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It explains key administrative topics including claims, prior authorizations, and care protocols, and provides contact and website resources for managing eligibility, referrals, and notifications. 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This guide contains important information on how to engage with us. It covers key topics such as claims, prior authorizations and protocols for health care professionals. You'll also find helpful contact details and websites to support your needs. More policies and online solutions are available [on](on UHCprovider.com)[ UHCprovider.com](on UHCprovider.com).  \n• If you are looking for a Community Plan (Medicaid) care provider manual, [go to](go to UHCprovider.com/guides)[ UHCprovider.com/guides](go to UHCprovider.com/guides) > Find Your State  \n• If you are a UnitedHealthcare or Optum® participating health care provider or facility with an active Department of Veterans Affairs Community Care Network (VA CCN) agreement, you can find more information about VA CCN on  \nthe Optum VA Community Care Network UnitedHealthcare Provider Portal at vacommunitycare.com/provider You may easily find information in this guide using these steps:  \n1. Keys CTRL+F  \n2. Type in the keyword  \n3. Press enter  \nThis 2026 UnitedHealthcare Care Provider Administrative Guide (this “guide”) applies to covered services you provide to our members or the members of our affiliates through our benefit plans insured by or receiving administrative services from us, unless otherwise noted.  \nThis guide is effective April 1, 2026, for physicians, health care professionals, facilities and ancillary health care providers currently participating in our commercial and MA networks. It is effective now for health care providers who join our network on or after Jan. 1, 2026. This guide is subject to change. We frequently update content in our effort to support our health care provider networks.  \nTerms and definitions as used in this guide:  \n• “Member” or “customer” refers to a person eligible and enrolled to receive coverage from a payer for covered services as defined or referenced in your Agreement  \n• “Commercial” refers to all UnitedHealthcare medical products that are not MA, Medicare Supplement, Medicaid, CHIP, workers’compensation or other government programs.“Commercial” also applies to benefit plans for the Health Insurance Marketplace, government employees or students at public universities.  \n• “You,”“your” or “provider” refers to any health care provider subject to this guide. These include physicians and other health care professionals (whether practicing or contracting independently or affiliated with a group or other entity), facilities and ancillary providers, except when indicated. All items are applicable to all types of healthcare providers subject to this guide.  \n• “Your Agreement,”“Provider Agreement,” “Agreement” or “your contract” refers to your Participation Agreement with us  \n• “Us,”“we” or “our” refers to UnitedHealthcare on behalf of itself and its other affiliates for those products and services subject to this guide  \n• Any reference to “ID card” includes both a physical or digital card  \nMA policies, protocols and information in this guide apply to covered services you provide to UnitedHealthcare MA members, including Erickson Advantage members and most UnitedHealthcare Dual Complete members, excluding UnitedHealthcare Medicare Direct members. We indicate if a particular section does not apply to such MA members. If there is a conflict or inconsistency between a Regulatory Requirements Appendix attached to your Agreement and this guide, the provisions of the Regulatory Requirements Appendix controls for benefit plans within the scope of that appendix.  \n 2026 UnitedHealthcare Care Provider Administrative Guide i  \nIf there is inconsistency between the terms of your Agreement and this guide, your Agreement controls. The exception to this rule is when ","cbCainggksTDuaVX","https://ap.wps.com/l/cbCainggksTDuaVX","pdf",6017402,484,"English","# Welcome to the UnitedHealthcare Care Provider Administrative Guide\n## Key topics covered: claims, prior authorizations, and protocols\n## How to find information (CTRL+F and keywords)\n## Applicability and effective dates\n## Terms and definitions\n## MA policy scope and regulatory hierarchy\n## Quick reference guide: join and credentialing, digital solutions","[{\"question\":\"What does the 2026 UnitedHealthcare Care Provider Administrative Guide cover?\",\"answer\":\"It covers important administrative information for engaging with UnitedHealthcare, including claims, prior authorizations, and care protocols, plus helpful contact details and websites.\"},{\"question\":\"When does the guide take effect?\",\"answer\":\"The guide is effective April 1, 2026 for providers currently participating in commercial and MA networks, and it is effective now for providers who join the network on or after Jan. 1, 2026.\"},{\"question\":\"How do you determine which parts apply to Medicare Advantage (MA) members?\",\"answer\":\"MA policies apply to covered services for UnitedHealthcare MA members, and the guide indicates when a particular section does not apply to such MA members. It also addresses how conflicts are handled with regulatory requirements and agreements.\"}]","2026 UnitedHealthcare Care Provider Administrative Guide - Effective April 1, 2026 | PDF",1791248883,1220]