Congratulations! You’re now ready to see patients as a UnitedHealthcare network care provider.
Before you begin, we encourage you – and your office staff – to watch this short Welcome Video from UnitedHealthcare leaders. View video transcript text.
The next step is to get connected with our online systems and resources. You’ll find everything you need from seeing patients to getting paid. View the Get Connected Quick Start Guide checklist.
Our care provider website is designed with you in mind. You’ll find everything you need in one place:
- Easily access information and online tools to submit, view and take action on claims
- Quickly find administrative guides, policies and protocols
- Stay current with the newest developments from UnitedHealthcare and Optum
Add UHCprovider.com/hicommunityplan to your bookmarks so you can quickly get the information you need, when you need it.
Our monthly electronic newsletter gives you and your staff the latest updates on UnitedHealthcare procedures, policy changes and other useful administrative and clinical information. View recent issues of Network Bulletin.
Through EDI, you’ll be able to submit claims, check eligibility, request prior authorization and referrals and more – all electronically through your practice management system (PMS) or hospital information system (HIS). There’s no need to manually enter data, make phone calls or log into our website. Using EDI for all eligible UnitedHealthcare transactions can help you improve efficiency and reduce costs.
Visit the EDI section to view the UnitedHealthcare requirements for exchanging electronic data and national standards for electronic data exchange among providers, health care plans, clearinghouses, vendors and other health care business associates.
UnitedHealthcare interacts with many clearinghouses and does not endorse a particular one. However, most of our transactions go through OptumInsight, a clearinghouse owned by Optum, an affiliate of UnitedHealthcare. Optum also interacts with many clearinghouses.
Use Link self-service tools to perform secure online transactions such as checking member eligibility and benefits, managing claims and requesting prior authorization. You can capture screenshots of your activity or record reference numbers for better documentation.
The fastest way to receive payments, as well as online Provider Remittance Advice (PRA)/Explanation of Benefits (EOB) statements, is by enrolling in Electronic Payments and Statements (EPS). It’s a free service offered to you by UnitedHealthcare.
Be sure to:
- Read the EPS Enrollment Guide and have the following handy:
- Bank account and routing numbers for direct deposit
- A voided check or bank letter to verify bank account information
- A copy of your practice or facility’s W-9 form
- Click on the “Enroll” button and follow the prompts to complete your enrollment.
Keeping your demographic and tax information up-to-date is important for several reasons – it can help connect you with members searching for a care provider, and it supports claims processing and compliance with regulatory requirements.
Review your information in our online directory. If anything needs to be updated, submit changes by using either the Care Provider Demographic Update Form or the Group/Organization Update Form.
In the future, you will be asked to verify your information every 90 days. You may also receive a call from us to verify your information stored in our systems.
From CEU/CME courses to recorded webinars, we have training options to help you stay current on the health care industry and learn how to use UnitedHealthcare’s many tools and resources. Highlights include:
The New Provider Orientation Training Course
This short, half-hour course will help you and your staff learn more about the tools and other resources you’ll need to use as you do business with UnitedHealthcare Community Plan. It’s available on demand, 24/7, so you can complete it whenever your schedule allows.
Click here to access the course.
UHC On Air
This is a source for live and on-demand video broadcasts that give you in-depth program information and other updates from UnitedHealthcare. And, they’re available from any device.
Check out all of the training options available here.
UHC On Air gives you in-depth program information and meaningful updates from UnitedHealthcare 24/7and from any device
Learn MoreBefore you see your first UnitedHealthcare Community plan patient,view the Care Provider Manual so that you and your staff are aware of the policies and protocols for UnitedHealthcare’s Community Plan members.
Quick Tips
- Wondering if you’re an in-network provider for a specific patient? You can use the eligibilityLink section of Link to check member eligibility and to view your participation status.
- Our health plan ID cards makes it easy to identify the member’s health plan and find important contact information. You can find images of all ID cards online when you check member eligibility on Link.