For California Residents
Enrollees, potential enrollees, providers, and members of the public may request a printed copy of providers in your area by contacting the Plan by phone, 1-800-999-9585; or by email sfpbh@uhc.com.
Directory was last updated online on 11/21/2024
Provider Accuracy: The accuracy of provider information is verified at least every 6 months for individual clinicians not affiliated with a provider group, and at least annually for provider groups and facilities. Information in the provider directory is updated at least on a weekly basis.
Reporting inaccuracies : California residents may report possible inaccurate, incomplete or misleading information listed in the provider directory by using the "Report Invalid Info" button found on the Provider's detail page, calling 1-800-999-9585, or emailing provider_feedback@optum.com. If you are an enrollee and believe that you reasonably relied upon materially inaccurate, incomplete, or misleading information in our provider directory, you may submit a complaint by calling the number on the back of your Enrollee ID card.
American Disabilities Act Notice: In accordance with the requirements of federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), we provide full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.
Timely Access to Care: Enrollees have the right to appointments within the following timeframes: Emergency (Non-Life Threatening) – 6 hours; Urgent (prior authorization not required by health plan) – 48 hours; Urgent (prior authorization required by health plan) 96 hours; Routine (Non-Urgent) – 10 business days; Non-Urgent Follow-up – within 10 business days of prior appointment. The wait time for a routine appointment may be longer if the provider has determined and documented that a longer time period will not negatively impact the enrollee’s health. Telephone Wait Times for OptumHealth Behavioral Solutions of California Representatives: During Normal Business Hours - Not to Exceed 10 minutes; After Normal Business Hours – Not to Exceed 30 minutes. Interpreter services are available to enrollees at the time of the appointment as requested. If you are unable to obtain a timely referral to an appropriate provider or would like to request interpreter services, please contact the number of the back of your Enrollee ID card. Additionally, the DMHC Help Center may be contacted at 1-888-466-2219 to file a complaint if you are unable to obtain a timely referral to an appropriate provider. For more information regarding Timely Access to Care, please click here: Timely Access to Care 
Language Interpreter Services: Under California law, you may be entitled to free interpretation services. To get help in your language, please call 1-800-999-9585 or call the number on your member identification card. Language interpretation services are available at no cost to the member.
Servicios de Interpretación de Idiomas: Conforme a las leyes de California, usted puede tener derecho a servicios de interpretación gratuitos. Para obtener ayuda en su idioma, llame al o llame al número que figura en su tarjeta de identificación de membresía. Los servicios de interpretación de idiomas se ofrecen sin costo para el miembro.
語言口譯服務：依據加州法律規定，您可能有資格取得免費口譯服務。如欲使用您的語言 取得幫助，請致電 1-800-999-9585 或撥打您會員卡上的號碼。語言口譯服務免費為 會員提供。
For Members Outside of California
If emergency care is needed, please seek care at the nearest hospital, regardless of network status.
Accepting New Patients: This attribute is for search and display, and it indicates whether a provider is accepting new patients on an outpatient basis only. This attribute is based on the information reported by a provider when they enroll or update their status, and it is routinely validated. However, it is recommended that you contact providers to confirm their status, as their appointment availability can change without notice.
Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.
Directory was last updated online on 11/21/2024
Disclosure Statement: The information provided or included in this directory is accurate as of the date posted to the web or as of the date of updating/printing. Covered persons or prospective covered persons should consult this electronic provider directory on this website or call the specified customer service telephone number on the covered person's insurance card to obtain more or current provider directory information.
Please check with your provider before scheduling your appointment or receiving services to confirm that the provider is participating in our network.
Provider information contained in this directory is updated weekly at a minimum, but may have changed since the last update.
Reporting Inaccuracies: Members may report possible inaccurate, incomplete or misleading information listed in the provider directory by using the “Report Invalid Info” button found on the Provider’s detail page, calling 1-800-557-5745, or emailing provider_feedback@optum.com.
Providers identified as offering telehealth services or virtual care is through the synchronous method, which includes real-time telephone or live audio-video interaction typically with a patient using a smartphone, tablet, or computer. Specific services offered through telehealth or virtual care can be searched by provider specialty in the directory, but should be confirmed with the provider when scheduling.
