Welcome to the Optum Network!

• Provider Policy and Procedure Manual and Associated Forms
• Behavioral Health Provider Directory
• Indiana Medicaid Website
• HIPAA and 42 CFR Part 2 Privacy Policy and Procedures

UnitedHealthcare Community Plan
P.O. Box 5240
Kingston, NY 12402-5240

1. Claims, Appeals/Disputes and Payments;
2. Eligibility and Benefits

For BH prior authorization, please submit the Universal PA form to 844-897-6514.

• Universal Prior Authorization Form 
  
• Substance Use Disorder (SUD) Universal Prior Authorization Form
• IHCP SUD Admission Assessment Form
• IHCP SUD Reassessment Form
• Psych-Neuropsych Prior Authorization Request Form
• UNITED HEALTHCARE COMMUNITY PLAN OF INDIANA HOOSIER CARE CONNECT BEHAVIORAL HEALTH PRIOR AUTHORIZATION LIST

For appeals information: uhcprovider.com/Indiana

Indiana Hoosier Care Connect Behavioral Health Provider Training

Provider Relations Advocate

Belen Stewart (Northern Indiana Counties)

Main Number: (612) 632-5962

Fax Number: (855) 572-3643

Northern Indiana Counties: Adams, Allen, Benton, Blackford, Carroll, Cass, Clinton, DeKalb, Elkhart, Fulton, Grant, Howard, Huntington, Jasper, Jay, Kosciusko, LaPorte, LaGrange, Lake, Marshall, Miami, Newton, Noble, Porter, Pulaski, St Joseph, Starke, Steuben, Tippecanoe, Tipton, Wabash, Warren, Wells, White, Whitley

David Hoover (Southern Indiana Counties)

Senior Provider Relations Advocate

Main Number: (763) 330-7588

Fax Number: (855) 572-3643

Southern Indiana Counties: Bartholomew, Boone, Brown, Clark, Clay, Crawford, Daviess, Dearborn, Decatur, Delaware, Dubois, Fayette, Floyd, Fountain, Franklin, Gibson, Greene, Hamilton, Hancock, Harrison, Hendricks, Henry, Jackson, Jefferson, Jennings, Johnson, Knox, Lawrence, Madison, Marion, Martin, Monroe, Montgomery, Morgan, Ohio, Orange, Owen, Parke, Perry, Pike, Posey, Putnam, Randolph, Ripley, Rush, Scott, Shelby, Spencer, Sullivan, Switzerland, Union, Vanderburgh, Vermillion, Vigo, Warrick, Washington, Wayne

Indiana Autism/ABA Network Management
(877) 614-0484