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United Healthcare

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What you need to know:

1. General Information

Contact Numbers

United Voice Portal: 1-877-842-3210
Benefits and Eligibility: 1-877-842-3210
United Healthcare Online Help Desk: 1-866-842-3278
Electronic Data Interchange (EDI)Claims: 1-800-842-1109
Electronic Payments and Statements (EPS): 1-866-842-3278
Hospital Comparison Program: 1-866-270-5588
United Behavioral Health: 1-877-633-7824
View360 Patient Opportunity Summary Reports: 1-866-270-5588
Practice-Facility Updates: 1-877-842-3210
Physician Designation Program: 1-866-270-5588
Specialty Center Designation Program: 1-866-270-5588

Address Information

On the back of the member's card and/or
listed in the provider agreement

Web Address

www.unitedhealthcareonline.com

2. Eligibility, Benefits and Claim Status

Eligibility, benefits, and claim status can be verified online in three ways:
  1. United Voice Portal Toll Free Number
  2. Through United Healthcare’s secure provider website, available through www.unitedhealthcareonline.com
  3. Through an electronic vendor/clearinghouse

Business Hours (Eastern Time)

Monday thru Friday: 6 a.m. - 12 a.m.
Saturday: 6 a.m. - 7 p.m.
Sunday: 7 a.m. - 5 p.m.

3. Precertification

How to Submit a Precertification Request

Submit precertification requests at least 2 business days prior to rendering services by:

  • Non Urgent precertification requests only fax 800-303-9902
  • Hospital Notification only fax 800-699-4712
  • General Provider Phone Number 877-842-3210
  • Electronic Referral System through www.unitedhealthcareonline.com
  • Submit via EDI

4. Billing Information

Three simple ways:
  1. Electronic claims can be submitted through United Healthcares’s secure provider website, available through www.unitedhealthcareonline.com.
  2. Electronic claims can be submitted through an electronic vendor/clearinghouse.
  3. Paper claims can be submitted to the United Healthcare claims mailing address listed on the member's ID card.
Secondary claims:
  • Submit electronically
  • Paper claims can be submitted with the primary payer's eob
  • Include adjustment amounts - at both claim level and service line level (if available)
  • Include adjustment reasons - contractual obligation, deductible, coinsurance, etc. Use the codes furnished by the primary payer's remittance
  • Primary payer paid amount - at both claim level and service line level (if available)

5. Timely Filing Requirements

Timely filing limits are specified in the provider agreement.

6. Corrected Claims

  • When making changes to previously paid claims, submit corrected claims electronically. Enter "CORRECTED CLAIM" in the notes field. Update the Claim Frequency Code with:
    7 = Replacement of a prior claim
    8 = Void/cancel of a prior claim
  • When making changes to previously denied claims, submit corrected claim on paper with a United Healthcare Claim Reconsideration Form and follow instructions.

7. Refunds

Submit a corrected claim and United Healthcare will recover/recoup the overpayment which will be reported on an ERA with a reversal of the incorrect claim adjudication, followed by the corrected adjudication of the claim.

Refunds due to existing credit balances can be sent to:

UnitedHealth Group Recovery Services
P.O. Box 740804
Atlanta, GA 30374-0804

Overpayments must be submitted within 30 days of receiving a request from United Healthcare and include all necessary information that corresponds with the payment receivied.

8. Appeal Information

Claim Reconsideration
  1. The quickest way to submit a Claim Reconsideration request is online. Go to www.unitedhealthcareonline.com
  2. If written documentation is needed, such as proof of timely filing or medical notes, you must use the Claim Reconsideration Request Form found on www.unitedhealthcareonline.com. The form should be mailed to the claim address on the back of the Customer’s health care ID card.

If you are submitting a Claim Reconsideration Request Form for a claim which was denied requesting medical documentation:

  1. Complete the Claim Reconsideration Request Form
  2. Provide a description of the documentation being submitted along with all pertinent documentation.

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