Monitoring of network care providers and health care professionals - Chapter 15, 2022 UnitedHealthcare Administrative Guide

We monitor sanction activity from state licensing boards, CMS, Office of Inspector General (OIG) and other regulatory bodies. If we find a health care provider has a sanction that results in loss of license or material restriction, we terminate them from our network.

Health care provider office site quality review

We have office site standards that you must follow, including:

  • Physical accessibility, such as handicapped accessible.
  • Physical appearance of the site.
  • Adequacy of waiting and examining room space.
  • Availability of appointments.
  • Adequacy of treatment record keeping (e.g., secure/confidential filing system).

We use a standardized site visit survey form that lists office-site and medical/treatment record-keeping standards