Electronic Data Interchange (EDI), Electronic Payments & Statements (EPS) and Link Basics
What transactions are available with EDI?
- Claim submission (837)
- Eligibility and benefits inquiry and response (270/271)
- Claim status inquiry and response (276/277)
- Authorization and referral submission (278)
- Notification submission (278N)
- Electronic remittance advice (835/ERA)
How can my company benefit from using EDI?
EDI can help your organization improve efficiency, reduce costs and increase cash flow. The 2018 CAQH Index shows that the average cost to conduct transactions manually are consistently higher than the cost of electronic transactions. View the complete CAQH Index for more details. Use the CAQH Index Savings Calculator to estimate potential cost and time savings for your organization.
We only use EDI for claim submissions. How do we use EDI for other transactions?
To learn more about connecting with us for all EDI transactions, go to UHCprovider.com/edi > EDI Connectivity.
What if EDI transactions don’t give me all the information I need?
We continuously work on enhancements to our EDI transactions. These may include making it easier to search for specific information, returning more information on a response or decreasing potential error responses.
Additionally, Link tools complement EDI transactions in cases where more information is available online. Refer to the Self-Service Comparison Guide to learn about the differences between EDI and Link.
What is Electronic Payments & Statements?
EPS is an Optum tool that UnitedHealthcare uses to administer payments by direct deposit (ACH) or virtual card (VCP). EPS has a website accessible from Link that provides PDF files identical to the remittance advice you would normally receive in the mail and can provide electronic remittance advice (835) files as well. You can learn more at UHCprovider.com/eps.
How can my company benefit from using EPS?
EPS speeds up your practice's revenue cycle by delivering more payment options, while helping you reconcile claims payments and identify patient responsibility more quickly. Optum has a Payment Savings Calculator you can use to compare the costs of processing checks, VCP and ACH/direct deposit.
How do we enroll in EPS?
Go to Optum.com/enroll. Click “I am enrolling my 3rd Party Billing Service Company” and follow the prompts. Your enrollment will be processed in five business days and then you’ll be able to setup additional users and associate care provider tax ID numbers to your account. EPS can also be accessed from a tile on your Link dashboard.
If you plan to autopost claim payments be sure to enroll in ERA with your clearinghouse for the 835 ERA file to be delivered directly to your practice management system. Go to UHCprovider.com/edi > EDI 835: Electronic Remittance Advice (ERA) for more information.
What can my company do on Link?
After your access is approved by the care provider, you can:
- Check claims status and submit claim reconsideration requests using claimsLink
- Verify patient eligibility and benefits details using eligibilityLink
- Access claim and prior authorization letters as well as provider remittance advice in Document Vault
- For enrolled care providers, access electronic payment information and remittance advice in Electronic Payments & Statements (EPS)
- Search for provider remittance advice/explanation of benefits documents using the Single EOB Search
- Check the status of notification and prior authorization requests in the Prior Authorization and Notification tool
- Look up referrals in referralLink
In addition, there are more Link tools available, including: Claim Submission, Paperless Delivery Options, UHC On Air and UnitedHealthcare Claim Research Project.
If you’d like to attend an instructor-led webinar to learn more about any of these tools, visit UHCprovider.com/training.
How can my company benefit from using Link self-service tools?
Link’s online tools can quickly provide the comprehensive information you need for most UnitedHealthcare benefit plans ‒ without the extra step of calling for information. Plus, you can print your activity or record reference numbers for better documentation, and reduce manual costs by submitting your work online.
Which tax ID number do I use to register for an Optum ID?
You must register using your RCM tax ID number and then get access to the tax ID numbers for the care providers you work with. The first person to register from your company will become the Link Password Owner who controls access for all other users in your organization.
Will I be able to access Link tools as soon as I register?
If you have self-registered, you’ll need to wait for your ID Administrator/Password Owner to grant you access to the tools and tax ID numbers needed for your role. You will receive an email once your registration is complete and at that point you may begin using the self-service tools on Link. If your Password Owner has created your account, you may begin using the self-service tools on Link as soon as you complete the Optum ID set-up.
