For improved online selfservice capabilities (previously referred to as Link) You’ll be able to access the Portal with your current log-in credentials. New users can find registration information at ‘ HCprovider.com/newuser. OQ Stay in the know Learn how you can check eligibility and benefits, manage prescription coverage, claim costs, referral requests and more.
Eligibility and benefits
Use the Eligibility and Benefits feature to check eligibility and benefit details, including:
- Copy, coinsurance and deductible amounts
- Referral and prior authorization requirements
- Care provider’s network status for most plans
¢ View or print a member’s digital ID card
More information: Goto UHCprovider.com/eligibilitytool.
Estimate cost of care
Use Claim Estimator to view a reimbursement estimate for a commercial claim and share
of a procedure with your patient before treatment.
More information: Go to UHCprovider.com/claims.
Prescriptions
Use PreCheck MyScript’ to:
- Check prescription coverage and out-of-pocket costs at the member’s pharmacy
the estimated cost
- Get information on lower-cost prescription alternatives, if available, to help save members money
- See which prescriptions require prior authorization or are non-covered or non-preferred
- Request prior authorization and receive status and results
More information: Goto UHCprovider.com/pems.
United
Healthcare
Referrals
Use the Referrals feature to submit or check the status of a referral request. You can also:
¢ Find out if areferral is needed for your patient
- Submit a referral request and receive a confirmation number
- Check the status of a referral request
- View, print or save confirmation numbers and timelines for submitted referrals
More information: Goto UHCprovider.com/referralstool.
Prior authorization and notification
Use Prior Authorization and Notification to:
¢ Determine requirements using the procedure code and plan type
e Submit or check the status of notification and prior authorization requests
° Get realtime authorization approvals for some requests
« Upload clinical notes, medical records or images to a request
- Provide pertinent clinical information, which may allow for quicker decisions and improved efficiency
e Access prior authorization letters in Document Vault
More information: Goto UHCprovider.com/paan.
Trackit
Use Trackit to see your work at a glance and take action:
¢ Check on your most recent updated reconsiderations, pended claims, appeals and Smart Edits
- Check on prior authorizations that require additional information to be completed, cases still under
review and closed cases - Sign up to get emails about your submissions
Flag your claims for easy access
¢ Review prior authorization status
More information: Goto UHCprovider.com/trackit.
oO Document Vault for letters, documents and reports
Claim and prior authorization letters, provider remittance advice and reports
Use Document Vault to:
e Download and print documents
« Flag letters for convenient viewing
Easily find your letters in folders or using one of the search options
¢ Get prior authorization letters for UnitedHealthcare commercial, Medicare, Community Plan and
UnitedHealthcare West members
continued
° Get claim letters for most UnitedHealthcare commercial and Medicare members
¢ Get payment documents — including provider remittance advices (PRAs) — for most UnitedHealthcare
commercial, Medicare, Community Plan and some UnitedHealthcare West payments
- Get overpayment letters for most UnitedHealthcare commercial, Medicare, Community Plan and
UnitedHealthcare West payments - Access reports and data files for UnitedHealthcare and UnitedHealthcare West members
If you’d like to stop receiving these letters in the mail, see the Paperless Delivery Options tool. Most of these
documents are added to Document Vault after the mail option is turned off. Forsome |etter types, paperless
delivery is automatic.
Some letter types may not be accessible in Document Vault for all health plans.
More information: Goto UHCprovider.com/documentvault.
Claims submission and follow-up
Submit claims
Use Claim Submission to submit a professional (non-facility) medical claim or a National Drug Code
(NDC) claim.
More information: Goto UHCprovider.com/selfservice.
Note: You can access claim information online using Document Vault.
Claims follow-up
Use the Claims feature to:
« View claims status
- Access letters, remittance advice documents and reimbursement policies through Document Vault
« Submit additional information requested on pended claims
¢ Flag claims for future viewing
¢ Submit claim reconsideration requests or appeals
- Receive instant printable confirmation for your submissions
More information: Goto UHCprovider.com/claimstool.
Use Claim Research Project to submit a reconsideration request for multiple claims with the same denial
reason or issue.
Not applicable for UnitedHealthcare West claims.
More information: Go to UHCprovider.com/claims.
continued
Use Optum Intelligent EDI to submit mu Iti-payer transactions online orth rough a clearinghouse for
commercial, Medicare and UnitedHealthcare Community Plan members. Using EDI allows payers and care
providers to send and receive information faster, often at a lower cost.
Excludes Harvard Pilgrim, The Alliance and NDC Home Infusion Specialty Pharmacy Claims. Charges apply
foran all-payer solution. For more information, go to UHC provider.com/ediconnect.
© Payments and provider remittance advices
View or print remittance advice
Use single explanation of benefit (EQB) to search fora provider remittance advice (PRA) by tax ID number
(TIN) and payment number or TIN, status and date.
More information: Goto UHCprovider.com/claims.
Note: You can access claim information online using Document Vault.
Electronic payment solutions
Paperless options available
UnitedHealthcare is transitioning from paper checks to electronic payments. We will no longer be sending
Paper checks for provider Payment in accordance with applicable laws.*
As part of those efforts, we are en couraging you to sign up for electronic payments, specifically Automated
Clearing House (ACH)/direct deposit through Optum Pay™. If you don’t elect to sign up for direct deposit,
you may receive virtual card Payments moving forward. The virtual card is not an actual hard plastic
card. An image of the card Prints on the Virtual Card Statement with all the information necessary to
process the payment.
management systems.
