Medicaid overpayment letters going paperless

Hawaii and Wisconsin Medicaid will see changes starting Nov. 4

Beginning Nov. 4, we’ll no longer mail overpayment letters sent directly by UnitedHealthcare* for most UnitedHealthcare Community Plans to network health care professionals (primary and ancillary) and facilities in Hawaii and Wisconsin. Instead, you’ll be able to view them digitally 24/7.

Note: Overpayment letters will continue to be mailed to Behavioral Health professionals and facilities and Home and Community Based Services.

Please share the following changes and digital workflow options with those who are affected, including outside vendors such as revenue cycle management companies.

View overpayment letters 1 of 3 ways

UnitedHealthcare Provider Portal

• Document Library ‒ View overpayment letters in this secure repository within the portal. We encourage you to set up a daily task to check Document Library for updates.
  • Go to UHCprovider.com > Sign In
  • Sign in to the portal with your One Healthcare ID and password 
    • If you don’t have a One Healthcare ID, visit UHCprovider.com/access to get started
  • In the menu, select Documents & Reporting > Document Library > Overpayment Documents folder
    • Use Advanced Search and search by Check ID or Claim No. to help you find what you need
  • Notifications: When new letters are available in Document Library, an email notification will be sent to the address on file, which is typically the Primary Access Administrator.
  • Need to notify multiple staff members? Document Library notifications are limited to 1 email address per letter type. If multiple staff members require notification, the Primary Access Administrator can consider using a group email address. See our Paperless Delivery Options for Primary Access Administrator for more information.

Explore Document Library

Paperless Delivery Options for Primary Access Administrators

View using API: You should consider API if you have significant claims volume and either automate correspondence intake or prefer an option other than looking up individual items in Document Library. Data can be pulled into your practice management system, portal or any application you prefer. API requires technical programming between your organization and UnitedHealthcare.

Learn about API

Schedule a demo

You can also view overpayment letters using Direct Connect: This free tool, is available in the UnitedHealthcare Provider Portal. Enrolling in Direct Connect helps you review and resolve overpaid claims quickly and easily. Use Direct Connect to reduce letters and calls from UnitedHealthcare and your work with third-party vendors. Here’s how it works:

• All initial overpayment notification letters will post to Document Library
• Subsequent communications, including reminder notifications and disagreements with overpayment findings, will be done via Direct Connect. You can also use the tool to submit refunds.
• To enroll, email directconnectaccess@optum.com. Please include the requestor’s name, as well as the organization’s tax ID number (TIN), physical address and mailing address.

What’s ahead in paperless 
Letters we mail you aren’t the only communications going digital. Looking ahead to 2023, contracted health care professionals and facilities will be required to submit most claims, claim attachments, reconsideration requests and appeal requests electronically. We’ll also begin to introduce digital member ID cards for commercial plans. All transitions will be announced in Network News at least 90 days prior to the change. We encourage you to explore our digital solutions and review your workflows so that your team is prepared. Review the most up-to-date information, exclusions and schedule.

Questions?
Please contact UnitedHealthcare Provider Services at 877-842-3210, TTY/RTT 711, 7 a.m.–5 p.m. CT, Monday–Friday.

* These changes include the following overpayment letters:

• Overpayment identified – Notifying you that UnitedHealthcare paid too much on a processed claim
• Overpayment reconsideration requests – Acknowledging UnitedHealthcare received your request to review our overpayment determination
• Overpayment reconsideration decision – Providing the outcome of the reconsideration review and outlining what happens next

This change includes letters sent by Optum for payment accuracy reviews they perform on behalf of UnitedHealthcare. It does not include overpayment letters sent by any other vendor. Those letters will continue to be mailed. Most will include both the vendor and UnitedHealthcare logos, and explain their review was done on our behalf.

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