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Resources and How to Contact Us - Chapter 1, 2019 UnitedHealthcare Administrative Guide

Resources and How to Contact Us

Self-Service Tools

UHCprovider.com

UHCprovider.com is your home for care provider information with access to Electronic Data Interchange (EDI), Link self-service tools, medical policies, news bulletins, and great resources to support administrative tasks including eligibility, claims, claims status and prior authorizations and notifications.

Electronic Data Interchange (EDI)

EDI is a self-service resource using your internal practice management or hospital information system to exchange transactions with us through a clearinghouse. 

The benefit of using EDI is it permits care providers to send batch transactions for multiple members and multiple payers in lieu of logging into different payer websites to manually request information. This is why EDI is usually care providers’ first choice for electronic transactions.

  • Send and receive information faster
  • Identify submission errors immediately and avoid processing delays
  • Exchange information with multiple payers
  • Reduce paper, postal costs and mail time
  • Cut administrative expenses
  • EDI transactions available to care providers are:
    • Claims (837),
    • Eligibility and benefits (270/271),
    • Claims status (276/277),
    • Referrals and authorizations (278),
    • Hospital admission notifications (278N), and
    • Electronic remittance advice (ERA/835).

Visit our EDI section for more information. Learn how to optimize your use of EDI.

Getting Started
  • If you have a practice management or hospital information system, contact your software vendor for instructions on how to use EDI in your system.
  • Contact clearinghouses to review which electronic transactions can interact with your software system.
  • Read our Clearinghouse Options for more information.

Link Tools

Link provides online resources to support your administrative tasks including eligibility, claims and prior authorization and notifications.

To sign in to Link, go to UHCprovider.com and click on the Link button in the upper right corner. Learn more information about all Link tools.

Our contracts generally require you to conduct business with us electronically. Using electronic transactions is fast, efficient, and supports paperless work environment. Use both EDI and Link for maximum efficiency in conducting business electronically.

You can use Link to access information for:

  • UnitedHealthcare Commercial
  • UnitedHealthcare Medicare Advantage
  • UnitedHealthcare Community Plan (as contracted by state)
  • UnitedHealthcare West
  • UnitedHealthcare of the River Valley
  • UnitedHealthcare Oxford Commercial

Available benefit plan information varies for each of our Link tools.

Here are most frequently used tools:

  • eligibilityLink — View patient eligibility and benefits information for most benefit plans. 
  • claimsLink — Get claims information for many UnitedHealthcare plans, including access letters, remittance advice documents and reimbursement policies.
  • Prior Authorization and Notification — Submit notification and prior authorization requests. 
  • My Practice Profile — View and update* your provider demographic data that UnitedHealthcare members see for your practice. 
  • Document Vault — Access reports and claim letters for viewing, printing, or download. 
  • Paperless Delivery Options — When you use Document Vault to access claim letters, your Link Password Owner may turn off delivery of paper copies by mail. The Paperless Delivery Options tool can send daily or weekly email notifications to alert you to new letters when we add them to your Document Vault. With our delivery options, you decide when and where the emails are sent for each type of letter. This is available to Link Password Owners only.

You need an Optum ID to access Link and use tools available to you. Register for an Optum ID.

Updates on Self-Service Resources

Watch for the most current information on our self-service resources by email, in the Network Bulletin, or online by visiting our EDI section or our information on Link tools.


Contact Us by Topic - Commercial & Medicare Advantage Products

UnitedHealthcare Provider Website: UHCprovider.com

Resources
  • Access to care provider policies and protocols, tools, training and network bulletins.
  • Enroll in Electronic Payments and Statements (EPS) for direct deposit for covered services and electronic remittance advice.
  • Authorizations and referrals information, submissions and status.
  • Verify eligibility and benefits.
  • Verify your network and tier status for a member’s benefit plan.
  • Claims management including filing, status information and clams reconsiderations. 
Help Desks
  • 866-842-3278 (option 1 for UHCprovider.com and Link assistance). 
  • Assistance is available Monday-Friday from 7 a.m. to 9 p.m., Central Time (CT).

EDI: View EDI transactions and code sets.

Online: Prior Authorization & Notification

Phone: 877-842-3210 (United Voice Portal)

See member’s health care ID card for specific service contact information.

An expedited appeal may be available if the time needed to complete a standard appeal could seriously jeopardize the member’s life, health or ability to regain maximum function.

Commercial, All Savers, UnitedHealthOne and UnitedHealthcare Oxford Navigate
  • Urgent Medical Fax: 801-994-1083
  • Urgent Pharmacy Fax: 801-994-1058
  • Urgent Appeal Fax: 866-654-6323
Medicare Advantage (MA)
  • Follow the directions in the customer decision letter.
Notification/Prior Authorization – Submission & Status

Online: Prior Authorization & Notification and select the specialty you need.

Phone: 866-889-8054

EDI: EDI - View our Claims Payer List to determine the correct Payer ID.

Link: claimsLink tool

Online: View our Claims, Payments and Billing section for policies, instructions and tips

Phone: 877-842-3210 (follow the prompts for status information)

Online:

Help Desk: 877-620-6194

Online: Go to Electronic Data Interchange (EDI)

Help: EDI Contacts

Phone: 800-842-1109 (Available Monday-Friday from 7 a.m. – 9 p.m. Central Time)

UnitedHealthcare EDI Support

Online: EDI Transaction Support Form

Email: supportedi@uhc.com

Phone: 800-842-1109

UnitedHealthcare Community Plan EDI Support

Online: EDI Transaction Support Form

Email: ac_edi_ops@uhc.com

Phone: 800-210-8315

Report potential fraud, waste or abuse concerns.

Online: uhc.com/fraud, select the “Report A Concern” icon.

Phone: 844-359-7736

Phone: 877-842-3210 (United Voice Portal)

For more information on fraud, waste, and abuse prevention efforts, refer to Chapter 16: Fraud, Waste and Abuse.

Online: myuhc.com

Phone: 877-842-3210

See the member’s health care ID card for carrier information and contact numbers.

Online: professionals.optumrx.com

Phone: 800-711-4555

For participating hospitals, health care, and ancillary providers; Locate your physician or hospital advocate.

Online: Contact Us > Network Management Contacts

Find a care provider, hospital, clinic or facility.

Online: Find a Provider

You can determine if a member’s benefit plan requires a referral when you view their eligibility profile.

EDI: 278 transaction

Link: eligibilityLink > Submit Referrals

Online: Go to Referrals section

Note: Submitted referrals are effective immediately, but may not be viewable for 48 hours.

See the member’s health care ID card for carrier information and contact numbers.

See the member’s health care ID card for carrier information and contact numbers.