Search

January 19, 2023

Texas Medicare: Claims process change

New claims process for Medicare Advantage patients with Southwestern Health Resources PCPs

On Jan. 1, 2023, we changed the claims submission process for patients assigned to a Southwestern Health Resources (SWHR) primary care provider enrolled in the following health maintenance organization (HMO) UnitedHealthcare® Medicare Advantage plans in the Dallas Fort-Worth area:

  • AARP® Medicare Advantage®
  • UnitedHealthcare Dual Complete®
  • UnitedHealthcare Group Retiree
  • UnitedHealthcare Medicare Ally

This change won’t affect your UnitedHealthcare contract or Participation Agreement, and you’ll continue to be a network provider for these patients. 

Submit 2023 Date of Service Claims

You can submit claims by:

  • Electronic: Payer ID 87726
  • Mail: 
    • UnitedHealthcare Dual Complete (HMO-POS D-SNP) Groups HCFAC3-OUL and HCFAO4-OE7:
      P.O. Box 30765, Salt Lake City, UT 84130 – 0765
    • All Others:
      P.O. Box 30975, Salt Lake City, UT 84130 - 0975

Submit 2022 Date of Service Claims

SWHR contracted or SWHR employed health care providers should submit 2022 claims to UST HealthProof by one of the following ways:

  • Electronic: Payer ID 83245
  • Mail: UST HealthProof, P.O. Box 317, Sidney, NE 69162-0317

Non-SWHR contracted health care providers should submit 2022 claims to UnitedHealthcare by one of the following ways: 

  • Electronic:  Payer ID 87726
  • Mail: UnitedHealthcare, P.O. Box 30975, Salt Lake City, UT 84130-0975
  • Groups HCFAC3-OUL, HCFAO4-OE7: UnitedHealthcare, P.O. Box 30765, Salt Lake City, UT 84130-0765

Utilization Management Services

You will continue to submit prior authorization and referral requests for utilization management services to Southwestern Health Care Management in one of the following ways:

Learn more

Please visit UHCprovider.com and sign in to the UnitedHealthcare Provider Portal to check coverage dates, policy information and get a copy of the member ID card.

Questions

If you have questions, please call Provider Services at 877-842-3210.

PCA-1-22-03732-M&R-NEWS_01112023
Finding news icon

Discover more news

Personalized news icon

Get personalized news