TheUnitedHealthcareCommunity Plancare provider administrative manualscontain 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 Needs (SNP) Plans, please view the comprehensive UnitedHealthcare Administrative Guide.
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Arizona
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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)
Care Provider Manuals
- UnitedHealthcare Community Plan AHCCCS Complete Care, DD and ALTCS Provider Manual
- UnitedHealthcare Dual Complete and Dual Complete One (HMO SNP) Care Provider Manual
- Dental Care Provider Manual for ACC, ALTCS EPD and DD
California
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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
Colorado
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The following guides are the most current revisions. Please use these for reference until you are notified of updates.
Care Provider Manuals
- Colorado Rocky Mountain Health Plans Behavioral Health Care Provider Manual
- Colorado Rocky Mountain Health Plans Care Provider Manual
District of Columbia
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of theDistrict of Columbia Care Provider Manual
Florida
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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
- UnitedHealthcare Community Plan of Florida Statewide Medicaid Managed Care Provider Manual
Hawaii
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Hawaii Care Provider Manual
Indiana
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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
- Indiana PathWays for Aging
Care Provider Manuals
- UnitedHealthcare Community Plan of Indiana Care Provider Manual - Hoosier Care Connect
- UnitedHealthcare Community Plan of Indiana Care Provider Manual - PathWays for Aging Provider Manual
- Dental Provider Manual
- Vision Provider Reference Guide
Kansas
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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.
Care Provider Manuals
- UnitedHealthcare Community Plan of Kansas Care Provider Manual
- Modivcare - Kansas NEMT Provider Manual
- Pharmacy Provider Manual
- SkyGen Dental Provider Manual
Other Resources
- MARCH® Vision Care - Provider Reference Guide
Kentucky
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UnitedHealthcare Community Plan of Kentucky supports the Kentucky state goals of increased access, improved healthoutcomes 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.
Care Provider Manuals
- UnitedHealthcare Community Plan of Kentucky Care Provider Manual
Louisiana
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Louisiana Care Provider Manual
Maryland
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Maryland Care Provider Manual
Massachusetts
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Massachusetts Senior Care Options and One Care Provider Administrative Manual
Michigan
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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®
Care Provider Manuals
- 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.
Minnesota
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Minnesota Care Provider Manual
Mississippi
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Mississippi Care Provider Manual for CHIP
- UnitedHealthcare Community Plan of Mississippi Care Provider Manual for MississippiCAN
Missouri
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Missouri Care Provider Manual
Nebraska
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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
Care Provider Manuals
- 2024 UnitedHealthcare Community Plan of Nebraska Care Provider Manual
Other Guides and Manuals
New Jersey
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of New Jersey Care Provider Manual
New Mexico
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The UnitedHealthcare Community Plan of New Mexico Physician, Health Care Professional, Facility and Ancillary Care Provider Manual applies to the following plan:
- UnitedHealthcare Community Plan of New Mexico
Care Provider Manuals
- UnitedHealthcare Community Plan of New Mexico Care Provider Manual
New York
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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)
Care Provider Manuals
- UnitedHealthcare Community Plan of New York Care Provider Manual
North Carolina
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of North Carolina Care Provider Manual
Ohio
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Ohio Care Provider Manual *For exclusive use and reference for Medicaid only
- UnitedHealthcare Connected™ - MyCare Ohio Medicare-Medicaid *For exclusive use and reference for United Healthcare Connected
Oklahoma
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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
Care Provider Manuals
- UnitedHealthcare Dual Complete (HMO-SNP) Care Provider Administrative Guide
Pennsylvania
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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.
Care Provider Manuals
- UnitedHealthcare Community Plan of Pennsylvania Care Provider Manual
Rhode Island
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Rhode Island Care Provider Manual
Tennessee
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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
Other Resources
Texas
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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)
Care Provider Manuals
- UnitedHealthcare Community Plan of Texas CHIP, STAR, STAR Kids, STAR+PLUS and the UnitedHealthcare Connected™ (Medicare-Medicaid Plan) Care Provider Manual
- UnitedHealthcare Community Plan of Texas Nursing Facility Care Provider Manual
Virginia
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Virginia Care Provider Manual
Washington
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Washington Care Provider Manual
Wisconsin
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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
Care Provider Manuals
- UnitedHealthcare Community Plan of Wisconsin Care Provider Manual
