UHC Community Plan provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.uhcprovider.com |
|---|---|
| Payer contact reference | Plan-specific |
| Claims payer ID | No nationwide Community Plan claims/ERA identifier is established. Hawaii QUEST distinguishes claims 87726 from ERA 04567; use the actual state/product instructions. |
| Eligibility payer ID | 87726 — registry reference; verify the member product, transaction and clearinghouse |
| ERA payer ID | 87726 — registry reference; verify the member product, transaction and clearinghouse |
| Timely filing | 90 days (verify applicability) |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- Use the state/product provider-service contact. The reviewed Hawaii instructions do not establish the baseline number as nationwide.
- This registry has not established a payer-specific appeal ladder for UHC Community Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
UHC Community Plan at a glance
| Legal name | UnitedHealthcare Community Plan |
|---|---|
| Also known as | UnitedHealthcare Medicaid, UHC Medicaid |
| Category | Medicaid MCO |
| Parent organization | UnitedHealth Group |
| Claims payer ID | No nationwide Community Plan claims/ERA identifier is established. Hawaii QUEST distinguishes claims 87726 from ERA 04567; use the actual state/product instructions. |
| Eligibility (270/271) payer ID | 87726 — registry reference; verify the member product, transaction and clearinghouse |
| ERA (835) payer ID | 87726 — registry reference; verify the member product, transaction and clearinghouse |
| NAIC company code | Not established in this registry |
| States covered | Arizona, California, Florida, Hawaii, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Tennessee, Texas, Virginia, Washington, Wisconsin |
| Members covered | ~8.0 million members |
| Provider resource entry point | https://www.uhcprovider.com |
| Provider phone | Plan-specific |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for UHC Community Plan
This registry lists 90 days as an initial-claim reference for UHC Community Plan. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
| Submission type | Window |
|---|---|
| Initial claim reference | 90 days (verify applicability) |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for UHC Community Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: UHC Community Plan provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with UHC Community Plan
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify UHC Community Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for UHC Community Plan. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for UHC Community Plan
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient UHC Community Plan volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | No nationwide Community Plan claims/ERA identifier is established. Hawaii QUEST distinguishes claims 87726 from ERA 04567; use the actual state/product instructions. |
| 270 / 271 eligibility | Listed in registry; verify current scope | 87726 — registry reference; verify the member product, transaction and clearinghouse |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | 87726 — registry reference; verify the member product, transaction and clearinghouse |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
What revenue cycle teams should verify before submitting claims
- Select the state, program and service before claim or authorization routing. Hawaii QUEST is a scoped example and does not establish nationwide Community Plan rules.
- Claims routing evidence does not independently verify eligibility, ERA enrollment, or X12 278 support. Confirm each transaction separately.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
record_scope
Source comparison: 2026-09-26
Community Plan is state/product-specific. HawaiiQUEST instructions are a scoped example, not a national identifier or phone mandate.
Primary source for record_scopepayer_ids.claims / payer_ids.era / era_payer_id
Source comparison: 2026-09-26
HawaiiQUEST publishes claims 87726 but ERA04567, demonstrating that copying 87726 across transactions is incorrect.
Primary source for payer_ids.claims / payer_ids.era / era_payer_idprovider_phone
Source comparison: 2026-09-26
Hawaii lists 888-980-8728 and a distinct D-SNP number. Baseline 866-675-1607 is not a nationwide contact.
Primary source for provider_phone
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; timely_filing_days / payer_ids.eligibility / supports_279_271 / supports_278: One state page cannot verify universal 90-day filing or national eligibility/278 capability..
Sources used for this guide
State coverage
UHC Community Plan operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for UHC Community Plan
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for UHC Community Plan; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for UHC Community Plan; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for UHC Community Plan before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about UHC Community Plan
Where is the UHC Community Plan provider portal?
Use https://www.uhcprovider.com as a starting point for UHC Community Plan provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for UHC Community Plan?
This registry lists 90 days as an initial-claim reference for UHC Community Plan. Confirm the applicable product, provider agreement, start event and current payer instructions. Do not apply this value automatically to out-of-network, secondary, corrected or appealed claims.
What is the UHC Community Plan payer ID?
Claims: No nationwide Community Plan claims/ERA identifier is established. Hawaii QUEST distinguishes claims 87726 from ERA 04567; use the actual state/product instructions.. Eligibility (270/271): 87726 — registry reference; verify the member product, transaction and clearinghouse. ERA (835): 87726 — registry reference; verify the member product, transaction and clearinghouse. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does UHC Community Plan accept electronic claims?
Verify UHC Community Plan electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a UHC Community Plan denial?
This registry has not established a payer-specific appeal ladder for UHC Community Plan. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do UHC Community Plan prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
How do providers contact UHC Community Plan?
This registry has not established one provider phone number for UHC Community Plan. Use the state/product provider-service contact. The reviewed Hawaii instructions do not establish the baseline number as nationwide. Use https://www.uhcprovider.com as a starting point for UHC Community Plan provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
For revenue-cycle teams
Connect payer lookups to your revenue-cycle workflow
Do staff repeatedly move between payer references, eligibility checks, claim status and remittance follow-up?
- Keep this payer's official reference available to the team.
- Identify one repeated administrative task and measure its handling time.
- Evaluate the required access, exceptions and reviewer handoff before expanding automation.
UHC Community Plan is an operational reference. Payer decisions remain with the payer. Confirm plan coverage, system access and supported actions during a scoped evaluation.
Download the illustrative workflow worksheet (PDF) · Explore the AI RCM evaluation toolkit · Model the workload and costs
Automate workflows around UHC Community Plan requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against UHC Community Plan's current published documents before submission. CPT® is a registered trademark of the American Medical Association.