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Provider search for doctors, clinics and facilities, plus dental and mental health
Policies for most plan types, plus protocols, guidelines and credentialing information
Specifically for Commercial and Medicare Advantage (MA) products
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View health plans available by state
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uhcprovider.com > scroll down to Support and Privacy > Contact Us > Health Plan Support by State.
Benefit Interpretation Policies: uhcprovider.com/policies > Commercial Policies > UnitedHealthcare West Benefit Interpretation Policies
Medical Management Guidelines: uhcprovider.com/policies > Commercial Policies > UnitedHealthcare West Medical Management Guidelines
EDI: Transaction 278
Arizona and Colorado Medicare Advantage Phone: 1-800-746-7405
California, Oregon and Washington: SignatureValue, Medicare Advantage, direct contract network and medical group/IPA carve-out
Nevada Medicare Advantage Phone: 1-888-1-866-8297
Texas and Oklahoma: Medicare Advantage, SignatureValue Inpatient Notification/Utilization Management
To view the most current and complete Advance Notification List, including procedure codes and associated services, go to uhcprovider.com/priorauth
CT scans, MRIs, MRAs, PET scans and nuclear medicine studies, including nuclear cardiology
Request prior authorization of radiology services as described in Outpatient radiology notification/prior authorization protocol in Chapter 7: Medical management.
Diagnostic Catheterization, Electrophysiology Implants, Echocardiogram and Stress Echocardiogram
Request prior authorization of cardiology services as described in Outpatient cardiology notification/prior authrorization protocol in Chapter 7: Medical management.
(Non-delegated) Inpatient includes: Acute Inpatient, Skilled Nursing Admission, Long-Term Acute Care, Inpatient Rehabilitation Places of Service.
EDI: Transaction 278N
Mental Health (Medicare Advantage): 1-800-508-0088
Encounter Collection, Submission and Controls, including ERA/835 transactions
Password and user ID are not required to review and access EDI information on uhcprovider.com.
Online: uhcprovider.com/edi > EDI Contacts > EDI Transaction Support Form
Phone: 1-800-842-1109 (For UnitedHealthcare West ERA/835 questions, select option 4 and then option 2)
Payer IDs: UnitedHealthcare West encounters, 95958. For claims, the Payer ID is 87726.
For a complete list of Payer IDs, refer to the Payer List for Claims.
Have claims payments deposited electronically or make changes to an existing EFT enrollment
Online: UnitedHealthcare West EFT tool in the UnitedHealthcare Provider Portal
Information: uhcprovider.com/claims > Request Change to Electronic Funds Transfer (EFT) for UnitedHealthcare West > UnitedHealthcare West EFT Enrollment App Overview
Email: email@example.com with questions about UnitedHealthcare West EFT.
EDI: Transactions 270 (Inquiry) and 271 (Response) through your vendor or clearinghouse
Online: Sign in to the UnitedHealthcare Provider Portal at uhcprovider.com and click Sign In in the top right corner.
(Follow prompts to access information)
Commercial and Medicare Advantage HMO/ MCO:
(Applies only to Commercial UnitedHealthcare Signature Value HMO/MCO)
California, Oklahoma, Oregon, Texas, Washington
P.O. Box 6107
Cypress, CA 90630
P.O. Box 6106
Cypress, CA 90630
Fax: 1-888-517 7113
(Applies only to Commercial UnitedHealthcare SignatureValue HMO/MCO)
(medical or pharmacy appeals)
Commercial products: UHCprovider.com
Medicare products: uhcMedicareSolutions.com > Our Plans > Medicare Prescription Drug Plans
See member’s ID card for carrier information and contact numbers.
View the member’s health care ID when you verify eligibility on uhcprovider.com
(applies only to commercial products in California)
Online: uhcprovider.com > UnitedHealthcare Links (scroll to bottom right) > Language Assistance
Fax: completed referral form to: 1-877-406-8212