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Provider Administrative Manuals
Provider Training Materials
Medicaid Managed Care Rule External FAQs (PDF 64.57 KB)
Medicaid Managed Care Rule Presentation (PDF 90.71 KB)
HIPAA Claim Edits
UnitedHealthcare applies HIPAA edits to professional (837p) and Institutional (837i) claims submitted electronically. Visit the EDI Claim Edits page for more information including a complete list of edits, edits related to ICD-10 codes and applicable payers. Claims that reject for HIPAA edits will appear on a clearinghouse level report, enabling you to Identify and correct rejected Information prior to UnitedHealthcare receiving the claim.
UnitedHealthcare Community Plan Medical & Drug Policies and Coverage Determination Guidelines
UnitedHealthcare has developed Medical Policies, Medical Benefit Drug Policies and Coverage Determination Guidelines to assist us in administering health benefits. 이러한 정책과 지침은 정보 제공을 목적으로 제공되는 것으로, 의학적인 조언은 아닙니다.
View the guidelines.
UnitedHealthcare Medicare Advantage Coverage Summaries
For policy guidance for Medicare Advantage plan members, view the UnitedHealthcare Medicare Advantage Coverage Summaries Manual and corresponding policy update bulletins here.
정부에 대한 청구, 보고 및 진술의 무결성
UnitedHealth Group은 메디케어와 메디케이드를 비롯한 연방 건강 보험 프로그램과 관련하여 허위 청구의 제출을 금지하는 연방 법률과 주 법률의 요건을 준수해야 합니다.
View our policy (PDF 38.15 KB).
사전 고지 사항
If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. 업데이트된 정책 변경 사항을 확인하려면 왼쪽에서 게시판 섹션을 선택하십시오.