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 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 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 EPS/Optum Pay. It’s a free service offered to you by UnitedHealthcare.
Be sure to:
- Read the EPS/Optum Pay 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.
Take a few minutes now to verify your demographic and tax ID information, using one of the options below:
- Sign in to Link and select the MyPractice Profile tile on your Link dashboard. View your information and if anything needs to be updated, you can submit changes through this tool.*
- Review your information in our online directory. If anything needs to be updated, submit changes by using our Demographic Change Request 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.
*MyPractice Profile is not yet available to all practices or facilities.
We have a variety of options for ongoing training and education — from recorded webinars you can watch whenever your schedule allows, to intructor-led sessions that give you the chance to participate in a Q&A discussion at the end. You can browse the complete training catalog at UHCprovider.com/training.
Before you see your first UnitedHealthcare patient, make sure you and your staff are aware of the health plans available in your state and the requirements for each plan.
Go to Health Plans by State and review the each plan’s details.
Bookmark your state’s page for future reference. Plan requirements can change, so you’ll want to check requirements when verifying member eligibility on Link.
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.