Health services from non-network providers paid as network benefits: If specific Covered Health Services are not available from a Network provider, you may be eligible for Network Benefits when Covered Health Services are received from non-Network providers. In this situation, your Primary Physician or other Network Physician will notify us and, if we confirm that care is not available from a Network provider, we will work with you and your Primary Physician or other Network Physician to coordinate care through a non-Network provider. If care is authorized from a non-Network provider because it is not available from a Network provider, you will be responsible for paying only the in-Network cost sharing for the service.
For Washington Residents: Telemedicine appointments may be available through your provider including video or audio-only services via phone permitting real-time communication between the patient and healthcare professional for the purposes of diagnosis, consultation, or treatment. Please contact your provider to determine what telemedicine services may be available. Beginning January 1, 2023 for audio-only telemedicine services, the covered person must have an established relationship with the provider or has been referred by another provider who has had at least one in-person appointment within the past three years or at least one real-time interactive appointment using both audio and video technology.
Illinois Only: For IL provider demographic inaccuracies, you may also contact the IL Office of Consumer Health Insurance at 1-877-527-9431
District of Columbia: Enrolling in this plan does not guarantee services by a particular provider on the list. If you wish to receive care from specific providers listed, you should contact those providers to be sure that they are accepting additional patients for this plan. The providers in this list are certified with the Drug Enforcement Administration (DEA) to prescribe opioid use disorder treatment medication. To access a list of Substance Use and Mental Health Care providers that treat opioid use disorders from Live and Work Well, select Behavioral Health Care Search directory, enter the location and search term, and select the Medication Assisted Treatment from the Treatment Options filter.
The District of Columbia has set the following standards for appointments with an in-network provider - Service Type (Time Frame): First appointment with a new or replacement provider for Behavioral Health treatment, including Substance Use Treatment (within 7 business days)
For Massachusetts Residents: NexusACO Tiered Benefit Plans may offer benefit plans, with a tiered benefit network, to commercial members. In a NexusACO plan, members may pay different levels of copayments, coinsurance, and deductibles depending on the tier of the provider delivering a covered service or supply. We may make changes to a provider's tier annually in January.
Massachusetts Complaint Process: Complaints relating to provider directory inaccuracies or provider network access issues may be filed with the state insurance department :
Commonwealth of Massachusetts Division of Insurance
Consumer Services Unit
1000 Washington Street, Suite 810
Boston, MA 02118-6200
Tel: (617) 521-7794; Toll-free: (877) 563-4467; Fax: (617) 753-6830
https://www.mass.gov/file-an-insurance-complaint
CSSComplaints@mass.gov
For CT Residents: Important Notice: Any physician included in this directory is listed for outpatient office visits. In addition, the directory includes information regarding whether the provider is currently accepting new patients.
Criteria Description: Our provider network is built to provide an array of licensed qualified professionals and programs/facilities in mental health and substance use disorders. This network represents an array of clinical specialties and expertise to allow timely access and availability for our membership taking into account geographic access in terms of distance and travel time as well as member population density. In addition, we continually work to ensure the diversity of our network to enable us to meet the clinical, cultural, linguistic and geographic needs of our members.
Source Statement: The source of the information required to be included in this provider directory is our participating providers.
Tiering: While every provider and group listed here has passed rigorous evaluation, Platinum providers have consistently demonstrated care and performance that exceeds both effectiveness and efficiency benchmarks as measured by an internal evaluation program
Disability/Language Assistance: This site offers web-based solutions that are accessible and usable to everyone, including those with disabilities. We have made every effort to ensure that all features on the site are accessible as possible, however because of technological constraints, some features cannot be fully accessible through assistive technologies, such as screen readers. If you find that you are having accessibility issues with any of our content, we’d like to know about it. We also offer language assistance services. These services are free and available to help you communicate with us and with your health plan. We are able to provide letters in other languages or you can ask for an interpreter. Details on how to obtain these services is available (https://www.optum.com/nondiscrimination.html).
