UnitedHealthcare Provider Portal

The UnitedHealthcare Provider Portal has more than 40 tools that allow you to take action on claims and get the answers you need quickly. It’s available 24/7 – and at no cost to you. All without having to pick up the phone.

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Eligibility and Benefits

Verify member eligibility, determine benefits, view care plans and get a digital copy of the member ID card.

Prior Authorization and Notification

Check prior authorization and notification requirements, submit requests, upload medical notes, check status and update cases.

Claims and Payments

Submit claims, look up fee schedules, check status, view payment information, and submit reconsideration and appeal requests.

Referrals

Check referral requirements, submit requests, review referral history and monitor the number of remaining visits.

Go Digital!

  • less paper
  • more automation
  • faster workflow 

All designed to support faster payments.

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Network News

Find the latest announcements, updates and reminders – prior authorization requirements, policy and protocol changes, reimbursement updates and other important information to guide how your practice works with UnitedHealthcare and our members.

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No Surprises Act open negotiations

Learn more about the requirements of the No Surprises Act of 2020 and the out-of-network claims covered under the Act. Step-by-step instructions guide you through submitting a negotiation request through the UnitedHealthcare Provider Portal.

Review the process

News

AZ, MO, D.C.: Get ready for paperless Medicaid prior authorization and clinical decision letters

Starting Sept. 9, 2022, Arizona, Missouri and Washington, D.C., C&S prior authorization and clinical decision letters are going paperless. View through the portal, API or TrackIt.

Helping you coordinate patient care

Care coordination can help improve health outcomes. UnitedHealthcare offers several care coordination programs, including controlled substance monitoring, maternity case management and assistance with transitions of care.

New Smart Edit for commercial plans

Smart Edit will be available for commercial plans to help with coordination of benefits when you submit a claim.

At-home A1C and kidney disease screening outreaches underway

Notification to providers who may have members who have been diagnosed with diabetes and have received communications encouraging them to order an at home eGFR and uACR testing kit or an A1C testing kit.

Exchange plans and Commercial plans: New 2022 codes for Pediatric Congenital Heart Disease

Beginning Jan. 1, 2022, there are new CPT codes in place for Pediatric Congenital Heart Disease.

New Mexico commercial plans: Provider grievance process

In accordance with New Mexico law, providers have the right to file a grievance about health care insurer operations, termination from a health plan, credentialing and timely claims payment.