Optum Pay helps health care professionals and staff spend less time on administrative tasks related to posting and reconciling payments.
Access the financial information you need
There are two Optum Pay options to access financial information from UnitedHealthcare:
- Basic Portal Access – free
- Available to all health care professionals and facilities who enroll in automated clearing house (ACH)/direct deposit through Optum Pay
- Beginning May 22, 2021, basic access includes unlimited users
- Online access to downloadable PRAs, as well as access to 835 files, for each payment processed through Optum Pay
- Access up to 13 months of payment data
- Payment and remittance notification emails
- Ability to associate with a third party billing service
May be best for: Organizations that receive all 835 files from a clearinghouse and that routinely auto-post claim payments
- Premium Portal Access – 0.5% per payment fee
- Includes all of the features of the basic portal access, as well as the following additional features when health care professionals opt-in to the premium access:
- Enhanced practice management features enable users to identify and sort new payments, payments pending reconciliation and fully reconciled payments
- Expanded claims payment data identifies the number of claims consolidated within a payment
- Access to data aggregation tools, eliminating individual data file downloads
- Invoices for premium access are sent monthly for the previous month’s payment activities
- For example, for payments deposited via ACH in January, users will receive an invoice in early February for the 0.5% per payment fee
- Fees will only be invoiced if over $10 per month and will not accumulate if under $10
- Fees will be capped at $2,000 per billing cycle, per Tax ID number (TIN)
- The ability to subscribe to Optum Pay premium access is now limited to only existing administrator(s) associated with an organization’s Tax ID or who has authority to make decisions for a TIN
- Providers and facilities who receive virtual card payments through Optum Pay receive premium level access at no additional cost
May be best for: Organizations that work with a third party billing service or who have significant claim volume with UnitedHealthcare. If you work with a third-party billing service, we have tools they can use to reconcile your claim payments while keeping your confidential information secure and protected.
Choose the electronic payment option you prefer
There are two ways to receive claim payments electronically through Optum Pay for most UnitedHealthcare claims:
- Automated Clearing House (ACH)/direct deposit
- This is the payment method we recommend, because:
- It is a quick form of payment available – payments are posted to your bank account on the same day they are issued by UnitedHealthcare
- There is no charge for the deposit – each payment is issued for the full amount of the claim payment
- Payments can be routed at both the tax ID number (TIN) and National Provider Identifier (NPI) number level
- If you are enrolled in ACH/direct deposit, you will automatically receive Optum Pay basic portal access, and can choose to enroll in premium access for a fee
- To enroll, you will need to provide your current bank account information – registration is online and should take less than 10 minutes
- Virtual Card Payment (VCP)
- If you do not enroll in ACH/direct deposit, in most instances you will receive a virtual card payment from Optum Pay instead of a paper check from UnitedHealthcare.*
- Virtual card payments are transactions that are processed through the point-of-sale terminal (Visa/Mastercard/American Express) that you typically use for patient copays.
- It is not a gift card or pre-loaded debit card
- Virtual cards are processed as a credit transaction
- A 16-digit, single-use virtual card will be issued for each payment (single or bundled claims)
- The payment amount and all information needed to process the payment will be sent with your remittance documents
- Each single-use virtual card is active for a limited amount of time. If you don’t process the card as a credit transaction prior to the expiration date, a new virtual card will be automatically issued for the payment
- 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
- Providers and facilities who receive virtual card payments through Optum Pay will receive premium level access at no additional cost
- With virtual card payments, there is no requirement to share bank account information with Optum Pay
Key things to keep in mind
Either electronic payment option – ACH/direct deposit or virtual card payment – may speed up payments to your practice, delivering funds five to seven days faster than paper checks.
UnitedHealthcare is transitioning from paper checks to electronic payments, where allowed by applicable laws. By the end of 2021, all eligible health care professionals will be asked to select their preferred method of electronic payment – automated clearing house (ACH)/direct deposit or virtual card payment. In fact, many health care professionals who work with Medicare Advantage and Commercial members have already been asked to select their electronic payment preference.
* Optum Pay is available for UnitedHealthcare Commercial, UnitedHealthcare Medicare Solutions, UnitedHealthcare Oxford and UnitedHealthcare Community Plan.
In Colorado, Georgia and New Jersey, if you do not consent to receive virtual card payment and you don’t want to set up direct deposit, call 877-548-0460 to receive a paper check. If you are an out-of-network provider in Florida, New Mexico, New York or Oregon, and you do not consent to a virtual card payment or you don’t have direct deposit, call 877-548-0460 to receive a paper check.
Optum Pay™ is provided by Optum Financial and its subsidiary Optum Bank®, Inc., Member FDIC.