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Policies and Clinical Guidelines

Reimbursement Policies

View the current UnitedHealthcare Community Plan Reimbursement Policies.

We’ve put together this list of evidence-based clinical guidelines, and the websites where they can be found, for our quality and health management programs. We hope you find this information helpful as we work together to offer our members, your patients, better quality, better health outcomes and better cost.

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 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.