Prompt claims
processing
We know that you want your claims to be processed promptly for the covered
services you provide to our members.
We work hard to process your claims timely and accurately. Here’s what you can
do to help us:
1 Review the member’s eligibility at UnitedHealthcareOnline.com, using swipe
card technology or keying in the member’s information.
You can also check member eligibility by phone by calling the United Voice
Portal at (877) 842-3210 or the Customer Care number on the back of the member’s health care ID card.
Disclaimer: Eligibility & benefit information provided is not a guarantee
of payment or coverage in any specific amount. Actual reimbursement depends on various factors, including compliance
with applicable administrative protocols, date(s) of services rendered and
benefit plan terms and conditions.
2 Notify us in accordance with the Standard Notification Requirements list.
3 Prepare complete and accurate claims (see “Complete Claims” below).
4 Submit claims online at UnitedHealthcareOnline.com or use another electronic
option.
a) Connectivity Director is a free direct connection for those who can create a
claim file in the HIPAA 837 format. This Web-based application enables real-time and batch submissions
direct to UnitedHealthcare.
b) UnitedHealthcare Online All-Payer Gateway™ is a Web-based connectivity
solution which links UnitedHealthcare Online users to a leading clearinghouse vendor (Ingenix) that
offers multi-payer health transactions and services at preferred pricing. Using your current
UnitedHealthcare Online User ID and password, you can register with Ingenix to submit batch claims to many of your
governmental and commercial
Electronic Claimsg Claims and Payments gpayers. For more information:
UnitdHealthcareOnline.com EDI Options.gSubmission
c) EDI Gateway and Clearinghouse Connections – UnitedHealthcare’s preferred clearinghouse
is Ingenix, but you can use any clearinghouse you prefer to submit claims
to UnitedHealthcare. Both participating and nonparticipating physician,
health care professional, facility and ancillary provider claims are accepted
electronically using UnitedHealthcare’s payer ID 87726. Other
UnitedHealthcare and affiliate payer ID s can be found
on UnitedHealthCareOnline.com.
UnitedHealthcare contracts generally require you to conduct business with us
electronically and contain requirements regarding electronic claim
submission specifically. Please review your agreement with us and abide by its
requirements. While some claims may require supporting information for
initial review, UnitedHealthcare has reduced the need for paper attachments
for referrals/notifications, progress notes, ER visits and more. We will
request additional information when needed.
5 Receive Electronic Payments and Statements (EPS)
If you are enrolled with us for EPS, payments are electronically deposited into
one or more checking accounts which you designate. Take the next step by auto-posting the electronic
835/Electronic Remittance Advice (ERA) that you receive from your clearinghouse, or obtain one free of
charge from our Web site at
UnitedHealthcareOnline.com.
Explanations of Benefits (EOBs) that match each daily/weekly consolidated
deposit are available on UnitedHealthcareOnline.com, where you can review, store and print hard copies
to use for manual posting.
EPS is UnitedHealthcare’s preferred method for receiving payments and
statements and results in faster and easier payment to you. If you have
not yet enrolled in this standard operating process, start receiving electronic
payments and statements now by enrolling online at
UnitedHealthcareOnline.com or by contacting us at (866) 842-3278, Option
5. Please note EPS is not available in all markets for our Medicare
Advantage plans.
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