Tag: UnitedHealthcare (UHC)

POET has received the following information from Anita Kindred, the UHC representative. And we quote:

“We have a new service model for provider to follow to get claim issues resolved:

1. Use LINK to request a claim reconsideration or contact Provider Service at the number listed on flyer if you have questions (must get a reference number for).

2. If issue still have not been resolved through the reconsideration above, please send the all information (including claim info, questions and/or issues), with the reference number from above  (1) to email box:  [email protected].” 

Attached to Anita’s email was the UHC Service Model Flyer for TX and OK. You can find it by clicking on the blue text.

From POET’s perspective, this looks like POET will no longer be able to help with UHC claims resolution or escalation.

However, POET took an extra step and found additional information to help you with the process.

1. UHC-Corrected Claim and Claim Reconsideration Request Guide. This is an overall General Guide.
2. UHC-Claim Research Project Quick Guide. This is a step by step guide on how to research and submit a reconsideration request for multiple claims with the same reason for denial.
3. UHC-Claim Reconsideration & Corrected Claims Quick Reference Guide. Is a step by step guide on how to look up the claim status and payment information. It also tells you how to submit claims for reconsideration or appeal a decision. This guide also reviews how to submit and check the status of a reconsideration request.

POET is very sorry to hear that UHC has decided to implement this new process.

Attached is the link to the UHC Provider News for June 2020. Topics for this Month include:

*Extending Temporary Telehealth Expansion and Reimbursement Through 9/30/20 *Extending Telehealth Cost Share Waivers *Updated COVID-19 Testing Guidance * Updated Program Dates

Starting Monday, June 1,2020 UHC will make effective a new Commercial fee schedule.

Your packets are being emailed.

Please be sure to carefully review the packet. The change is not only the new fee schedule but effects which products you will required to accept.

UHC has rolled all products, MEDICAID, MEDICARE AND COMMERCIAL into one contract as of September 15, 2020 .

This means a physician will be required to see members with any of those products. UHC will no longer allow a physician to choose which products they will participate in.

To help you manage the claim submission and reimbursement process with UnitedHealthcare, as well as access the CARES ACT funding available to health care professionals, here’s a summary of resources to address your most common questions and concerns. Use this link to view the list.