UnitedHealthcare Provider Portal
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.
COVID-19 resources
Access resources, information and tools to help you provide care to patients and support your practice during the public health emergency. You’ll find details on federal, state and health plan requirements, claim and billing guidelines for COVID-19 testing, treatment and vaccines, and any temporary provisions in effect. The site is updated as new information becomes available.
News
May 18, 2022
Michigan Medicaid: What you need to know about caring for members with hepatitis C
The Michigan Department of Health and Human Services (MDHHS) launched the We Treat Hep C Initiative to help eliminate the hepatitis C virus (HCV) in Michigan. The We Treat Hep C initiative has removed barriers to care and offers support to health care professionals testing and treating UnitedHealthcare Community Plan members for hepatitis C.
May 16, 2022
Pennsylvania Medicaid: Billing updates for personal care services
The Pennsylvania Department of Human Services has updated its billing requirements for personal care services that are verified using an electronic visit verification (EVV) system. For dates of service starting May 1, 2022, health care professionals administering personal care services to UnitedHealthcare Community Plan members in their home must use HCPCS code T1019 when submitting claims and requesting prior authorization.
May 09, 2022
Electronic payments required for claim payments starting June 1
Effective June 1, 2022, in accordance with your contractual agreement that you do business with us electronically, UnitedHealthcare is no longer sending paper checks for claim payments. This change supports our continued efforts to accelerate payments to your practice by moving to digital transactions.
May 06, 2022
Medicaid: Charging patients for non-covered services
The Centers for Medicare & Medicaid (CMS) requires all Medicare members, including Dual Eligible Special Needs Plan (D-SNP) members, to know costs prior to receiving non-covered services. Request a prior authorization if you know or have reason to believe that a service for a Medicare Advantage member may not be covered.
May 04, 2022
Central/Southeast/Northeast regions: Prior authorization and clinical decision letters are going paperless
Starting May 20, 2022, UnitedHealthcare will no longer mail prior authorization and clinical letters to network providers and facilities in AL, AR, CT, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MA, MD, ME, MI, MO, MS, NC, ND, NE, NH, NJ, NY, OH, OK, PA, RI, SC, SD, TN, TX, VA, VT, WI and WV.
