Claims and Payments | UnitedHealthcare Community Plan of Louisiana

If you are not satisfied with the outcome of a Claim Reconsideration Request, you may submit a formal Claim Dispute/Appeal using the process outlined in your provider manual.

• A formal Claim Dispute/Appeal is a comprehensive review of the disputed claim(s), and may involve a review of additional administrative or medical records by a clinician or other personnel.
• UnitedHealthcare Community Plan generally completes the review within 30 calendar days. However, depending on the nature of the review, a decision may take up to 60 days from the receipt of the claim dispute documentation. We will contact you if we believe it will take longer than 30 days to render a decision.
• Please allow 10 business days from the submission date to enable us to begin processing the review before requesting a status update.

Additional state requirements may apply. Please consult the applicable state Provider Administrative Guide or Manual for more details or contact the provider services center.

To view up to date claim reconsideration information go to UHCprovider.com/claims.

• Single Paper Claim Reconsideration Form
  

Member dental plan and benefit information can be found at UHCCommunityPlan.com/LA and myuhc.com.

Dental Benefits for Members under Age 21 

Managed Care of North America is a premier dental benefits administrator that provides exceptional service to State Agencies and managed care organizations for Medicaid. 

For benefits, claims, provider enrollment, direct deposit issues, demographic changes, NPI Information, etc., contact Managed Care of North America Customer Service at 1-855-701-6262.

Adult Benefits - Dental Benefits for Member over Age 21

Members over 21 will be provided routine dental exams, x-rays, cleanings, fillings and extractions with in-network providers limited to $500 per year. 

For benefit and claims information, contact Customer Service at 1-866-675-1607.

Using Electronic Data Interchange (EDI) for all eligible UnitedHealthcare transactions can help your organization improve efficiency, reduce costs and increase cash flow. We encourage you to use the following tools and resources to help you get started with electronic transactions.

Fee Schedules are available from the State of Louisiana Department of Health & Hospitals.

View the latest Fee Schedules.

Member vision plan and benefit information can be found at UHCCommunityPlan.com/LA and myuhc.com.

Vision for Members under 21 Years of Age

March Vision Care is the vision vendor for UnitedHealthcare and provides routine vision services which include:

• Services and exams for vision correction and refraction error
  
• Eyewear, contacts if the only means to restore vision

For all other vision services please contact UnitedHealthcare Community Plan customer service at 1-866-675-1607.

Adult Vision for Members over Age 21

March Vision Care is the vision vendor for UnitedHealthcare and provides routine vision services. Additional vision and services will be provided to complement the limited Medicaid vision benefit. Services include:

• One Routine Eye Exam every two years; and 
• $100 allowance for frames/lenses every two years
  

Note: Vision services performed by an Optometrist are reimbursable for routine and non-routine services. Claims must be submitted to March Vision Care for processing. This is due to the expanded scope of the services the Louisiana Board of Optometry now allows Optometrists to perform in the office setting. 

March Vision Care Contact Information

Phone:  1-844-52-MARCH or 1-844-526-2724
Online:  https://www.marchvisioncare.com/providerreferenceguides.aspx

Mailing Address for March Vision Claims:

Claims Processing Center
6701 Center Drive West, Suite 790
Los Angeles, CA 90045

A PRA is generated for every processed claim and includes relevant details about how the claim was processed.