Arizona: Avoid denials with timely filing of claims

Last modified: August 12, 2021

Timely filing of claims helps ensure payment to health care professionals who participate with UnitedHealthcare Community Plan. The receipt date of the claim is either the date stamp on the claim, the date the claim was electronically received or the date we received the claim.

Primary claims

• Submit primary claims within 90 days of service or according to the timely filing limits outlined in your agreement

Secondary claims

• Submit secondary claims before 180 days from the date of service. This includes claims for members with Medicare as the primary carrier.
• Submit explanation of benefits (EOB) from the primary carrier. Policy documentation that establishes the primary carrier has denied or would deny payment can also be used.
• If you had to submit a secondary claim without an EOB to meet timely filing guidelines, you can resubmit a corrected claim with the EOB within 365 days of service.

Coordination of Benefits Agreement

UnitedHealthcare Community Plan has a Coordination of Benefits Agreement with the Centers for Medicare & Medicaid Services (CMS) Benefits Coordination & Recovery Center. As a result, for claims processed by UnitedHealthcare Community Plan, you may:

• Receive payments or denial information for secondary claims you didn’t submit to UnitedHealthcare Community Plan
• See an increase in duplicate or incorrect form denials. This may happen because we receive secondary claims from you as well as CMS.

Questions?

Contact your Provider Advocate or call Provider Services at:

• 800-445-1638 for AHCCCS Complete Care, Developmentally Disabled or Developmentally Disabled Children's Rehabilitative Services
• 800-377-2055 for Arizona Long-Term Care or Elderly Physically Disabled

PCA-1-21-02419-C&S-News