How to contact Oxford Commercial - 2021 UnitedHealthcare Administrative Guide

Mail:    UnitedHealthcare Grievance Review Board
            P.O. Box 29134
            Hot Springs, AR 71903

Clinical & Medical Necessity Appeals:

Fax: 1-877-220-7537

Mail: 

Oxford Clinical Appeals Department
P.O. Box 29139
Hot Springs, AR 71903

Behavioral Health Appeals:

Phone: 1-800-999-9585 
Fax: 1-855-312-1470

Mail:

Behavioral Health Appeals
P.O. Box 30512
Salt Lake City UT 84130-0512

OxfordHealth.com > Providers or Facilities > Tools & Resources > Network Information > Forms

• Claim(s) Review Request Form
• Member Authorization for a Designated Representative

Mail:  

UnitedHealthcare Grievance Review Board
P.O. Box 29134
Hot Springs, AR 71903

Forms: OxfordHealth.com > Providers or Facilities > Tools & Resources > Network Information > Forms.

• Claim(s) Review Request (1-19 claims)
• Claims Research Project (20 or more claims)
• New Jersey Provider Claim Appeal Form

Fax: 1-801-994-1058

Phone: 1-800-201-6991

• Utilization Review/Medical Necessity Review
• Cardiac Catheterization Prior Authorization
• Echocardiogram and Stress Echocardiogram

Online: UHCprovider.com/priorauth > Cardiology 24 hours a day

Online Policies: Refer to the back of the member’s health care ID card for the applicable website.

• OxfordHealth.com > Providers > Tools & Resources > Medical Information > Medical and Administrative Policies > Medical & Administrative Policy Index

OR

• UHCprovider.com/policies > Commercial Policies > UnitedHealthcare Oxford Clinical, Administrative and Reimbursement Policies

Phone (eviCore): 1-877-PREAUTH / 1-877-773-2884 (Monday–Friday, 7 a.m. – 7 p.m. ET)

Provider Services and Claims

Online: myoptumhealthphysicalhealth.com

Phone: 800-985-3293

EDI: Commercial Claims Payer ID: 06111

More information about EDI: optumpay.com/optumpay

Learn more on OxfordHealth.com > Providers or Facilities > Tools & Resources > Administrative Tools & Information > Electronic Data Interchange (EDI)

You may also visit PNTdata.com > Customers > Providers to learn about a free submission tool that doesn’t require practice management software.

Online: UHCprovider.com/claims

Mail (paper claims):

UnitedHealthcare
Attn: Claims Department
P.O. Box 29130
Hot Springs, AR 71903

EDI: Submit facility claim corrections electronically.

Online: UHCprovider.com/link

Paper: OxfordHealth.com > Providers or Facilities > Tools & Resources > Network Information >  Forms

• Claim Review Request (1-19 claims)
• Claim Research Project (20 or more claims)
• New Jersey Provider Claim Appeal Form

EDI: 276/277

Claim Status Inquiry and Response transactions are available through your vendor or clearinghouse.

Online: OxfordHealth.com > Providers or Facilities > Transactions > Check > Claims

Phone: 1-800-666-1353 and say “Claims” when prompted. You may speak with a representative Monday–Friday, 8 a.m. - 6 p.m. ET.

Online: Refer to the back of the member’s ID card for the applicable website.

OxfordHealth.com > Providers > Tools & Resources > Medical Information > Medical and Administrative Policies > Medical & Administrative Policy Index

OR

UHCprovider.com/policies > Commercial Policies > UnitedHealthcare Oxford Clinical, Administrative and Reimbursement Policies

Phone: 1-800-666-1353 (Monday–Friday, 8 a.m. – 6 p.m. ET)

Member of the Council for Affordable Quality Healthcare (CAQH)

Online: UHCprovider.com > UnitedHealthcare’s Credentialing & Recredentialing Plan

Phone: United Voice Portal at 1-877-842-3210

New Jersey only:

Online: State of New Jersey Department of Health: nj.gov/health or CAQH.org.

Phone: Provider Services at 1-800-666-1353 or CAQH Support at 1-888-599-1771

Information and Enrollment

Online:

•  optum.com/optumpay or

•  Optumbank.com > View your account > Log in

Helpdesk: 1-877-620-6194

Check status of referrals, pre- certifications and claims; member eligibility and benefits

Payer ID: 06111 EDI Support:

Online:

•  UHCprovider.com/edi

•  OxfordHealth.com > Providers or Facilities > Tools & Resources > Administrative Tools & Information > Electronic Data Interchange

Phone: 1-800-842-1109, Monday–Friday, 8:30 a.m. – 5 p.m. ET

EDI: 270/271 Eligibility and Benefits Inquiry and Response transactions are available through your vendor or clearinghouse.

