Community Plan Care Provider Manuals for Medicaid Plans By State

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

• View the UnitedHealthcare Community Plan AHCCCS Complete Care, DD and ALTCS Provider Manual
• View the UnitedHealthcare Dual Complete and Dual Complete One (HMO SNP) Care Provider Manual
• View the Augmentative and Alternative Communication Arizona Complete Care (ACC) and Long-Term Care (LTC) Provider Manual
  
• View the Augmentative and Alternative Communication DDD Provider Manual
• View the Dental Care Provider Manual for ACC, ALTCS EPD and DD 

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 following guides are the most current revisions. Please use these for reference until you are notified of updates.

• Rocky Mountain Health Plans Provider Guide:  Commonly used forms for providers > RMHP Provider Manual
• RMHP RAE Resource Guide:  Commonly used forms for providers > RMHP RAE Resource Guide
• RMHP Behavioral Health Provider Manual:  Commonly used forms for providers > RMHP Behavioral Health Provider Manual

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

• District of Columbia Dual Choice

View the UnitedHealthcare Community Plan of the District of Columbia 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

• Care Provider Manual - Florida Statewide Medicaid Managed Care

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

• UnitedHealthcare Community Plan of Indiana Care Provider Manual
• Dental Provider Manual
• Vision Provider Reference Guide

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 Kansas Care Provider Manual

Other Provider Manuals

• Modivcare - Kansas NEMT Provider Manual
• MARCH® Vision Care - Provider Reference Guide
• Pharmacy Provider Manual
• SkyGen Dental Provider Manual

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 2023 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 and One Care
  • UnitedHealthcare Community Plan of Massachusetts Senior Care Options and One Care 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 Minnesota Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plan:

• UnitedHealthcare Community Plan of Minnesota

View the 2023 UnitedHealthcare Community Plan of Minnesota Care Provider Manual

View the 2022 UnitedHealthcare Community Plan of Minnesota 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 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)
• UnitedHealthcare Medicaid
• UnitedHealthcare Essential Plan
• UnitedHealthcare Dual Advantage (Medicaid)
• UnitedHealthcare Dual Complete (Medicare)
• UnitedHealthcare Wellness4Me (HARP)

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 PDF of the UnitedHealthcare Community Plan of Ohio 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

• UnitedHealthcare Community Plan of Tennessee Care Provider Manual
• Tennessee UnitedHealthcare Dual Complete® (HMO-SNP) Care Provider Manual
• TennCare CLS Manual
• TennCare Regulatory Appendix Addendum
• Intellectual & Developmental Disabilities (DIDD) Long-Term Services and Supports (LTSS) Supplement

Other Resources

• UnitedHealthcare Community Plan of Tennessee Member Handbook
  

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, STAR Kids, and STAR+PLUS Care Provider Manual (Last Modified 08.19.2022)

View the UnitedHealthcare Connected™ (Medicare-Medicaid Plan) Care Provider Manual (Last Modified 08.19.2022) 

View the UnitedHealthcare Community Plan of Texas Nursing Facility Care Provider Manual (Last Modified 10.10.2022)

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.