HBMA Logo
Leading the Business of Healthcare
Menu
News

Get Ready to Submit Electronically in 2023

Get ready to submit electronically in 2023

Reconsiderations, appeals and claims are moving to digital submissions only

We started with transitioning mail we send you to electronic delivery. Next, we’ll shift to eliminating paper you send us.

In 2023, network (contracted) health care professionals, practices and facilities will be required to submit claim submissions, claim attachments, and reconsideration and appeal requests to UnitedHealthcare electronically. In response to feedback from members, we’ll also emphasize and encourage the use of digital ID cards for commercial plans.

We recognize that these changes are significant, so we’re alerting you early to give you additional time to plan ahead. The effective dates for these incoming paper-to-digital transitions will be announced in Network News at least 90 days prior to the change.

Here’s a preview of what to expect with these changes, as well as more information on digital ID cards for commercial members.

Goodbye mailroom, hello computer

These are the electronic submission options available for each claim-related task:

 

Communication

Digital submission options

For more information

Claim submissions (general)

EDI

Learn about EDI

UnitedHealthcare Provider Portal

Submission Interactive Guide

Claims with proactive/unsolicited attachments

EDI (available in 2023)

Not yet available

UnitedHealthcare Provider Portal

Submission Interactive Guide

Reconsideration requests

API

Learn about API

UnitedHealthcare Provider Portal

Claims Follow-Up Interactive Guide

Appeal requests

API

Learn about API

UnitedHealthcare Provider Portal

Claims Follow-Up Interactive Guide

 

You’ll see digital ID cards from members more often

Like many other payers, we’ve heard from members that they prefer digital health plan ID cards. In 2023, we’ll continue to provide and promote ID cards in digital formats to members covered by our commercial health plans. This means you may see more patients who don’t have physical ID cards when they arrive for care.

Help your staff get ready for digital

Please consider any impacts to your processes as we move further into this digital space. Over the next several months, we encourage you to:

  • Evaluate your current digital workflows and processes — are all teams and employees using them? What gaps or issues may need to be addressed?
  • Consider the 3 UnitedHealthcare digital solutions — API, EDI and the UnitedHealthcare Provider Portal. Do you need to add any of them to your workflows? Does your staff need training on how to use them?
  • Ensure all staff members have their own One Healthcare ID to access the UnitedHealthcare Provider Portal and are connected to the Tax ID (TINs) they support. Anyone who needs an ID can get started at UHCprovider.com/access.

 

You can access member-specific eligibility and benefits information, including digital ID cards, through the UnitedHealthcare Provider Portal. You may also want to explore how members can provide a PDF of the ID card through your practice check-in process, if available. Instead of asking for the ID card, explore how you can get this information electronically using alternative options.

Our commitment

As part of our commitment to reducing our environmental impact, UnitedHealthcare has made a companywide commitment to replacing paper with personalized, digital tools. These tools are designed to help you get the specific information you need as quickly and efficiently as possible. For the most up-to-date information, go to UHCprovider.com/digital.

Questions?
Please contact UnitedHealthcare Provider Services at 877-842-3210, TTY/RTT 711, 7 a.m.–5 p.m. CT, Monday–Friday. For help accessing the portal, please contact UnitedHealthcare Web Support at providertechsupport@uhc.com or 866-842-3278, option 1, 7 a.m.–9 p.m. CT, Monday–Friday. You can find more information on digital member ID cards here.

PCA-1-22-02519-PO-Web_10222022

Please Share Me On