PCP Assignment Requirement for UHCCP Members: Important Guidelines for Reimbursement

UnitedHealthcare Community Plan of New York (UHCCP) demands that members must utilize the primary care provider (PCP) listed on their ID card to improve patient population management and patient relationships.

What This Means for You

• PCP Assignment Compliance: UHCCP members must receive primary care services from a PCP within the same practice (under the same Tax ID) as the one indicated on their ID card.
• Reimbursement Policy: If primary care services are provided to a UHCCP member who is not assigned to a PCP in your practice (same Tax ID), reimbursement for those services may not be provided.

Confirm Eligibility Before Scheduling

The scheduling process requires you to check both eligibility and PCP assignment status for UHCCP members to prevent potential problems when providing care. The UnitedHealthcare Provider Portal enables providers to check eligibility through their account.

PCP Reassignment Option

In case a UnitedHealthcare member who is scheduled to see you for a primary care appointment is not assigned to one of your PCPs, that patient can call 1-800-493-4647 and request the change at any time before the scheduled appointment.