Learn how your practice can prepare for Surest members and claims
Learn how your practice can prepare for Surest members and claims
Learn how your practice can prepare for Surest members and claims
Bind, a UnitedHealthcare company, is changing its name to Surest™. This change began to take effect on Sept. 1, 2022
Surest, a UnitedHealthcare company, administers a health plan without a deductible or coinsurance. Members have access to the nationwide UnitedHealthcare and Optum® Behavioral Health networks and can check costs and care options in advance.
Some members have the Surest Flex plan, which includes the feature of flexible coverage. For a small number of plannable tests, procedures or treatments, the member must activate coverage at least 3 business days in advance of the service.
To help you work with Surest plan members and claims, please visit surest.com/providers.
While Surest plans leverage the UnitedHealthcare network, these members must present their Surest member ID card.
Sample member ID card for illustration only; actual information varies depending on payer, plan and other requirements.
Please include the subscriber ID and rendering address on the claim to help us confirm the copay/member price. Note that if you submit a Surest plan claim to UnitedHealthcare, it’ll be denied.
Beginning Jan. 1, 2023, you can use the UnitedHealthcare Provider Portal to check member eligibility and coverage.
You’ll need to provide the subscriber ID if you’re requesting information about a dependent.
To help ensure pricing reflects the best and most recent data, member copays/prices are updated annually. Accordingly, you always need to check the current member copay/price before collecting payment for a service. Although a service's member copay/price may change, your contracted rate for the service doesn’t.
For members with Surest Flex plans, a small set of plannable procedures and treatments require the member to activate coverage at least 3 business days in advance or they won’t have coverage for the treatment. You should confirm the member’s eligibility and benefits and that the member has activated coverage for a service in advance for certain treatments or procedures.
The prior authorization/notification requirements in the UnitedHealthcare Administrative Guide apply to Surest Flex plans. These are services for which the member must activate coverage for certain plannable procedures or treatments at least 3 business days in advance.
Beginning Jan. 1, 2023, you can use the UnitedHealthcare Provider Portal to check a claim’s status.
Prior to Jan. 1, please call UHSS Provider Services at 844–368–6661.
Please send claim reconsiderations to:
Mail: UHSS, Attn: Claims, P.O. Box 30783, Salt Lake City, UT 84130
Fax: 866-427-7703
Note that clinical appeals are only for services that received a medical necessity review and weren’t determined to be medically necessary.
Please send clinical appeals to:
Mail: UHC Appeals — UHSS, P.O. Box 400046, San Antonio, TX 78229
Phone: 800-808-4424, ext. 15227
Fax: 888-615-6584
Remember to provide all supporting materials in your appeal, including member-specific treatment plans and clinical records.