Who can create or approve new users?
Link Password Owners can create, approve and edit ID Administrators and Standard Users. ID Administrators can create, approve and edit all users except the Password Owner.
If I’m unable to access some tools on my Link dashboard, what should I do?
Please contact your Primary Administrator/Password Owner so they may update your access.
Do I need to create another Optum ID for a new care provider client?
No, you can easily access another tax ID number using your existing Optum ID. To start the process, your Password Owner must request access to the provider tax ID number using the Multi-TIN process and the care provider’s office needs to approve the request. Then your Password Owner can give you access to the new client’s Tax IDs.
Can an RCM employee be the Link Password Owner for a care provider?
No, someone from the care provider’s office must register for Link and become the Password Owner for the care provider TIN.
Can there be more than one Link Password Owner for my company?
No, the RCM and care provider can have only one Password Owner each but there can be multiple ID Administrators and Standard Users.
My Link Password Owner is no longer with the company, what do I do?
You will need to call the UnitedHealthcare Connectivity Help Desk at 866-842-3278, Option 1, to request a new Password Owner.
How can I identify the Password Owner/Primary Administrator for my account?
Sign in to Link and open the UnitedHealthcare Manage My Account tool on your dashboard. On the Account Information page, look for your Primary Administrator’s name toward the bottom of the page.
How do I get access to all the tax ID numbers we support?
Your Password Owner must request access to all care provider tax ID numbers using the Multi-TIN process and the care provider’s office needs to approve the request. Then your Password Owner can give you access to the provider tax ID numbers as well.
For Password Owners: In Link Security, select Multi-TIN Access, then Multi-TIN Access Summary. Choose Request Access and enter the required information.
We have requested access to a client’s tax ID number. How will we know when access is approved?
The system will send an email after the request has been approved or denied. Your Link Password Owner can also check the status of the request by selecting View Access on the Multi-TIN Access tab in Link Security.
One of our clients doesn’t use Link yet. Will they be able to approve our request for access to their tax ID number?
Yes, a letter will be mailed to the care provider’s office with a Security Key (number). If the care provider wants to approve your access, they will give you the Security Key. Your Password Owner can then sign in to Link and go to Link Security > Multi-TIN Access > Request Multi-TIN Access > Enter Security Key.
EDI: Use the EDI Transaction Support Form online or call or email us.
- UnitedHealthcare: email@example.com or 800-842-1109
- UnitedHealthcare Community Plan: firstname.lastname@example.org or 800-210-8315
Visit UHCprovider.com/edi > EDI Contacts for additional contact information.
EPS: If you need help enrolling in EPS or using any of its features, call us at 877-620-6194.
- Choose "option 1" for enrollment.
- Choose "option 2" for access questions.
Support is available Monday ‒ Friday from 7 a.m. – 6 p.m. Central Time.
Link: If you have any questions about registering for or using Link, please email email@example.com or call the UnitedHealthcare Web Support at 866-842-3278, option 1. We're available Monday – Friday from 7 a.m. – 9 p.m. Central Time.
Insurance coverage provided by or through UnitedHealthcare Insurance Company, All Savers Insurance Company, Oxford Health Insurance, Inc. or their affiliates. Health Plan coverage provided by UnitedHealthcare of Arizona, Inc., UHC of California DBA UnitedHealthcare of California, UnitedHealthcare Benefits Plan of California, UnitedHealthcare of Colorado, Inc., UnitedHealthcare of Oklahoma, Inc., UnitedHealthcare of Oregon, Inc., UnitedHealthcare of Texas, LLC, UnitedHealthcare Benefits of Texas, Inc., UnitedHealthcare of Utah, Inc. and UnitedHealthcare of Washington, Inc., Oxford Health Plans (NJ), Inc. and Oxford Health Plans (CT), Inc., or other affiliates. Administrative services provided by United HealthCare Services, Inc., OptumRx, OptumHealth Care Solutions, Inc., Oxford Health Plans LLC or their affiliates. Behavioral health products are provided by U.S. Behavioral Health Plan, California (USBHPC), United Behavioral Health (UBH) or its affiliates.