KY, MO, OH, D.C.: Medicaid PRAs are going paperless
Effective Sept. 9, 2022, we will no longer print and mail paper provider remittance advice (PRAs) for most* UnitedHealthcare Community Health Plans to network health care professionals and facilities (primary and ancillary) in Kentucky, Missouri, Ohio and Washington, D.C.
The change does not impact the payment method for subscribers enrolled in Optum Pay™.
You will continue to receive an electronic remittance advice (ERA)/835, but the paper PRA will no longer be mailed.
Please share these changes and new digital workflow options with those who are affected, including outside vendors, such as revenue cycle management companies.
Then, click Document Library and select the Payment Documents folder
Use Advanced Search and search by Member ID, Check ID or Claim No. to help you find what you need
Notifications: When new letters are available in Document Library, an email notification will be sent to the address on file, which is typically the Primary Access Administrator.
Need to notify multiple staff members? Document Library notifications are limited to 1 email address per letter type. If multiple staff members require notification, the Primary Access Administrator can consider using a group email address. See Paperless Delivery Options for Primary Access Administrators for more information.
Optum Pay: For payments facilitated by Optum Pay, you can reconcile remittance data with basic portal or premium portal access.
Basic portal access is free to those enrolled in ACH/direct deposit through Optum Pay. Premium portal access is a fee-based service that includes additional practice management features and data aggregation tools. (Premium portal access is available at no additional cost for those receiving virtual card payments from UnitedHealthcare.)
EDI: Set up electronic remittance advice (ERA) 835 transactions using electronic data interchange (EDI) to receive your PRAs electronically. An additional benefit is the capability to autopost payments into your practice management or hospital information system. Contact your clearinghouse to start the process. Note: ERA/385 setup takes about 30 days from when we receive the request.
What’s ahead in paperless
Letters we mail you aren’t the only communications going digital. Later this year, we’ll begin to introduce digital member ID cards and the ability to submit claim attachments online through an EDI 275 transaction. And, in 2023, we will start requiring contracted health care professionals to submit most claims, reconsideration requests and appeal requests electronically. All transitions will be announced in Network News at least 90 days before mailings end to give you time to prepare for the change. For the most up-to-date information, exclusions and full schedule, go to UHCprovider.com/digital.