Online: OxfordHealth.com > Providers or Facilities > Transactions > Check > Eligibility and Benefits

Voice Portal and Provider Services:

1-800-666-1353 (Say “Benefits and Eligibility” when prompted).

You may speak with a representative Monday–Friday, 8 a.m. - 6 p.m. ET.

Online: OxfordHealth.com > Provider or Facilities > Tools & Resources > Network Information > Forms

Phone: 1-866-242-7727

Online: UHCprovider.com/priorauth and select the specialty you need.

Online: uhc.com/privacy

For additional information on granting remote access to your EMR system: emrcdsa@ uhc.com.

Phone: 1-877-512-9340

Fax: 1-855-536-0491

EDI: Use your clearinghouse.

Online: OxfordHealth.com > Providers or Facilities > Transactions > Submit > Precert Requests

Phone: 1-800-666-1353

Fax: 1-800-303-9902

Phone: 1-800-666-1353

Online: evicore.com (24 hours per day)

OxfordHealth.com > Providers or facilities > Tools & Resources > Medical Information > Radiology and Radiation Therapy Information

UHCprovider.com/policies > Commercial Policies > UnitedHealthcare Oxford Clinical, Administrative and Reimbursement Policies

Fax: 1-888-242-9058

Mail:

UnitedHealthcare
Attn: Clinical Coverage Review 1300 River Drive, Suite 200
Moline, IL 61265

Phone: 1-877-PREAUTH (1-877-773-2884) (Monday–Friday, 7 a.m.-7 p.m. ET)

Locate participating laboratories:

Online: OxfordHealth.com > Providers or Facilities > Search > Laboratories

Online: UHCprovider.com/priorauth > Oncology

Phone: 1-800-201-4911

• Available 24 hours per day
• Staffed by registered nurses
• Assistance for urgent and non-urgent medical problems, recommend an appropriate site of care

Phone: 1-800-788-4863

TTY/TDD: 1-800-498-5428

Available 24 hours per day

Phone: 1-800-711-4555

Available 24 hours per day

Provider Services: 1-877-369-7564

Online: myoptumhealthphysicalhealth.com

For claims submitted electronically: Payer ID 06111

Phone: 1-800-666-1353

Mail (paper claims):

UnitedHealthcare
Attn: Claims Department
P.O. Box 29130
Hot Springs, AR 71903

OptumRx
P.O. Box 2975
Mission, KS 66201

EDI: Use your vendor or clearinghouse.

Online: OxfordHealth.com > Providers or Facilities > Transactions > Submit > Precert Requests

Online: UHCprovider.com/paan (use the Link Prior Authorization and Notification tool)

Find the form on OxfordHealth.com > Providers or Facilities > Tools & Resources > Network Information > Forms

Phone: Provider Services 1-800-666-1353 (Monday–Friday, 8 a.m.- 6 p.m. ET)

EDI: Use your vendor or clearinghouse.

Online: OxfordHealth.com > Providers or Facilities > Transactions > Check > Precert Status

Phone: Voice Portal: 1-800-666-1353 (Representatives are available Monday–Friday, 8 a.m.- 6 p.m. ET).

Say “Precertification” when prompted.

Online: UHCprovider.com/priorauth > Radiology (available 24 hours per day, seven days per week)

Forms and policies: OxfordHealth.com > Providers or Facilities > Tools & Resources > Medical Information > Radiology & Radiation Therapy Information

Phone (eviCore): 1-877-PREAUTH (1-877-773-2884) (Monday–Friday, 7 a.m.-7 p.m. ET)

EDI: Use your clearinghouse or vendor.

Online: OxfordHealth.com > Providers > Transactions > Submit > Referrals or Transactions > Check > Referrals

Phone: Voice Portal: 1-800-666-1353 (Monday–Friday, 8 a.m. - 6 p.m. ET) Say “referral” when prompted.

Online: OxfordHealth.com > Providers or Facilities > Search > (select the provider type)

Phone: 1-800-666-1353

Phone: 1-800-666-1353

Mail: Physicians and other health care professionals send by certified mail, return receipt requested to:

UnitedHealthcare
Network Contract Support
Mail Route: TX023-1000
1311 W President George Bush Highway, Suite 100
Richardson, TX 75080-9870

Behavioral health providers only:

Phone: 1-877-614-0484