Here you will find the tools and resources you need to help manage your practice’s submission of claims and receipt of payments. Your primary UnitedHealthcare claims resource, the Claims capability on the UnitedHealthcare Provider Portal, the gateway to UnitedHealthcare’s self-service tools.
Direct deposit and virtual card payments (VCP) information is available on Optum Pay, if you are enrolled.
If you are not satisfied with the outcome of a Claim Reconsideration Request, you may submit a formal Claim Dispute/Appeal using the process outlined in your provider manual.
Additional state requirements may apply. Please consult the applicable state Provider Administrative Guide or Manual for more details or contact the provider services center.
Using Electronic Data Interchange (EDI) for all eligible UnitedHealthcare transactions can help your organization improve efficiency, reduce costs and increase cash flow.
UnitedHealthcare applies HIPAA edits to professional (837p) and Institutional (837i) claims submitted electronically. Claims that reject for HIPAA edits will appear on a clearinghouse level report, enabling you to Identify and correct rejected Information prior to UnitedHealthcare receiving the claim.
A PRA is generated for every processed claim and includes relevant details about how the claim was processed.