Provider Electronic Payment Options
Choose how you want to be paid
You have 2 options for receiving payments from UnitedHealthcare. Both are facilitated by Optum Pay, a full-service payment and remittance solution used by all sizes and types of health care organizations. And, both options integrate with financial management systems and can help reduce the time spent on administrative tasks related to posting and reconciling payments.
Automated Clearing House (ACH)/Direct deposit
This option — also referred to as Electronic funds transfer (EFT) — is preferred by most practices for its speed and efficiency in depositing claim payments directly into your bank account(s). Each payment is issued for the full amount of the claim payment — there is no charge for the deposit.
- Remittance data available on the same day the deposit is made to your bank account
- Payments can be routed by Taxpayer Identification Number (TIN), payer and National Provider Identifier (NPI) number
Virtual card payment (VCP)
VCPs are processed as a credit transaction through the same terminal used for patient copays. Each payment is issued for the full amount of the claim payment. However, virtual card transactions are subject to additional terms and conditions, including fees, between you and your card service processor.
- No bank account information required
- A virtual card is issued for each new claim payment
The VCP statement has a picture of a card and all information needed to process the transaction
Choose how you want to review payment information
There are 3 ways to review your provider remittance advice (PRA) and other payment documents. Choose the one that works best for your practice or facility.
| 1. Document Library |
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Available in the UnitedHealthcare Provider Portal
All professionals and facilities are encouraged to access Document Library, whether for one-off requests or day-to-day payment reconciliation.
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| 2. Electronic Data Interchange (EDI) |
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ERA/835 transactions via EDI can be set up to receive PRAs electronically for both ACH and virtual card payments
Contact your clearinghouse to request direct delivery of your UnitedHealthcare 835 files. Once we receive the request for 835s from your clearinghouse/EDI vendor, it takes about 30 days to set up delivery of the ERA/835. |
| 3. Optum Pay | |
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| Basic portal | Premium portal |
Simple and easy access to core payment data. It’s available at no cost to those enrolled in ACH through Optum Pay.
May be best for: Organizations that receive all 835 files from a clearinghouse and that routinely auto-post claim payments |
Enhanced functionality, robust search tools and extended historical data. Available for 0.5% fee per ACH payment.
May be best for: Organizations that work with a third-party billing service or have significant claim volume |
Frequently asked questions
Have these items on hand to start the enrollment process for either EFT/ACH or VCP:
- Organization name, mailing information and TIN
- Contact information for your designated Optum Pay contacts
- Banking information (for the EFT/ACH option)
- Your organization’s federal W-9 form
- A voided check or bank letter for each account where payments will be deposited (for the EFT/ACH option)
How long will it take to process my application for ACH/direct deposit/EFT?
The standard processing time takes about 10 business days. However, it may take longer if there are any questions or issues with the documentation submitted. If that happens, Optum Pay will reach out via email to resolve. The application will be pended until the health care professional responds.
Once signed up for ACH/direct deposit/EFT, how do I track my payments?
As payments and remittances are processed, you’ll receive an email notification with a link to Optum Pay. Once you’re signed in to Optum Pay, you can review all claims and remittance information on the “View Payments” tab.
Are there any fees for using Optum Pay services?
It depends which Optum Pay option you choose — basic or premium access.
- Basic: Available to all health care professionals and facilities who enroll in ACH/direct deposit/EFT through Optum Pay for free
- Premium: Same as basic access, plus other additional features, but has a 0.5% fee per ACH/direct deposit/EFT
Will I receive the full claim payment amount on my virtual card?
Yes. Like a check or an ACH/direct deposit/EFT, each virtual card payment is issued for the full amount of the claim payment.
Should I process this payment as a credit or debit transaction?
You should process a virtual card payment as a credit transaction. If you accidentally select debit, the transaction will decline. Simply reprocess as credit.
Can I use Square or a non-traditional point-of-sale terminal to process my virtual card payment?
Yes. Any device that can process a Mastercard® payment can process a virtual card payment. Ensure that the device is registered to your business.
Are there fees associated with virtual card payments?
Like a check or an ACH/direct deposit/EFT, each virtual card payment is issued for the full amount of the claim payment. However, virtual card transactions are subject to additional terms and conditions, including fees, between you and your card service processor.
Do virtual cards expire?
Yes. The expiration date appears in the format “MM/YY” and expires on the last day of that month. If you fail to redeem it prior to the expiration date, a new, single-use virtual card will be automatically issued for the payment approximately 1–2 weeks after expiration date.
What if I need help or can’t process a virtual card?
You can call the number provided on the virtual card statement.
