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Resources and How to Contact Us - Chapter 1, 2018 UnitedHealthcare Administrative Guide


Self Service


UHCprovider.com 

UHCprovider.com is your home for care provider information with access to Link self-service tools, medical policies, news bulletins, and great resources to support administrative tasks including eligibility, claims and prior authorizations and notifications. UHCprovider.com replaces unitedhealthcareonline.com and UHCwest.com as these sites are being retired.

Link

Link provides online resources to support your administrative tasks including eligibility, claims and prior authorization and notifications.

To sign in to Link, go to UHCprovider.com and click on the Link button in the upper right corner. For more information about all Link apps, go to UHCprovider.com/Link.

Our contracts generally require you to conduct business with us electronically. Using electronic transactions is fast, efficient, and supports paperless work environment. Link is your gateway to our online tools and is accessible on UHCprovider.com.

After submitting your transaction using Electronic Data Interchange (EDI), use Link apps to quickly find transaction and documentation information related to our members and your submissions.

You can use Link to access information for:

  • UnitedHealthcare Commercial
  • UnitedHealthcare Medicare Advantage
  • UnitedHealthcare Community Plan (as contracted by state) 
  • UnitedHealthcare West
  • UnitedHealthcare of the River Valley
  • UnitedHealthcare Oxford Commercial

Available benefit plan information varies for each of our Link applications.

There are several Link apps to choose from. Here is a list of our most frequently used apps:

  • eligibilityLink — View patient eligibility and benefits information for most benefit plans. 
  • claimsLink — Get claims information for many UnitedHealthcare plans, including access letters, remittance advice documents and reimbursement policies. 
  • Prior Authorization and Notification — Submit notification and prior authorization requests. 
  • My Practice Profile — View and update your provider demographic data that UnitedHealthcare members see for your practice. For more instructions on this process, visit UHCprovider.com/Training.
  • Document Vault — Access reports and claim letters for viewing, printing, or download. 
  • Paperless Delivery Options — When you use Document Vault to access claim letters, your Link Password Owner may turn off delivery of paper copies by mail. The Paperless Delivery Options app can send daily or weekly email notifications to alert you to new letters when we add them to your Document Vault. With our delivery options, you decide when and where the emails are sent for each type of letter. This app is available to Link Password Owners only.

You need an Optum ID to access Link and use apps available to you. Register for an Optum ID at UHCprovider.com/NewUser.

Watch for the most current information on Link updates by email in the Network Bulletin.


Contact Us by Topic - Commercial & Medicare Advantage Products


UnitedHealthcare Provider Website: UHCprovider.com

To make navigating to our provider portal even easier, we have created ‘vanity URLs’ such as UHCprovider/PriorAuth. These are more direct hyperlinks to frequently used pages.

Resources:

  • Access to care provider policies and protocols, tools, training and network bulletins.
  • Enroll in Electronic Payments and Statements (EPS) for direct deposit for covered services and electronic remittance advice.
  • Authorizations and referrals information, submissions and status.
  • Verify eligibility and benefits.
  • Verify your network and tier status for a member’s benefit plan.
  • Claims management including filing, status information and clams reconsiderations. 

Help Desks: 866-842-3278 (option 1 for UHCprovider.com and Link assistance). M-F, 7 a.m. to 9 p.m., Central Time (CT)

Advance Notification, Prior Authorization and Admission Notification - Submit and Get Status Information 

Air Ambulance, Fixed-Wing Non-Emergency Transport

Appeal – (Clinical) Urgent Submission

An expedited appeal may be available if the time needed to complete a standard appeal could seriously jeopardize the member’s life, health or ability to regain maximum function.

Commercial:

All Savers, UnitedHealthOne and UnitedHealthcare Oxford Navigate:

  • Individual Urgent Medical fax: 866-654-6323

MA – follow the directions in the customer decision letter

Cardiology, Radiology, and Outpatient Injectable Chemotherapy

Chiropractic, Physical Therapy, Occupational Therapy and Speech Therapy Providers

Claims - Filing, Payments, Reconsiderations

Electronic Payments and Statements (EPS)

Electronic Data Interchange (EDI) Support

Fraud, Waste and Abuse: Report Potential Non-Compliance or Suspected Issues

  • Online: uhc.com/fraud, select the “Report A Concern” icon
  • Phone: 877-842-3210 (United Voice Portal)
  • Phone: 844-359-7736
  • For more information on Medicare fraud, waste, and abuse prevention efforts, refer to Chapter 14: Fraud, Waste and Abuse 

Member/Customer Care

Mental Health and Substance Use Services: See member’s health care ID card for carrier information and contact numbers.

Pharmacy Services

Provider Advocates: For participating hospitals, health care, and ancillary providers; locate your physician or hospital advocate Online at UHCprovider.com > Contact Us under Network Management Contacts

Provider Directory: UHCprovider.com/FindProvider

Referral Submission and Status

Skilled Nursing Facilities (Free-standing)

Therapeutic Radiation Prior Authorization (IMRT, SRS, and SBRT)

Transplant Services: See member’s health care ID card for carrier information and contact numbers.

Vision Services: See member’s health care ID card for carrier information and contact numbers.