UnitedHealthcare Community Plan - QUEST Integration Program
Choose a Primary Care Provider (PCP):
Your Primary Care Provider is called a PCP. Each member of the UnitedHealthcare Community Plan must pick a PCP. If you have a UnitedHealthcare Medicare Advantage plan or Medicare fee-for-service plan and Medicaid coverage, you may pick an In-Network or Out-of-Network PCP. If you have other Medicare Advantage plan and Medicaid coverage, you are not required to have a PCP. If you have Medicare and Medicaid coverage you may pick an In-Network or Out-of-Network PCP. If you choose an Out-of-Network PCP, we will work with your PCP to join our network of doctors. Each member of UnitedHealthcare Community Plan must pick a PCP from our network unless a PCP is not available who will give you the services you need. If you are in your second or third trimester of pregnancy and you are getting covered prenatal services, you may continue to see your OB/GYN even if he/she is not in our network. Once you have picked a PCP, you should see him or her for all your medical needs. Your PCP will provide or coordinate all of your healthcare. If you need tests or treatments that your PCP cannot provide, your PCP will refer you for this care.
How to schedule an appointment:
Call your PCP to schedule an appointment. Give the office:
· Your name
· Your Member ID number (on your member ID card)
· The name of the person who needs to see the doctor (and their information if the appointment is not for you)
· The reason why you need to see the doctor
Click here to Search for a Provider
Click here (PDF 999.47 KB) for a downloadble provider directory.
Clinical Practice Guidelines
UnitedHealthcare Community Plan has practice guidelines that help providers make healthcare decisions. These guidelines come from nationally recognized sources. UnitedHealthcare Community Plan has practice guidelines for preventive health and other health conditions.
Click here (PDF 220.63 KB) to view the entire list of guidelines or call our Member Services toll-free at 1-888-980-8728 (TTY:711) to request a printed copy.