When these medical policies are used to determine medical necessity, clinical guidelines will be applied in the following order:
1) State Medical Policies
2) UnitedHealthcare Medical Policies
3) Milliman Care Guidelines
UnitedHealthcare has developed Medical Policies, 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.
For state medical policies, see below.
For UnitedHealthcare Medical Policies, are viewable here
For Medicare Medical Policies, click here.
UnitedHealthcare has identified and adopted evidence-based clinical guidelines to guide our quality and health management programs. View the guidelines (PDF 149.18 KB).
Provider Advisory Committee Approval - May 31, 2016