How to identify Optum Care delegated claims online
Now you can identify and view Optum Care delegated claim information in the UnitedHealthcare Provider Portal. Updates to the portal make the submission process clearer, reduce misdirected claims and help you get to the right payer faster.
What’s changing?
- You can see Optum care delegated claims when searching by member
- Alerts will let you know if a delegated medical group may manage a claim
- A “Why” indicator will flag delegated claims and provide payer contact details
- Pop-up messages during submission will help you route claims to the correct payer
- Confirmation messaging will reinforce delegation details after submission
How to identify a delegated claim
Members’ claims are managed either by UnitedHealthcare or a delegated medical group. You can identify Optum Care delegated claims either through the UnitedHealthcare Provider Portal when searching for a member or by entering the payer ID for a delegated group.
What to know
- Delegated claim information is available for Optum Care payer ID 87726
- Delegated claims are viewable but not fully actionable in the portal
- Submission, remittance and Act on a claim functionality aren’t available
- Other payer IDs to be added soon
- By member name or ID number
- Before submitting a claim
- Use Member Lookup to search for a member by name or member ID number
- On the Search results page, an alert will display indicating that a delegated medical group may be managing the claims for some of the members listed
- When submitting a claim
On the Claims submission page, an alert will display indicating the member’s claims are being managed by a delegated group. You can choose to either:- Select “Submit claim” to enter the information in the UnitedHealthcare Provider Portal
- Click the website link to be directed to the delegate payer’s claim submission page
The confirmation page shows a summary of the claim submission and information for the delegate institution managing the member’s claims.
- When searching for the status of a claim
- On the Claims search results page, the status of a delegated claim will display “Misdirected”
- Select the “Why?” dropdown to view the delegate’s payer ID, address and link to its website
- Before submitting a claim
- By payer ID
On the Provider search page, enter the payer ID number to identify claims managed by a specific delegated group. The payer ID for Optum Care is 87726.
What you’ll see and where
- General information about a member’s claim appears in the portal on the Member Lookup page, including the following:
- Dates of service
- Claim received date
- Diagnosis codes
- Status and claim history
- Specific information about the claim and certain functionality are available only on the delegate’s website:
- Claim submission details
- Letters and provider remittance advice (PRA) notices
- Act on a claim functionality
What is the role of Optum Care?
Under a delegated arrangement between UnitedHealthcare and Optum Care, LIFE1 claims are routed to and managed by Optum Care. This means Optum Care handles the following services:
- Processes and adjudicates claims
- Issues payments to health care providers for services rendered
- Researches inquiries and responds to providers and members
Questions? We’re here to help.
Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.
PCA-1-26-00895-POE-NN_08112026
