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Policies and clinical guidelines

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.

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We have compiled a list of evidence-based clinical guidelines and where to find them for our quality and health management programs. 


We respect the expertise of the physicians and other health care professionals in our network.  We appreciate your help as we work together to offer our members better quality and health outcomes at a 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 guidelines

View the current UnitedHealthcare Community Plan reimbursement policies.

 

View policies

UnitedHealthcare has developed medical policies, medical benefit drug policies and coverage determination guidelines to help us administer health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.

 

View policies

You can find policy guidance for Medicare Advantage plan members by checking the coverage summaries and corresponding policy update bulletins.


View current policies