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UnitedHealthcare Community Plan Added to Electronic Payments & Statements (PDF 59,89 KB)

Medicaid Managed Care Rule External FAQ’s (PDF 64,57 KB)

Medicaid Managed Care Rule Presentation (PDF 90,71 KB)

 

Provider Manual

2017 Washington Apple Health Care Provider Manual (PDF 1,1 MB) - 1.8.2018

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 1/1/2018 (PDF 282,37 KB)

Chương Trình Cộng Đồng UnitedHealthcare
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)

UnitedHealthcare Medicare Solutions Notification/Prior Authorization List - Effective 1/1/16 (PDF 250,02 KB)

UnitedHealthcare Medicare Solutions Notification/Prior Authorization List - Effective 1/1/16 (PDF 249,77 KB)

Advance Notification Requirements - Effective 10/1/2014 (PDF 186,05 KB)

 

Thuốc Tiêm Y Tế

Các loại thuốc chuyên ngành trong nhà thuốc được bao trả trong Quyền Lợi Y Tế có thể được cung cấp qua nhiều kênh khác nhau – nhà cung cấp tiêm truyền tại nhà, cơ sở điều trị ngoại trú, bác sĩ, hoặc nhà thuốc chuyên ngành.

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:

Nhà Thuốc Chuyên Ngành Trong Hệ Thống

Số Điện Thoại

BriovaRx

855-427-4682

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

Nhà Thuốc Chuyên Ngành Trong Hệ Thống

Loại Thuốc

Số Điện Thoại

Accredo (nursing services)

Thiếu Enzyme

Bệnh Gaucher

Miễn Dịch Globulin

Tăng Áp Phổi

800-803-2523

 

Option Care (nursing services)

Thiếu Enzyme

Bệnh Gaucher

Chứng rối loạn đông máu

Miễn Dịch Globulin

Bệnh Makena

866-827-8203

Nhà Thuốc Chuyên Ngành CVS Caremark

Tăng Áp Phổi

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.

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. Những chính sách và hướng dẫn này được cung cấp nhằm mục đích thông tin, và không thiết lập thành ý kiến tư vấn y khoa.
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

Yêu cầu khai đúng sự thật của các Yêu Cầu Bảo Hiểm, Báo Cáo, và Trình Bày với Chính Phủ

Tập Đoàn UnitedHealth yêu cầu tuân theo các quy định của luật pháp tiểu bang và liên bang, nghiêm cấm việc nộp các yêu cầu bảo hiểm gian lận có liên quan đến các chương trình chăm sóc sức khoẻ của liên bang, bao gồm Medicare và Medicaid. 
View our policy (PDF 38,15 KB).

Miễn Trách

If UHG policies conflict with provisions of a state contract or with state or federal law, the contractual / statutory / regulatory provisions shall prevail. Để xem các thay đổi chính sách được cập nhật, hãy chọn phần Bản Tin ở bên trái.