- Provider Information
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- Claims and Member Information
- Claim Reconsideration and Appeals
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete (HMO-POS SNP) Program
- Electronic Data Interchange (EDI)
- Medicare Part D Educational Materials
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Clinical & Behavorial Health Practice Guidelines
Behavioral Health Practice Guidelines
Behavioral Policy & Analytics Committee Approval - January 20, 2015
Kansas Provider Advisory Committee Approval - June 17, 2015
View a Summary of Changes (printable version) here.
Clinical Practice Guidelines
UnitedHealthcare Community Plan has compiled a list of evidence-based clinical guidelines, and the websites where they can be found, for our quality and health management programs.
We respect the expertise of the physicians and other health care professionals in our network and appreciate your help as we work together to offer our members better quality, better health outcomes and better cost.
If you have questions, please contact your Physician Advocate or call the number on the back of the member’s ID card.
View the Clinical Practice Guidelines (PDF 134.51 KB).
Provider Advisory Committee Approval - June 22, 2017
Healthcare Effectiveness Data and Information Set (HEDIS)
Healthcare Effectiveness Data and Information Set (HEDIS) is a standardized set of performance measurements developed by the National Committee for Quality Assurance (NCQA) to evaluate consumer health care.
HEDIS 2017 involves the acquisition, abstraction and validation of member records for the calendar year 2016.
HEDIS FAQs for KanCare (PDF 131.57 KB)