UnitedHealthcare Provider Portal Resources

With CommunityCare, You Can:

• View a member’s plan of care and health assessment for most Medicaid and Medicare SNP populations
• Enter plan notes and view notes history for some plans
• Obtain HEDIS information for your member population
• Access information about member’s admitted to or discharged from an inpatient facility
• Access information about member’s seen in an Emergency Department
• View and export the full member roster

• CommunityCare Introduction
• CommunityCare self-paced guide

• Quickly receive an estimate of a UnitedHealthcare Commercial claim reimbursement and share the estimated cost of a procedure with your patient before treatment.
• Use claim bundling logic for professional claims and determine how the CPT or HCPCS codes will be paid.

Resources:

• Quick Reference: Claims Estimator

• Direct Connect is a free online tool that helps you review and resolve overpaid claims quickly and easily. Using Direct Connect, you can track and manage overpayment requests, dispute an overpayment finding and submit refunds – reducing the letters and calls you receive from UnitedHealthcare, or the need to work with third-party vendors.
• Direct Connect is available on the UnitedHealthcare Provider Portal. To get started, simply email directconnectaccess@optum.com. Please include the requestor’s name as well as the organization’s TIN(s), physical address and mailing address.

With Claim Submission, You Can:

• Submit professional claims, including National Drug Code (NDC) claims, for all UnitedHealthcare members
• Easily see which fields are required. The highlighted fields will update based on the information you enter
• View on-screen messages that allow you to correct certain errors before you hit submit
• Eliminate paper, postage and mail time

Resources:

• Claim Submission Overview
• Claim Submission self-paced guide