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Policies and Clinical Guidelines

Reimbursement Policies

For reimbursement guidance for Community Plan members, view the current UnitedHealthcare Community Plan Reimbursement Policies. 

CRS Behavioral Health Residential Facility, without Room and Board, Child and Adult Practice Guideline (PDF, Last Modified 01.01.2017 - This guideline outlines the management and best practices using treatment of Home Care Training to Home Care Client (HCTC), also known as Therapeutic Foster Home, which adheres to the Arizona Vision Twelve Principles for children up to age 18 and to the nine Guiding Principles for Recovery Oriented Adult Behavioral Health Services and System for individuals 18 and over.

CRS Behavioral Health Home Health Care Training to Client (HCTC) Practice Guidelines (PDF, Last Modified 08.04.2017)- UnitedHealthcare Community Plan Community Plan guideline outlines the management of Behavioral Health Residential Treatment which adheres to Arizona Vision Twelve Principles for children up to the age of 18 and Principles for Recovery Oriented Adult Behavioral Health Services and Systems. 

UnitedHealthcare Community Plan has compiled a list of evidence-based clinical guidelines, and the websites where they can be found, for our quality and health management programs.

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

Provider Advisory Committee Approval - June 21, 2017

If you have questions, please contact your Physician Advocate or call the number on the back of the member’s ID card.

UnitedHealthcare has developed Pharmacy Clinical Coverage Determination Guidelines to assist us in administering health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.

UnitedHealthcare has developed Medical Policies, Medical Benefit Drug Policies and Coverage Determination Guidelines to assist us in administering health benefits. These policies and guidelines are provided for informational purposes, and do not constitute medical advice.

For policy guidance for Medicare Advantage plan members, view the UnitedHealthcare Medicare Advantage Coverage Summaries and corresponding policy update bulletins.