Community Plan Care Provider Manuals for Medicaid Plans By State

The UnitedHealthcare Community Plan care provider administrative manuals contain helpful information on topics such as prior authorization, processing claims and protocol information, as well as UnitedHealthcare contact information and other resources.

For UnitedHealthcare Dual Special Need (SNP) Plans, please view the comprehensive UnitedHealthcare Administrative Guide.

The UnitedHealthcare Community Plan of Arizona Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • AHCCCS Complete Care / Medicaid
  • Developmentally Disabled (DD)
  • Arizona Long Term Care System Elderly and Physical Disability (ALTCS EPD)

Provider Manuals

The UnitedHealthcare Community Plan of California Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of California – Medi-Cal

View the UnitedHealthcare Community Plan of California Care Provider Manual.

The UnitedHealthcare Community Plan of Florida Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans.

  • Florida Long Term Care (LTC) Medicaid Managed Care
  • Florida M*Plus MMA Medicaid

Care Provider Manuals

The UnitedHealthcare Community Plan of Hawaii Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Hawaii - QUEST Integration Program

UnitedHealthcare Community Plan of Hawaii Care Provider Manual.

The UnitedHealthcare Community Plan of Indiana Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • Indiana Hoosier Care Connect

Care Provider Manuals

The UnitedHealthcare Community Plan of Kansas Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Kansas - KanCare 

The UnitedHealthcare Community Plan Care Provider Administrative Guide has been approved by the State of Kansas. 

UnitedHealthcare Community Plan of Kentucky supports the Kentucky state goals of increased access, improved health outcomes and reduced costs by offering Medicaid benefits to the following members:

  • Children, from birth through 18 years of age, eligible for Medicaid under expanded pediatric coverage provisions of the Social Security Act.
  • Pregnant women eligible for Medicaid under expanded maternity coverage provisions of the Social Security Act.
  • Children eligible for the Children’s Health Insurance Program (CHIP).
  • Categorically needy — blind and disabled children and adults who are not eligible for Medicare.
  • 19–64 years old who are not eligible for another type of Medicaid and who have an income of less than 138% of the federal poverty level.
  • Medicaid-eligible families.

View the UnitedHealthcare Community Plan of Kentucky Care Provider Manual

The UnitedHealthcare Community Plan of Louisiana Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Louisiana - Healthy Louisiana 

View the UnitedHealthcare Community Plan of Louisiana Care Provider Manual.

The UnitedHealthcare Community Plan of Maryland Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Maryland - HealthChoice

View the UnitedHealthcare Community Plan of Maryland Care Provider Manual

The UnitedHealthcare Community Plan of Massachusetts Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Massachusetts - Senior Care Options

UnitedHealthcare Community Plan of Massachusetts Senior Care Options Provider Administrative Manual.

The UnitedHealthcare Community Plan of Michigan Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Michigan
  • UnitedHealthcare Community Plan of Michigan - Healthy Michigan Plan
  • UnitedHealthcare Dual Complete®

View the UnitedHealthcare Community Plan of Michigan Care Provider Manual.

Rapid Dispute Process

To view our Rapid Dispute Process for non-contracted hospitals providing services to UnitedHealthcare Community Plan Medicaid member, visit Michigan.gov.  

The UnitedHealthcare Community Plan of Mississippi Physician, Health Care Professional, Facility and Ancillary Care Provider Manuals apply to the following plans:

  • Mississippi Children’s Health Insurance Program (CHIP)
  • UnitedHealthcare Community Plan of Mississippi - MississippiCAN

View the UnitedHealthcare Community Plan of Mississippi Care Provider Manual for CHIP.

View the UnitedHealthcare Community Plan of Mississippi Care Provider Manual for MississippiCAN.

The UnitedHealthcare Community Plan of Missouri Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan - Missouri HealthNet Managed Care

View the UnitedHealthcare Community Plan of Missouri Care Provider Manual.

The UnitedHealthcare Community Plan of Nebraska Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Nebraska - Heritage Health

View the UnitedHealthcare Community Plan of Nebraska Care Provider Manual.

The UnitedHealthcare Community Plan of New Jersey Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan - New Jersey FamilyCare
  • UnitedHealthcare Dual Complete® ONE

View the UnitedHealthcare Community Plan of New Jersey Care Provider Manual.

