Responsible for the administration and payment of workers’ compensation and auto liability programs accessing the OneNet PPO Network. Responsibilities include:
- determining bill eligibility,
- processing bills,
- providing explanation of benefit (EOB) statements or remittance advices,
- and may also include case management and utilization review services.
For questions related to these services, please contact the payer identified on the EOR orthe payer provided by the patient. Procura and OneNet names will appear on the EOR / EOB / remittance advice when the OneNet PPO Workers’ Compensation or Auto Network is being accessed.
Contact your UnitedHealthcare Network Management representative. If you require assistance determining who your representative is, or how to reach them, visit UHCprovider.com > Contact Us > Find a Network Contact.
If you are disputing state pricing or services deemed not part of the workers’ compensation/auto illness or injury, contact the client at the number identified on the EOR.
For all network-related concerns, contact Procura:
Some states have formal dispute resolution or appeals processes. You must submit your appeal to Procura before using these appeals processes for both workers’ compensation and auto bills.
Our Injury Management department will assist you in resolving your concerns:
For non-Allstate NJ customers and clients only: 800-275-9485
For Allstate NJ customers and clients only: 877-722-8037
Contact the payer identified on the EOR. DPR Plan provides specific requirements for submitting an appeal for medical reconsideration of an auto liability claim, but they are not required in all states.
OneNet pricing sheets are available on UHCprovider.com > Link > UnitedHealthcare OneNet PPO Pricing. Final payment determination is the responsibility of our clients.
Contact the injured worker’s employer, workers’ compensation carrier, auto liability insurer or administrator to verify acceptance of an injury for purposes of coverage. ID cards are not usually issued or used for workers’ compensation and auto liability programs. Injured workers and claimants accessing you through the OneNet PPO Network will not present an ID card. Insurers, administrators and employers are instructed to advise you of network access, if known, when you call to verify the injury and coverage. You may wish to ask if the employer, carrier or administrator is contracted with Procura to provide workers’ compensation or auto liability network access.