- Provider Information
- Claims and Member Information
- Claim Reconsideration and Appeals
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete Program
- Electronic Data Interchange (EDI)
- Pharmacy Program
- Provider Administrative Manual
- Provider Forms
- Provider Training
- Reimbursement Policy
We are committed to working with you and your staff to achieve the best possible health outcomes for our members.
This website is dedicated to information specific to our health plan. Look here for policies, processes, news and alerts.
Care Provider Quick Reference Guide (PDF 136.85 KB) - Use this guide to learn how to verify eligibility, where to submit claims, and more.
UnitedHealthcare Community Plan
UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan
Click on the arrow above to view the Prior Authorization Archive.
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.
UnitedHealthcare Medicare Advantage Coverage Summaries
For policy guidance for Medicare Advantage plan members, view the UnitedHealthcare Medicare Advantage Coverage Summaries Manual and corresponding policy update bulletins here.
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).
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.