1/2016 (PDF 195.63 KB)

UnitedHealthcare Community Plan Prior Authorization TX CHIP - Effective 7/1/2016 (PDF 195.03 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification/Prior Authorization Requirements - Effective 7/1/2016 (PDF 266.74 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification/Prior Authorization Requirements - Effective 5/1/2016 (PDF 251.42 KB)

UnitedHealthcare Community Plan Prior Authorization TX STAR.STAR+PLUS - Effective 5/1/2016 (PDF 201.6 KB)

UnitedHealthcare Community Plan Prior Authorization TX CHIP - Effective 5/1/2016 (PDF 193.82 KB)

UnitedHealthcare Community Plan Prior AuthorizationTX CHIP - Effective 1/1/2016 (PDF 221.04 KB) Posted 1.28.2016

UnitedHealthcare Community Plan Prior AuthorizationTX STAR, STAR+PLUS - Effective 1/1/2016 (PDF 223.42 KB) Posted 1.28.2016

UnitedHealthcare Medicare Solutions Notification/Prior Authorization List - Effective 1/1/16 (PDF 250.02 KB) Posted 1.28.2016

CHIP Prior Authorization (PDF 217.91 KB) Posted 11.30.2015

STAR, STAR+PLUS Prior Authorization (PDF 236.02 KB) Posted 11.30.2015

UnitedHealthcare Medicare Solutions Notification/Prior Authorization List - Effective 1/1/16 (PDF 249.77 KB)- Posted 1.12.2016

CHIP Required Authorization (PDF 214.25 KB)Posted 7.1.2015

STAR.STAR+PLUS Prior Authorization (PDF 232.48 KB) Posted 7.1.2015

CHIP Required Authorization (PDF 203.44 KB)

STAR, STAR+PLUS Prior Authorization
(PDF 607.66 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.

Medical Injectables Information

Click on the arrow above to view more information about medical injectables. 

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 one of the following network specialty pharmacies:

Network Specialty Pharmacy

Phone Number

BriovaRx

866-815-5338

BioScrip (offers nursing services)

• also serves as a national home infusion provider for medical benefit medications

866-788-7710

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

Network Specialty Pharmacy

Medication Category

Phone Number

Accredo (nursing services)

Enzyme Deficiency

Gaucher's Disease

Immune Globulin

Pulmonary Hypertension

800-803-2523

 

Option Care (nursing services)

Cardiovascular/Heart Failure

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.

 

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

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.

 

Site Outage

Our back up server helps ensure our site information is available to you 24/7. In the event you receive an error message, please wait a few minutes and try again, utilize UnitedHealthcare® Online or you may call Customer Service at 888-887-9003.