You can learn more about the many tools available to help you prepare, submit and manage your UnitedHealthcare claims on uhcprovider.com/claimsincluding: Claim Estimator with bundling logic, training tools and resources including frequently asked questions (FAQs), quick references, step-by-step instructions and tutorials.
Prompt claims processing
We know you want prompt payment. We work hard to process your claims timely and accurately. This is what you can do to help us:
Note: When we give you eligibility and benefit information, we are not guaranteeing payment or coverage in any specific amount. Actual reimbursement depends on many factors, such as compliance with administrative protocols, date(s) of services rendered, and benefit plan terms and conditions. For Medicare Advantage (MA) benefit plans, reimbursement also depends on CMS guidance and claims processing requirements.
Submit claims electronically with EDI for fast delivery and confirmation of receipt.
Electronic submissions are preferred for sending claims to UnitedHealthcare. View our Claims Payer List to determine the correct Payer ID to use.
Our contracts generally require you to conduct business with us electronically. They contain specific requirements for electronic claim submission. Review your Agreement and follow the requirements. While some claims may require supporting information for initial review, we have reduced the need for paper attachments. We request additional information when needed.
When claims are submitted using EDI, HIPAA edits are applied by the clearinghouse to help ensure claims contain specific information. Any claims not meeting requirements are rejected and returned back to the care provider to make corrections and resubmit electronically.
Smart Edits are an EDI capability which auto-detects claims with potential errors. Smart Edits may also be applied to help reduce claim denials and improve the claim processing time. You have 5 calendar days to correct claims rejected by Smart Edits before they are automatically processed.