Complex Case Management Program:The Complex Case Management Program is for members who could be helped through more intensive coordination of services. This program is intended to help members with complex behavioral health conditions connect with needed services and resources. For additional information about the Complex Case Management Program, please call the number on the back of your insurance card, Please Click here: Complex Case Management Program
Authorization for Services: Many benefit plans require you to call to obtain authorization, certification, or referral before you obtain services. Use the number on the back of your insurance card to confirm benefits and authorization requirements. There are some services that are not guaranteed until the requirements for utilization review have been completed and documentation of authorization has been issued. Use the number on the back of your card to obtain information on how to seek authorization, if you (and/or your representative) believe the necessary care is not available from contracted providers; initiate a grievance if coverage has been denied, reduced, modified, or terminated; and obtain information concerning the potential consequences if authorization is not obtained.
Joining Our Network : Providers of mental health or substance use services not currently under contract with the managed care organization that are willing to meet the terms and conditions for participation may apply for contracted status and may become contracted after successful completion of credentialing. Please refer provider to providerexpress.com for further details.
Notice about virtual visits for Medicaid/Medicare members: Your virtual visit coverage may vary depending on your Medicaid/Medicare plan. To find out if you’re covered for virtual visits, please call the number on the back of your insurance card. If you’re covered, and once you choose a provider, that provider must confirm your coverage, determine if the service is right for you, and tell you if you need to complete a consent form(s).
Medicare Advantage: Appointment Wait Time Standards – Medicare Advantage plans are required to maintain written standards for timeliness of access to care. The Medicare Advantage plan’s written standards for appointment wait times for behavioral health services must meet or exceed the minimum standards as follows:
- Urgently needed services or emergency—immediately;
- Services that are not emergency or urgently needed, but the enrollee requires medical attention—within 7 business days; and
- Routine and preventive care—within 30 business days.
Maryland State Specific Notice: Maryland Accommodation Process
For Florida Residents: Florida Medicaid Network Adequacy Standards
For Ohio Residents: When a provider no longer participates in the network, or has changed participation status, additional liability is likely to result. Soon after the provider changes their status, out of network penalties or increased cost sharing will result. In some cases, extension of in network or greater network benefits may be available.
Not all providers at listed facilities (hospitals, surgical centers, etc.) are network providers. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with our network, or call the toll-free member phone number on your health plan ID card.
UnitedHealthcare Connected MyCare Ohio - OHMM: http://www.myuhc.com/content/myuhc/Member/Assets/Pdfs/Medicaid/OHMM_Disclaimers.pdf
UnitedHealthcare Community Plan - OHMD: http://www.myuhc.com/content/myuhc/Member/Assets/Pdfs/Medicaid/OHMD_Disclaimers.pdf
For New York Residents: Site of Service Clinical Review by a Network Participating Provider - A site of service review can change where services can be obtained. It can also change if a Network provider is available to provide a service.
Provider
Except where noted, all information about provider's name, gender, hospital affiliation, office location, phone number, language spoken and whether they are accepting new patients is voluntarily self-reported by the provider and only updated upon his or her request.
Discipline/provider type, specialty and board certification information is self-reported by the provider and verified when the provider first joins the network by verification of the provider's training in the specialty or his/her board certification status. For more information, please visit the following board certification websites:
American Board of Medical Specialties (ABMS)
American Osteopathic Association (AOA)
The accuracy of clinician credentialing data and other information is validated at least every 36 months. Information is updated on a real-time basis.
Facility
Except where noted, all information about the facility name, location, and phone number is self-reported by the facility and only updated upon request. Accreditation information is self-reported by the facility and verified when the facility first joins the network. The accuracy of this information is validated at least every 36 months.
Accreditation is a process in which certification of competency, authority or credibility is presented. Hospital Accreditation status is verified directly with the accreditation body when the facility is first credentialed and then at least every 36 months thereafter. For more information, please visit the following accreditation websites:
Commission on Accreditation of Rehabilitation Facilities (CARF)
American Association for Ambulatory Health Care (AAAHC)
Council on Accreditation (COA)
Community Health Accreditation Program (CHAP)
Critical Access Hospitals (CAH)
Accreditation Commission for Healthcare (ACHC)
Healthcare Facilities Accreditation Program (HFAP)
National Integrated Accreditation for Healthcare Organizations (NIAHO)