To speed up payments to your practice, UnitedHealthcare is transitioning from paper checks to electronic payments when possible. The transition is taking place in waves, based on line of business and state. Notifications are sent ahead of the transition to allow you time to select the electronic payment option you prefer.
Instead of enrolling in ACH/direct deposit/EFT, will UnitedHealthcare allow health care professionals to be paid by check?
Certain health care professionals have been proactively exempted and will be paid by paper check, including:
- Home- and community-based health care professionals
- Fire departments
- Non-emergency medical transport
- Rural health clinics
- Indian health services/tribal organizations
- Federally Qualified Health Clinics
- Oral surgeons contracted with UnitedHealthcare Community Plan states
May request an exemption
There may be unique situations where UnitedHealthcare may pay you by paper check when requested, including:
- Out-of-network health care professionals in Florida, New Mexico, New York and Oregon
- All network and out-of-network medical health care professionals in Utah, Vermont, Colorado, Georgia and New Jersey
- Indiana dental professionals
In these states, health care professionals must consent to receive a virtual card payment. The processing of the virtual card is their consent to receive and accept virtual card payments. If they don’t consent, when they receive a virtual card, they will need to call the number provided on the virtual card payment statement to arrange an alternative payment method.
How do I request an exemption?
You can request an exemption by calling us at 866-323-3681 option 4 and providing the Token ID or Trans ID. It’s located on the VCP statement below the payment amount, to the left of the Mastercard logo. It’s a mix of numbers and letters.
What if I’m not in one of the listed exemption categories and I don’t want virtual card payments?
If you’re not listed in one of the exempted categories, ACH/direct deposit/EFT is your alternative. ACH/direct deposit/EFT is a safe, secure and fast way to get paid.
Why are some of my payments coming by paper check?
There are some unique circumstances that may not allow, or temporarily not allow, virtual card payments for certain claim payments. Enrolling in ACH/direct deposit/EFT offers you the most consistent payment experience.
- Merchant card processing fees may apply to virtual cards. Please reach out to your merchant processor or financial institution for information on specific terms and costs.
- Processing your virtual card indicates your consent to receive and accept virtual card payments as payment in full from the payer.
- Unspent funds for virtual cards are subject to state unclaimed property laws.
- The following health care professionals must consent to receive a virtual card payment:
- Out-of-network medical health care professionals in Florida, New Mexico, New York and Oregon
- All network and out-of-network medical health care professionals in Utah, Vermont, Colorado, Georgia and New Jersey
- Indiana dental professionals
The processing of the virtual card is your consent to receive and accept virtual card payments. If you don’t consent, when you receive a virtual card, please call the number provided on your virtual card payment to arrange an alternative payment method.
- You will have the option of signing up for ACH/direct deposit, the preferred method of payment, or to receive a virtual card payment (VCP). The only alternative to a virtual card is direct deposit. Both options allow you to get paid quickly and securely.
- If your practice/health care organization is still receiving paper checks, you can enroll in ACH/direct deposit for your claim payments now. If you don’t elect to sign up for ACH/direct deposit, a virtual card will be automatically sent in place of paper checks.
- If your practice/health care organization is already enrolled and receiving your claim payments through ACH/direct deposit from Optum Pay, there is no action you need to take.
- Both provider remittance advice (PRA) documents and VCP payments are available online through Document Library.
- Because this initiative will roll out in phases, you may receive virtual card payments for some claim payments and check payments for others (if not enrolled for direct deposit).
- When you are paid is determined by when you process your payment on your point-of-sale terminal.
- Optum Financial, a UnitedHealthcare-affiliated company, provides payment services to the health care industry and offers various claim payment options. UnitedHealthcare-affiliated companies may receive transaction fees or other compensation related to some payment options.
- The virtual card payment program will exclude KanCare payments. Health care professionals enrolled in ACH/direct deposit will receive their payments accordingly. All other health care professionals will receive KanCare payments through paper check.
*Optum Pay is available for UnitedHealthcare commercial, UnitedHealthcare Medicare Solutions, UnitedHealthcare Oxford and UnitedHealthcare Community Plan.
Out-of-network health care professionals in Florida, New Mexico, New York and Oregon, as well as all network and out-of-network Utah, Vermont, Colorado, Georgia and New Jersey medical health care professionals and Indiana dental professionals, must consent to receive a virtual card payment. The processing of the virtual card is your consent to receive and accept virtual card payments. If you don’t consent, when you receive a virtual card, please call the number provided on your virtual card payment to arrange an alternative payment method.
Optum Pay® is provided by Optum Financial and its subsidiary Optum Bank®, Inc., Member FDIC.