5 tips for prompt claim processing

Prompt claims processing


We know that you want your claims to be processed promptly for the covered services you provide to our members.

We work hard to process your claims timely and accurately. Here’s what you can do to help us:

1 Review the member’s eligibility at UnitedHealthcareOnline.com, using swipe card technology or keying
in the member’s information.

You can also check member eligibility by phone by calling the United Voice Portal at (877) 842-3210 or the
Customer Care number on the back of the member’s health care ID card.

Disclaimer: Eligibility & benefit information provided is not a guarantee of payment or coverage in any specific
amount. Actual reimbursement depends on various factors, including compliance with applicable administrative protocols, date(s) of services rendered and benefit plan terms and conditions.

2 Notify us in accordance with the Standard Notification Requirements list.

3 Prepare complete and accurate claims (see “Complete Claims” below).

4 Submit claims online at UnitedHealthcareOnline.com or use another electronic option.

a) Connectivity Director is a free direct connection for those who can create a claim file in the HIPAA 837
format. This Web-based application enables real-time and batch submissions direct to UnitedHealthcare.
Connectivity Director provides immediate response back to all transaction submissions (claims, eligibility, and
more). Additional information can be found at UnitedHealthcareCD. com, including a comprehensive User Guide and information on how to get started.

b) UnitedHealthcare Online All-Payer Gateway™ is a Web-based connectivity solution which links
UnitedHealthcare Online users to a leading clearinghouse vendor (Ingenix) that offers multi-payer health
transactions and services at preferred pricing. Using your current UnitedHealthcare Online User ID and
password, you can register with Ingenix to submit batch claims to many of your governmental and commercial
payers. For more information: UnitedHealthcareOnline.com  Claims and Payments  Electronic Claims
Submission  EDI Options.

c) EDI Gateway and Clearinghouse Connections – UnitedHealthcare’s preferred clearinghouse is Ingenix, but you can use any clearinghouse you prefer to submit claims to UnitedHealthcare. Both participating and nonparticipating physician, health care professional, facility and ancillary provider claims are accepted electronically using UnitedHealthcare’s payer ID 87726. Other UnitedHealthcare and affiliate payer ID s can be found on UnitedHealthCareOnline.com.


UnitedHealthcare contracts generally require you to conduct business with us electronically and contain requirements regarding electronic claim submission specifically. Please review your agreement with us and abide by its requirements. While some claims may require supporting information for initial review, UnitedHealthcare has reduced the need for paper attachments for referrals/notifications, progress notes, ER visits and more. We will request additional information when needed.

5 Receive Electronic Payments and Statements (EPS)


If you are enrolled with us for EPS, payments are electronically deposited into one or more checking
accounts which you designate. Take the next step by auto-posting the electronic 835/Electronic Remittance
Advice (ERA) that you receive from your clearinghouse, or obtain one free of charge from our Web site at
UnitedHealthcareOnline.com.

Explanations of Benefits (EOBs) that match each daily/weekly consolidated deposit are available on
UnitedHealthcareOnline.com, where you can review, store and print hard copies to use for manual posting.


EPS is UnitedHealthcare’s preferred method for receiving payments and statements and results in faster and easier payment to you. If you have not yet enrolled in this standard operating process, start receiving electronic payments and statements now by enrolling online at UnitedHealthcareOnline.com or by contacting us at (866) 842-3278, Option 5. Please note EPS is not available in all markets for our Medicare Advantage plans.