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Provider forms

Health care professionals can access forms for UnitedHealthcare plans, including commercial, Medicaid, Medicare and Exchange plans in one convenient location.

Easily access and download all UnitedHealthcare provider-forms in one convenient location.

Select plan type

If your select says “Complete in portal”, you can skip the PDF form and complete the action online in the UnitedHealthcare Provider Portal.

Claims and payments

  • Claims Overpayment Refund Form  PDF 
  • Corrected Claim and Claim Reconsideration Request Form  PDF | Complete in portal

Exception Requests

Other

  • Confidential Exchange of Information Form  PDF
  • Commercial Designation of Authorized Representative Form  PDF | Complete in portal
  • Option Care Health Medication Prescriber Order Form  PDF 
  • Skilled Nursing Facilities Clinical and Therapy Request Form  PDF

Our network

Prior authorization

Sign in to the UnitedHealthcare Provider Portal to complete prior authorizations online.

To learn more about Medicare Part D prescription drug coverage or to access related forms, review the materials available on the Plan Information and Forms page of UHC.com/medicare.

Pharmacy prior authorization

General

If your select says “Complete in portal”, you can skip the PDF form and complete the action online in the UnitedHealthcare Provider Portal.

Claims and payments

  • Claims Overpayment Refund Form  PDF 
  • Corrected Claim and Claim Reconsideration Request Form  PDF | Complete in portal

Exception Requests

Other

  • Confidential Exchange of Information Form  PDF
  • Commercial Designation of Authorized Representative Form  PDF | Complete in portal
  • Option Care Health Medication Prescriber Order Form  PDF 
  • Skilled Nursing Facilities Clinical and Therapy Request Form  PDF

Our network

Prior authorization

Sign in to the UnitedHealthcare Provider Portal to complete prior authorizations online.

To learn more about Medicare Part D prescription drug coverage or to access related forms, review the materials available on the Plan Information and Forms page of UHC.com/medicare.

Pharmacy prior authorization

General