If You Are Having UHC OON
Claims Issues,
Please Read This!
POET is working with the TMA regarding UHC OON issues. They have confirmed the following:
If you are billing with a GROUP TIN:
You will not utilize the group NPI# in box 33a – if you do, it will process OON. Only the individual physician’s NPI# should be listed here since your physicians has an individual contract with UHC, not a group contract.
For those claims processing OON, if timely filing limits have not passed you should file corrected claims with the individual NPI in box 33a.
When verifying whether a physician is in or out of network, you should not provide the group NPI#.
This only reflects physicians who are in the POET All Products contract. If you have a direct, POET is unable to direct you in this matter.