- Provider Information
- Billing and Reference Guides
- Claims and Member Information
- Claim Reconsideration and Appeals
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete (HMO-SNP) Program
- Electronic Data Interchange (EDI)
- Healthy Michigan Plan Health Risk Assessment (HRA)
- Pharmacy Program
- Provider Administrative Manual
- Provider Forms
- Reimbursement Policy
Clinical Practice Guidelines
UnitedHealthcare Community Plan supports the Global Initiative for Chronic Obstructive Lung Disease (GOLD) evidence-based guidelines for Chronic Obstructive Lung Disease (COPD) diagnosis, management and prevention.
GOLD works with health care professionals and public health officials to raise awareness of COPD and improve prevention and treatment of this lung disease for patients around the world. These guidelines are available at www.goldcopd.org.
UnitedHealthcare Community Plan follows the MAHP Bariatric Surgery Guidelines. Click here (PDF 17.73 KB) for the guidelines.
UnitedHealthcare Community Plan supports the mission of the Michigan Quality Improvement Consortium (MQIC) which is to establish and implement a core set of clinical practice guidelines and performance measures.
MQIC is a diverse collaborative involving physicians, health plan administrators, researchers, quality improvement experts and specialty societies. This consortium recognizes the need to collaborate with other entities and experts to successfully achieve their vision.
Clinical practice and preventive health guidelines for the topics below are available at www.mqic.com. If your office would like a hard copy of the MQIC guidelines, please contact your Provider Relations Advocate.
Advance Care Planning
Advance Care Planning Guideline
General Principles for the Diagnosis and Management of Asthma Guideline
Management of Asthma in Children 0-4 Years Guideline
Management of Asthma in Children 5-11 Years Guideline
Management of Asthma in Youth 12 Years and Older and Adults Guideline
Management of Acute Low Back Pain Guideline
Management of Uncomplicated Acute Bronchitis in Adults Guideline
Primary Care Diagnosis and Management of Adults with Depression Guideline
Management of Diabetes Guideline
Adults with Systolic Heart Failure Guideline
Screening and Management of Hypercholesterolemia Guideline
Medical Management of Adults with Hypertension Guideline
Diagnosis and Management of Adults with Chronic Kidney Disease Guideline
In Office Use of Sedation
Medical Management of Adults with Osteoarthritis Guideline
Management and Prevention of Osteoporosis Guideline
Overweight and Obesity
Prevention and Identification of Childhood Overweight and Obesity Guideline
Treatment of Childhood Overweight and Obesity Guideline
Management of Overweight and Obesity in the Adult Guideline
Acute Pharyngitis in Children 2 - 18 Years Old Guideline
Routine Prenatal and Postnatal Care Guideline
Prevention of Pregnancy in Adolescents 12-17 Years Guideline
Prevention of Unintended Pregnancy in Adults 18 Years and Older Guideline
Routine Preventive Services for Infants and Children (Birth - 24 Months) Guideline
Routine Preventive Services for Children and Adolescents (Ages 2 - 21) Guideline
Adult Preventive Services Guideline (18-49)
Adult Preventive Services Guideline (50-65+)
Screening, Diagnosis, and Referral for Substance Use Disorders Guideline
Tobacco Control Guideline
Outpatient Management of Uncomplicated Deep Venous Thrombosis Guideline
UnitedHealthcare Community Plan supports the additional guidelines listed below.
Please visit the following links for more information.
Guideline for the Treatment of Children 6-12 Years Old with ADHD
Pain Management Guideline
www.michigan.gov/documents/mdch_MI_guidelines_91795_7.pdf (PDF 38.08 KB)
Adult Immunization Schedule
AIM Toolkit (Alliance for Immunization in Michigan)
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 149.18 KB).