Review these payment policy updates to help code and submit your claims correctly. To receive email notifications of payment policy updates, please sign up for Network News.
We have compiled a list of evidence-based clinical guidelines and 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, health outcomes and 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 current UnitedHealthcare Community Plan Reimbursement Policies.
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.
For drugs covered under both pharmacy and medical benefit, our coverage criteria will be no more restrictive than the criteria of the Vendor Drug Program.
For policy guidance for Medicare Advantage plan members, view the UnitedHealthcare Medicare Advantage Coverage Summaries and corresponding Policy Update Bulletins.