Practice Admin

In today’s world, being able to work quickly, efficiently and securely is more important than ever before. That’s why UnitedHealthcare is embarking on a multi-year effort to enhance our digital delivery channels and transition paper transactions to electronic, whenever possible. Our goal is to make it easier for you to work with us, reduce the time it takes for you to perform claim and clinical activities — and ultimately, help you get paid faster.

UnitedHealthcare Provider Portal

Our new and improved UnitedHealthcare Provider Portal will allow you to quickly get the answers you need, so you can save valuable time and get better documentation and visibility. Access the portal with your current log-in credentials.
Access the portal by going to UHCprovider.com and logging in with your One Healthcare ID user name and password. You can learn more about the tasks you can complete on the portal at UHCprovider.com/portal.

Document Library

Document Vault is our secure online repository of UnitedHealthcare reports and claim-related communication, such as prior authorization letters and provider remittance advice (PRA) documents. No need to wait for the mail to arrive — PDFs of items are loaded into Document Vault shortly after they’re created, and your staff is notified when new items are available to view. To learn more about Document Vault, including a self-paced course to help you learn how to navigate through it, go to UHCprovider.com/documentvault.

No Surprises Act

The surprise billing legislation establishes federal standards to protect patients from balance billing for defined items and services provided by specified doctors, hospitals and air ambulance carriers on an out-of-network basis. The federal law applies to individual, small group, and large group fully insured markets and self-insured group plans including grandfathered plans.

Prior Authorizations and Notifications

We offer flexibility with our prior authorization and notification capabilities on the UnitedHealthcare Provider Portal. You can check requirements, submit requests, upload medical notes, check status and update cases — without faxing or calling. This means you can complete these tasks when your schedule allows.

Check requirements, submit requests, upload medical notes, check status and update cases – without faxing or calling. Learn more about the prior authorization tool that helps you do it all.

Network News

Network News is a source of truth for health care professional news and updates from UnitedHealthcare. You can find the latest protocol and policy changes, administrative information, clinical resources and more on UHCprovider.com/networknews.

Claims and Payment Accuracy

There are many resources that you can use to help manage your practice’s submission of claims and receipt of payments. Our self-service resources for claims include using Electronic Data Interchange (EDI) and the Claims capability in UnitedHealthcare Provider Portal.

The Payment Integrity team proactively provides education on coding and billing issues that may help you avoid claim denials. Our team of certified coders and nurses use data analytics and trending reports to identify opportunities for improving coding behaviors and provide upfront education on new topics and trends. Please reach out to them for help with resources and support.

Smart Edits is a claims optimization tool that identifies billing errors within a claim and allows health care professionals the opportunity to review and repair problematic claims. Smart Edits are sent within 24 hours of a claim submission, so you can review identified claims in a matter of hours instead of potential claims denials days later.

Electronic Payments

Now more than ever, having a stable cash flow and faster payments is important. That’s why we are phasing out sending payments by paper checks, except where mandated by state laws. Instead, we’re encouraging both in-network and out-of-network health care professionals to sign up for automated clearing house (ACH)/direct deposit. This is the fastest way to get paid, and there is no charge for the deposit. Each payment is issued for the full amount of the claim payment. If you don’t enroll in ACH/direct deposit, you may receive virtual card payments in place of paper checks.

Policies and Protocols

Please visit our UHCprovider.com/policies page for the latest medical and reimbursement policies and protocol information for your practice. Eligibility and benefits, including certificate of coverage resources, can be found on the UnitedHealthcare Provider Portal.

Education Resources

We provide a full range of training resources including interactive-self paced courses and instructor-led sessions, available on UHCprovider.com/training.