The UnitedHealthcare Community Plan of New York Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • Children’s Health Insurance Program (CHIP)
  • New York Child Health Plus
  • New York Essential Plan
  • New York Community Plan MLTSS
  • New York UnitedHealthcare Community Plan
  • New York UnitedHealthcare Wellness4Me
  • UnitedHealthcare Community Plan for Families/Kids 
  • UnitedHealthcare Dual Advantage (Medicaid) 
  • UnitedHealthcare Dual Complete (Medicare) 
  • UnitedHealthcare Managed Long Term Care (LTC)

View the UnitedHealthcare Community Plan of New York Care Provider Manual.

The UnitedHealthcare Community Plan of North Carolina Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of North Carolina

View the UnitedHealthcare Community Plan of North Carolina Care Provider Manual.

 

The UnitedHealthcare Community Plan of Ohio Physician, Health Care Professional, Facility and Ancillary Care Provider Manuals applies to the following plans:

  • UnitedHealthcare Community Plan of Ohio
  • UnitedHealthcare Connected™ - MyCare Ohio Medicare-Medicaid

View the UnitedHealthcare Community Plan of Ohio Care Provider Manual.

View PDF of the UnitedHealthcare Community Plan of Ohio Care Provider Manual.

View the UnitedHealthcare Connected™ for MyCare Ohio Medicare-Medicaid Care Provider Manual.

The UnitedHealthcare Community Plan of Oklahoma Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Dual Complete® (HMO-SNP)
  • UnitedHealthcare Community Plan of Oklahoma SoonerSelect

View the UnitedHealthcare Dual Complete (HMO-SNP) Care Provider Administrative Guide.

The UnitedHealthcare Community Plan of Pennsylvania Physician, Health Care Professional, Facility and Ancillary Care Provider Manuals applies to the following plans:

  • Pennsylvania UnitedHealthcare Community Plan for Families
  • Pennsylvania UnitedHealthcare Community Plan for Kids

Use the care provider manual for current plan information including claims reconsiderations, appeals and grievances.

View the UnitedHealthcare Community Plan of Pennsylvania Care Provider Manual.

The UnitedHealthcare Community Plan of Rhode Island Physician, Health Care Professional, Facility and Ancillary Care Provider Manuals applies to the following plans:

  • Rhode Island Children with Special Health Care Needs
  • Rhode Island UnitedHealthcare RIte Care
  • Rhode Island UnitedHealthcare Rhody Health Partners
  • Rhode Island UnitedHealthcare Rhody Health Partners ACA Adult Expansion

View the UnitedHealthcare Community Plan of Rhode Island Care Provider Manual.

The UnitedHealthcare Community Plan of Tennessee Physician, Health Care Professional, Facility and Ancillary Care Provider Manuals apply to the following plans:

  • UnitedHealthcare Community Plan of Tennessee - TennCare (Medicaid)
  • Tennessee UnitedHealthcare Dual Complete (HMO-SNP)

Care Provider Manuals

Other Resources

UnitedHealthcare Community Plan of Texas Physician, Health Care Professional, Facility and Ancillary Care Provider Manuals apply to the following plans:

  • Children's Healthcare Insurance Program (CHIP)
  • State of Texas Access Reform (STAR)
  • State of Texas Access Reform PLUS (STAR+PLUS)
  • State of Texas Access Reform Kids (STAR Kids)
  • UnitedHealthcare Connected™ (Medicare-Medicaid Plan)

View the UnitedHealthcare Community Plan of Texas CHIP, STAR and STAR+PLUS Care Provider Manual (Last Modified 09.08.2021)

View the UnitedHealthcare Community Plan of Texas STAR Kids Administrative Guide / Care Provider Manual (Last Modified 05.06.2021)

View the UnitedHealthcare Connected™ (Medicare-Medicaid Plan) Care Provider Manual (Last Modified 05.06.2021) 

View the UnitedHealthcare Community Plan of Texas Nursing Facility Care Provider Manual (Last Modified 09.02.2021)

The UnitedHealthcare Community Plan of Virginia Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Virginia-Virginia Commonwealth Coordinated Care Plus (CCC Plus)
  • UnitedHealthcare Community Plan of Virginia-Medicaid and Family Access to Medical Insurance Security Community Plans

View the UnitedHealthcare Community Plan of Virginia Care Provider Manual

The UnitedHealthcare Community Plan of Washington Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan - Apple Health

View the UnitedHealthcare Community Plan of Washington Care Provider Manual.

The UnitedHealthcare Community Plan of Wisconsin Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plans:

  • UnitedHealthcare Community Plan of Wisconsin

View the UnitedHealthcare Community Plan of Wisconsin Care Provider Manual.