UnitedHealthcare Community Plan
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Please remember to check our website frequently for updates regarding reimbursement policies, provider manuals and bulletins, providing information to our provider network of changes throughout the year. 

 

Provider Resources

Care Provider - Quick Reference Guide (PDF 161.55 KB)

Hospital Webinar Invite (PDF 98.87 KB)

All Physicians Webinar Invite (PDF 104.61 KB)

 

Prior Authorization and Notification

UnitedHealthcare Community Plan Prior Authorization CA Effective 10/1/2017 (PDF 217.45 KB) - posted 7.18.2017

 

 

UnitedHealthcare Community Plan Medical & Drug Policies and Coverage Determination Guidelines

UnitedHealthcare has developed Medical Policies, Medical Benefit Drug Policies and Coverage Determination Guidelines to assist us in administering health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.
View the guidelines > 

Integrity of Claims, Reports, and Representations to the Government

UnitedHealth Group requires compliance with the requirements of federal and state laws that prohibit the submission of false claims in connection with federal health care programs, including Medicare and Medicaid. 
View our policy (PDF 38.15 KB).

UnitedHealthcare Medicare Advantage Coverage Summaries

For policy guidance for Medicare Advantage plan members, please  view the UnitedHealthcare Medicare Advantage Coverage Summaries Manual and corresponding policy update bulletins.

Disclaimer

If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. To see updated policy changes, select the Bulletin section at left.