UNITEDHEALTHCARE

myNEXUS | UnitedHealthcare, Inc. Resources

myNEXUS is proud to announce its partnership with UnitedHealthcare, Inc. to provide utilization management for home health services in Alabama. Please find important announcements, documents, and forms listed below.

Current Announcements:

  • Delegation: Effective July 1st, 2021, myNEXUS will manage UnitedHealthcare Medicare Advantage (MA) plans in the state of Alabama. Delegated services will include Utilization Management.
  • Orientation Sessions: myNEXUS is offering training sessions to orient home health agencies with myNEXUS services. Registration for orientation sessions is listed at the bottom of this page. Please select the date and time of your choice below to register for a session.
  • Notice: The delegation notice and orientation letter mailed and emailed to agencies is available here.

Authorization Program Materials:

In-Scope Plans:
In-Scope Plan List: 
The list of in-scope UnitedHealthcare plans for the myNEXUS delegation.

Authorization Requests:
myNEXUS Provider Portal:
myNEXUS encourages providers to utilize the online Provider Portal to submit authorization requests.

Initial Authorization Request Fax Form: Fax form to use for initial authorization requests if needed.
Re-Authorization Request Fax Form: Fax form to use for re-authorization requests if needed.

Fax Number Confirmation Form: Online Form providers use to confirm their fax numbers for authorization requests.

Agency Information Form: Online form providers use to submit their information if not populating in portal.

Additional Information:

myNEXUS utilizes CMS National and Local Coverage Determinations (NCD and LCDs) when applicable, or UHC medical policies and clinical Utilization Management guidelines to facilitate the appropriate evaluation of medical necessity by including assessment of the member throughout the continuum of care. A synopsis of the criteria is available to Providers and Members on request and free of charge by calling myNEXUS at 866-936-1635 or by emailing provider_network@myNEXUScare.com.

Contact Us:

Please contact the myNEXUS Provider Network team with any questions at provider_network@myNEXUScare.com.

Phone: 1-833-866-0393
Fax: 1-866-936-1635

Provider Orientation Sessions

Thursday, May 20th @ 2pm CST/3pm EST

Tuesday, May 25th @ 2pm CST/3pm EST

Thursday, May 27th @ 2pm CST/3pm EST

Tuesday, June 1st @ 2pm CST/3pm EST

Thursday, June 3rd @ 2pm CST/3pm EST

Tuesday, June 8th @ 2pm CST/3pm EST

Thursday, June 10th @ 2pm CST/3pm EST

Tuesday, June 15th @ 2pm CST/3pm EST

Thursday, June 17th @ 2pm CST/3pm EST

Tuesday, June 22nd @ 2pm CST/3pm EST

Thursday, June 24th @ 2pm CST/3pm EST

Tuesday, June 29th @ 2pm CST/3pm EST