We are committed to supporting you in providing quality care and services to the members in our network. Here you will find frequently used forms, PDFs, provider manuals and guides, prior authorization information, practice policies and support for delivering benefits to our members.
Provider forms are located on the Forms page for easy access.
UniCare Health Plan of West Virginia, Inc. (UniCare) offers training and tutorials to support providers in continuing their education through the Provider Training Academy. Presentations, videos and other training documentation will be added as they become available.
UniCare provider manuals contain key administrative information, details regarding programs including the utilization management program and case management programs, quality standards for provider participation, guidelines for claims and appeals, coding spotlights and more. The dental provider manual can also be found here.
Many of the tools you need — such as eligibility and benefits inquiry, claims submission, claims status inquiry and authorizations — can now be accessed by logging into your account on the Availity Web Portal.
* Availity, LLC is an independent company providing administrative support services on behalf of UniCare Health Plan of West Virginia, Inc.
UniCare is available by fax or ICR 24 hours a day, 7 days a week to accept prior authorization requests. ICR is a real-time prior authorization system through the Availity Web Portal where authorization requests can be completed, edited and submitted electronically. Alerts are sent to a provider’s email address when the status of the authorization changes or additional information is needed. For more information related to submitting a prior authorization request, please refer to the Provider Manual.
The Prior Authorization Lookup Tool Online can help you determine a code’s precertification (prior authorization) requirements before a request is submitted.
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
UniCare’s behavioral health provider network includes psychiatrists, psychologists, social workers, psychiatric nurses, and other mental health and employee assistance health care professionals.
Our facility network includes hospital inpatient units, residential treatment centers, partial hospitalization programs, and intensive outpatient services and programs.