Skip left navigation

Community Plan Care Provider Manuals

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:

  • Arizona Medicaid
  • Children’s Rehabilitative Services (CRS)
  • Developmentally Disabled (DD)
  • Long-Term Care (LTC) 
  • Elderly and Physically Disabled (EPD)

View the UnitedHealthcare Community Plan of Arizona Care Provider Manual.

View the UnitedHealthcare Community Plan of Arizona Care Provider Manual Effective October 1, 2018.

UnitedHealthcare Dual Complete and Dual Complete One (HMO SNP) Care Provider Manual

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.

Additional Resources

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

  • UnitedHealthcare Community Plan for Families
  • UnitedHealthcare Community Plan for Kids
  • Diamond State Health Plan Plus (DSHP Plus) - Delaware Medicaid Long Term Care

View the UnitedHealthcare Community Plan of Delaware Medicaid and DSHP Plus Long Term 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 Healthy Kids
  • Florida Long Term Care (LTC) Medicaid Managed Care
  • Florida M*Plus MMA Medicaid

View the UnitedHealthcare Community Plan Florida Healthy Kids Care Provider Manual

View the UnitedHealthcare Community Plan of Florida Long Term Care (LTC) Medicaid Managed Care Provider Adminstrative Manual.

View the UnitedHealthcare Community Plan of Florida M*Plus MMA Medicaid Care Provider Manual.

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

View the UnitedHealthcare Community Plan of Hawaii Care Provider Manual.

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

  • UnitedHealthcare Community Plan of Iowa - Iowa Health Link
  • UnitedHealthcare Community Plan of Iowa - Iowa Hawk-i

View the UnitedHealthcare Community Plan of Iowa Care Provider Manual.

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. 

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.

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 CHIP Care Provider Manual.

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.

Checklist for UnitedHealthcare Community Plan of New Jersey - Use this checklist to quickly find important plan information about care provider enrollment, prior authorization, claims, coordination of benefits, etc.

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

  • UnitedHealthcare Community Plan of New Mexico - Centennial Care
  • UnitedHealthcare Dual Complete®

View the UnitedHealthcare Community Plan of New Mexico 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 Dual Complete® (HMO-SNP)

View the UnitedHealthcare Care Provider Administrative Guide.

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 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)

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.

Chapter 12: Claim Reconsiderations, Appeals and Grievances - Use this document for the most current information on claim reconsiderations, appeals and grievances.

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)

View the UnitedHealthcare Community Plan of Tennessee Care Provider Administrative Manual.
View the Tennessee UnitedHealthcare Dual Complete® (HMO-SNP) Care Provider Manual.

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 04.10.2018)

View the UnitedHealthcare Community Plan of Texas STAR Kids Administrative Guide / Care Provider Manual (Last Modified 04.09.2018)

View the UnitedHealthcare Community Plan of Texas UnitedHealthcare Connected™ Care Provider Manual (Last Modified 07.02.2018)

Additonal Provider Manuals

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)
  • Virginia Managed Long-Term Services and Supports (MLTSS)

View the Virginia Medallion 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.