Healthcare Identification (ID) Card - Chapter 2, 2018 UnitedHealthcare Administrative Guide

Our members receive health care ID cards that include information necessary for you to submit claims, such as the payer ID for electronic claims submission. Information on the cards may vary by health benefit plan.

Please check the member’s health care ID card at each visit. You may keep a copy of both sides of the health care ID card for your records. Possession of a health care ID card is not proof of eligibility.

Quick Tip: Member ID Cards

You can view current ID cards for most members when you verify eligibility using eligibilityLink.

Bar-Coded Health Care ID Cards

We use bar codes on most health care ID cards to make it easy for you to access member information.

A 2D bar code scanner is required to scan these cards. The scanner can be used together with UHCprovider.com to access the Member’s Personal Health Record, verify eligibility, submit a claim and perform other administrative transactions. We use the national Workgroup for Electronic Data Interchange (WEDI) card standards for our ID cards.

Commercial Health ID Card Example

Commercial Health ID Card Example Image

Commercial Health Care ID Card Legend

  1. UnitedHealthcare brand: including UnitedHealthcare, AllSavers, Golden Rule, UnitedHealthcare Oxford, UnitedHealthOne.
  2. Member Plan Identifier: This is a customized field to describe the member’s benefit plan (i.e., Individual Exchange, Tiered Benefits, ACO, etc.).
  3. Payer ID: Indicates claim can be submitted electronically using the number shown on card. Contact your vendor or clearinghouse to set up payer in your system, if necessary.
  4. Primary Care Provider (PCP) name and phone number: Included for benefit plans that have PCP selection requirements. For Individual Exchange Members ‘PCP required’ is listed in place of the PCP name and number. This section may also include Laboratory (LAB) and Radiology (RAD) participant codes.
  5. Copay information: If this area is blank, the member is not required to make a copay at the time of service.
  6. The Benefit Plan Name: Identifies the applicable benefit plan name.
  7. Referral requirements identifier: Identifies plans with referral requirements. Requires PCP to send electronic referrals.
  8. For Members section: Lists benefit plan contact information and if applicable, referrals and notifications information.
  9. For Providers section: Including the prescription plan name.

Medicare Advantage (MA) Health Care ID Card Example 

To see specific MA benefit plan ID cards go to UHCprovider.com/Plans > Select your state > Select the Medicare Advantage cell.

Medicare Advantage (MA) Health Care ID Card Example Image

MA ID Health Card Legend

  1. Payer ID: Indicates claim can be submitted electronically using the number shown on card. Contact your vendor or clearinghouse to set up payer in your system, if necessary.
  2. Dental Benefits: Included if routine dental benefits are part of the benefit plan and/or if the member purchased an optional supplemental dental benefit rider.
  3. PCP name and phone number: Included for benefit plans that require a PCP selection.
  4. Prescription information: If the benefit plan includes Part D prescription drug coverage, the Rx Bin, PCN and Group code are visible. If Part D coverage is not included, this area lists information for Medicare Part B Drugs.
  5. Copay information: Including PCP, specialist, and ER copays. Some Special Needs Plans do not list copay information. Select HMO benefit plans in FL and NC have tiered copayments. These plans have two copayments for PCPs and for specialists.
  6. Referral requirements identifier: Identifies benefit plans with referral requirements. Refer to the Medicare Advantage (MA) Referral Required Plans of this guide for more detailed information. If the benefit plan does not require referrals “No Referral Required” appears on the back of member’s health care ID card.
  7. The Benefit Plan Name: Identifies the applicable benefit plan. Examples of some MA benefit plans include, but are not limited to:
    • AARP Medicare Complete benefit plans
    • Care Improvement Plus benefit plans
    • UnitedHealthcare Assisted Living Plans
    • UnitedHealthcare Dual Complete benefit plans
    • UnitedHealthcare MedicareComplete benefit plans
    • UnitedHealthcare Nursing Home Plans
  8. For Members: Lists benefit plan contact information for the member.
  9. For Providers: Lists benefit plan contact information for the care provider.