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Policies and Protocols
This library includes UnitedHealthcare policies and protocols. The policies and protocols presented here may not apply to all UnitedHealthcare plans.
Additional Resources
- Clinical Guidelines
- Dental Clinical Policies and Coverage Guidelines
- Requirements for Out-of-Network Laboratory Referral Requests
- Laboratory Test Registry
- Protocols
- UnitedHealthcare Credentialing Plan 2019–2021
- Credentialing Plan State and Federal Regulatory Addendum: Additional State and Federal Credentialing Requirements
Hospital Outpatient Facility Reimbursement Policies
- Hospital Outpatient Radiology Services Rebundling Reimbursement Policy - Commercial and UnitedHealthcare Community Plan: This policy describes the rebundling edits applied by UnitedHealthcare to determine reimbursement for the technical component of hospital outpatient radiology services contracted under the UnitedHealthcare Facility Outpatient Radiology Fee Schedule.
- Hospital Outpatient Laboratory and Pathology Services Rebundling Reimbursement Policy - Commercial and UnitedHealthcare Community Plan: This policy describes reimbursement for hospital outpatient laboratory and pathology services reimbursed according to the UnitedHealthcare Facility Laboratory and Pathology Fee Schedule.