Optum Pay offers you a choice of basic level features to manage your payments at no charge anda
Premium level version with expanded features fora monthly fee. Enroll in Optum Pay to:
- Reconcile claims, access data and view reports
- View or print remittance advice and payment information (paper is no longer mailed)
- Get electronic remittance advice (ERA)/835 files by free download or clearinghouse connection
More information: Go to UHCprovider.com/optumpay.
continued
Virtual card payment
While ACH/direct deposit is the preferred method for electro nic payment, virtual card payment is an
alternative electronic payment method that uses merchant card-based technology to process health care
claim payments. Where selected, a 16-digit, single-use virtual card will be issued for each claim payment a
health care professional organization receives.
If you don’t sign up for ACH/direct deposit, you will receive a virtual card payment. You will continue to have
the option to enroll in ACH/direct deposit even after receiving a virtual card payment. However, ACH/direct
deposit will be for future payments and cannot be applied to payments previously made.
More information: Goto UHCprovider.com/payment > Virtual Card Statement and Processing
Instructions.
Use UnitedHealthcare West EFT Enrollment to enroll or make changes to EFT and 835s for your
UnitedHealthcare West claims.
Currently applies to payments from SignatureValue and Medicare Advantage plans.
More information: Goto UHCprovider.com/ciaims.
“In Colorado, Georgia and New Jersey, if you do not consent to receive virtual card payment and you don’t want to set up direct
deposit, call 877-548-0460 to receive a paper check. if you are an out-ofnetwork provider in Florida, New Mexico, New York or
Oregon, and you do not consent to a virtual card payment or you don’t have direct deposit, call 877-548-0460 to receive a
paper check.
Look up fee schedules
Use Fee Schedule Lookup to view contracted rates for CPT* and Healthcare Common Procedure Coding
System (HCPCS) codes for commercial and some Community Plan states. Available for participating care
providers only. Fees are not available for revenue codes, anesthesia codes, dental HCPCS or United
Behavioral Health plans.
More information: Go to UHCprovider.com/claims.
@ Clinical tools
Patient health records
Use Individual Health Record (IHR) to view a unified record of your patients’ health history, including lab
results and prescribed medications, based on claims submissions, enabling a person and their care team to
help improve collaboration and care.
More information: Goto UHCprovider.com/ihr.
Premium program
Use UnitedHealth Premium’ to view evaluation details for your physician or group in the Premium program.
More information: Goto UHCprovider.com/ premium.
continued
© Password owner tools
Manage user access
Use the Security feature to add, change or deactivate users in our self-service tools.
ID administrators can:
¢ Approve or deactivate access for other administrators and standard users
- Assign roles to administrators and standard users to determine which tools the user can access
- Assign profiles to administrators and standard users to determine which TINs, specialties and
physicians/facilities the user can access
Password owners can do everything an ID administrator can do plus:
- Grant multi-TIN access, which allows users to have a single Optum ID for all the TINs they need
to access
¢ Download a report of users and their access
More information: Goto UHCprovider.com/securitytool.
Only available for password owners and ID administrators
Turn off mail delivery
Use Paperless Delivery Options to:
¢ Turn off paper delivery of some or all the letters in Document Vault and set up email notifications
- Get an email notification when new letters are available
¢ Use our flexible delivery options to:
o Choose daily or weekly notifications for each type of letter
o Specify different email addresses for each type of letter
Available for password owners only.
More information: Goto UHCprovider.com/paperless.
Make demographic updates
Use My Practice Profile to:
° View, update and attest to demographic and location data for your practice
- View contracted UnitedHealthcare plans for care providers
Not yet available to all facilities and ancillary organizations.
More information: Goto UHCprovider.com/mpp.
continued
We’re here to help
Go to UHC provider.com/selfservice for more information. You can also check out ourtraining
resources at UHCprovider.com/training.
If you have questions about using any of the tools above, please contact UnitedHealthcare Web
Support at providertechsupport@uhc.com Or 866-842-3278, option 1, from 7a.m.to 9 p.m. CT,
Monday through Friday.
| | | United
insurance coverage provided by orthrough UnitedHealthcare Insurance Company or its affiliates. Health plan coverage provided by UnitedHealthcare of Arizona, Ine, UHC of California DBA, UnitedHeathcare of
California, United Healthcare Benefits Plan of California, UnitedHealthcare of Colrade, Inc, UnitedHeatthcare of the Mid-Atlantic, Inc, MAMS! Life and Health Insurance Company, UnitedHealthcare of New York,
Inc., United Healthcare hsurance Company of New York, UnitedHeathcareof Oklahoma, Inc, UnitedHealthcare of Oregon, Inc., UnitedHedthcare of Pennsylvania, Inc., United Heatheare of Texas, inc.,
United Healthcare Benefits of Texas, Inc., UnitedHealthcare of Utah, Inc., Unted Healthcare of Washington, inc., Optimum Choice, Inc, Oxford Heath Insurance, Inc., Oxford Health Pans (NJ), Inc, Oxford Heath
Plans (CT), Inc., Al Savers insurance Company, or other affiliates. Administrative services provided by OptumHealth Care Sol utions, LLC, OptumRx, Oxford Heath Plans LLC, United HealthCare Services, Inc, or
other affiliates. Behavioral health products Provided by U.S. Behavioral Health Plan, California (USEHPC), or its affiliaes.
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