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請選擇您執業的所在州。

You don't have time to spare:that's why we put all the documents you need in one place.

Use the navigation items on the left to find what you're looking for fast.

 

Provider Manual

2018 Washington Apple Health Care Provider Manual (PDF 1.04 MB) - 3.2.2018

Quick Reference Guide for the UnitedHealthcare Administrative Guides (PDF 112.23 KB)

 

Prior Authorization

UnitedHealthcare Outpatient Injectable Chemotherapy Prior Authorization Program Overview (PDF 72.29 KB)

UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan
UnitedHealthcare Medicare Prior Authorization Requirements - Effective 4/1/2018 (PDF 293.21 KB)

UnitedHealthcare Community Plan
UnitedHealthcare Community Plan Prior Authorization WA - Effective 4/1/2018 (PDF 232.35 KB)

UnitedHealthcare Medicare Prior Authorization Requirements - Effective 1/1/2018 (PDF 282.37 KB)

 

UnitedHealthcare Community Plan Prior Authorization WA - Effective 1/1/2018  (PDF 233.05 KB)

UnitedHealthcare Medicare Prior Authorization Requirements - Effective 10/1/2017 (PDF 286.74 KB)

UnitedHealthcare Community Plan Prior Authorization WA - Effective 10/1/2017 (PDF 245.49 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 7/1/2017 (PDF 300.09 KB)

UnitedHealthcare Community Plan Prior Authorization WA - Effective 7/1/2017 (PDF 235.5 KB)

UnitedHealthcare Community Plan Prior Authorization WA - Effective 4/1/2017 (PDF 225.06 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 5/1/2017 (PDF 299.55 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements -  Effective 1/1/2017 (PDF 306.96 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan-Medicare Notification/Prior Authorization Requirements - Effective 4/1/2017 (PDF 300.79 KB)

UnitedHealthcare Community Plan Prior Authorization WA - Effective 1/1/2017 (PDF 225.54 KB)

UnitedHealthcare Community Plan Prior Authorization WA - Effective 10/1/2016 (PDF 219.2 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification / Prior Authorization Requirements -  Effective 10/1/2016 (PDF 277.31 KB)

UnitedHealthcare Community Plan Prior Authorization WA - Effective 7/1/2016 (PDF 213.47 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification/Prior Authorization Requirements - Effective 7/1/2016 (PDF 266.74 KB)

UnitedHealthcare Medicare Solutions and UnitedHealthcare Community Plan Notification/Prior Authorization Requirements - Effective 5/1/2016 (PDF 251.42 KB)

UnitedHealthcare Community Plan Prior Authorization List WA - Effective 5/1/2016 (PDF 215.72 KB)

 

醫療注射

醫療承保福利涵蓋之專賣藥房藥物,可透過多種管道提供 - 居家輸液服務提供者、門診機構、醫師或專賣藥房。

Specialty pharmacy medications covered under the member’s medical benefit may be obtained through various sources ‒ home infusion providers, outpatient facilities, physicians or specialty pharmacy.

If you don’t want to buy and bill a specialty pharmacy medication covered under the member’s medical benefit, you may order it through the following network specialty pharmacy:

專賣藥房網路

電話號碼

BriovaRx

855-427-4682

The following specialty pharmacies also provide certain types of specialty medications:

專賣藥房網路

藥物種類

電話號碼

Accredo (nursing services)

酶缺乏

高歇氏病

免疫球蛋白

肺循環血壓過高

800-803-2523

 

Option Care (nursing services)

酶缺乏

高歇氏病

血友病

免疫球蛋白

Makena

866-827-8203

CVS Caremark 專賣藥房

肺循環血壓過高

800-237-2767


Coverage of a requested medication depends on the member’s benefit, and availability of a specific drug from a network specialty pharmacy may vary.

Upon request, a specialty pharmacy can deliver the medication to your office or another site such as a member’s home.

Medications obtained through a specialty pharmacy will be directly billed to the patient’s health plan.

 

Provider Training Materials

Medicaid Managed Care Rule External FAQs (PDF 64.57 KB)
Medicaid Managed Care Rule Presentation
(PDF 90.71 KB)

 

News

Fostering Positive Youth Development:Opportunities to Reframe the Conversation About Trauma
April 1, 2016, 10:00–11:00 a.m. How might we create school systems and services that engage young people to improve their experience of school climate and wellness?This webinar will explore frameworks and approaches for developing effective youth leadership and positive school climate in your school community, unpacking how and why youth voice is essential to building healthy school climates and cultures.Specific challenges with youth engagement will be discussed.

Self and Collective Care of Youth-Serving Adults
April 8, 2016, 10:00–11:00 a.m. Students are at the center of our work.At the same time, adults in our school communities need support in order to show up for the young people they serve.This webinar will explore how we can create cultures of care not only for youth, but also for the adults who work with them. 



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.這些政策與準則僅供參考,不構成醫療建議。
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

索賠、報告與向政府的陳述屬實

UnitedHealth Group 要求遵守聯邦法與州法的規定,禁止提交與包括 Medicare 與 Medicaid 等聯邦醫療保健計劃相關的不實索賠。
View our policy (PDF 38.15 KB).

免責聲明

If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail.欲查看更新後的政策變更,請選擇左方的公告欄部份。