Admission notification is required for all inpatient services as described in Chapter 7: Medical management.
Where to go:
Call the number on the back of the member’s ID card, or go to UHCprovider.com/priorauth.
Where to go:
Call the number on the back of the member’s ID card, or go to myuhone.com
Requirements and Notes:
To inquire about a member’s plan benefits or eligibility
Where to go:
Prior Authorizations:
Online: professionals.optumrx.com
Benefit Information: Call the pharmacy number on the back of the member’s ID card.
Requirements and Notes:
For information on the Prescription Drug List (PDL), go to uhcprovider.com.
Where to go:
Online: providerexpress.com
Phone: 1-855-779-2859
Requirements and Notes:
Submit admission notification or prior authorization for behavioral health, including substance use and autism.
Diagnostic catheterization, electrophysiology implants, echocardiogram and stress echocardiogram
Where to go:
Online: uhcprovider.com/paan
Information: uhcprovider.com/cardiology
Phone: 1-866-889-8054
Requirements and Notes:
Request prior authorization for services as described in the Outpatient cardiology notification/prior authorization protocol section of Chapter 7: Medical management.
Where to go:
Online (clinical submission request): myoptumhealthphysicalhealth.com
Phone: 1-888-676-7768
Requirements and Notes:
Follow the clinical submission process for chiropractic, physical and occupational therapy as described in Chapter 7: Medical management.
Where to go:
Electronic Claims Submission: Payer ID 37602
Paper Claims Submission: Mail to the address listed on the back of the ID card.
Where to go:
Prior Authorizations:
Online: professionals.optumrx.com
Benefit Information: Call the pharmacy number on the back of the member’s ID card.
Requirements and Notes:
For information on the PDL, go to UHCprovider.com/pharmacy
Where to go:
EDI: Transactions 278 and 278N
Online: uhcprovider.com/paan
Phone: 1-800-999-3404
Information: uhcprovider.com/priorauth
Requirements and Notes:
Prior authorization and admission notification is required as described in Chapter 7: Medical management. EDI 278A transactions are not available.
Where to go:
CT scans, MRIs, MRAs, PET scans and nuclear medicine studies, including nuclear cardiology
Online: uhcprovider.com/paan
Information: uhcprovider.com/radiology
Phone: 1-866-889-8054
Requirements and Notes:
Request prior authorization for services as described in the Outpatient radiology notification/ prior authorization protocol section of Chapter 7: Medical management.
Members receive health plan ID cards with information to help you submit claims accurately. Information varies in appearance or location on the card. However, cards display the same basic information (e.g., claims address, copayment information, phone numbers).
You can view and download current member ID cards when you verify eligibility and benefits in the UnitedHealthcare Provider Portal.
For more detailed information and to see a sample ID card, refer to the Health Care Identification (ID) Cards Section of Chapter 2: Provider Responsibilities and Standards.