Overpayments - Chapter 10, 2022 UnitedHealthcare Administrative Guide

If we inform you of an overpaid claim that you do not disagree with, send us the refund check or recoupment request within 30 calendar days (or as required by law or your Agreement) from the date of notification. We may apply the overpayment against future claim payments unless your Agreement states otherwise or as required by law. If you find we overpaid for a claim, use the Overpayment Refund/Notification Form. Call 1-800-727-6735 with questions related to overpayments. Send refunds to:

Regular mail
UnitedHealthcare Insurance Company
P.O. Box 101760 Atlanta, GA 30392-1760

Overnight mail

UnitedHealthcare Insurance Company – Overnight Delivery
Lockbox 101760
3585 Atlanta Ave
Hapeville, GA 30354

Include documentation that shows the overpayment, including member’s name, health plan ID number, date of service and amount paid. If possible, also include a copy of the provider remittance advice (PRA) that corresponds with our payment. If the refund is owed because of COB with another carrier, provide a copy of the other carrier’s EOB/remittance advice with the refund.

If we find a claim was paid incorrectly, we may make a claim adjustment. You will see the adjustment on the EOB or PRA.

Disagreement

If you disagree with the claim adjustment, or request for an overpayment refund or recoupment, you may submit your disagreement within 30 calendar days (or as required by law or your Agreement) from the date of receipt of notification. You must clearly state the items in your disagreement and include any relevant and supporting documentation.

Direct connect

Direct Connect is a no-cost, web-based platform that helps payers and health care providers communicate effectively, automate workflows and drive resolutions. This portal can replace previous methods of letters, faxes, phone calls and spreadsheets. It also helps:

  • Track and manage certain types of overpayments in a controlled process; some inventory restrictions apply.
  • Create a transparent view between health care provider and payer.
  • Avoid duplicate recoupment and returned checks.
  • Decrease resolution time frames.
  • Real-time reporting to track statuses of inventories in resolution process.
  • Provide control over financial resolution method.
  • Manage and review overpayment disagreements.
  • Attach images for quick reference.

For more information, contact the Optum Direct Connect Team at directconnectaccess@optum.com.