Changes that transform how we work together
Changes that transform how we work together
Changes that transform how we work together
We’ve gone digital
Over the past several years, we’ve transitioned most claim communications we send you from paper to digital. This change makes it easier to do business with us but also helps you focus on what matters most — caring for your patients.
Going forward, unless there’s a system limitation or regulatory exception, we’ll no longer mail most claim-related documents to health care professionals and facilities serving UnitedHealthcare® Medicare Advantage or commercial plan members. Instead, you can find most claim-related documents 24/7 in Document Library within the UnitedHealthcare Provider Portal. Your organization will receive an email notification when you have new letters available to view. We encourage you to check Document Library regularly for new notifications. For letters not available digitally, you will continue to receive mail.
Check out what’s already moved to digital and what’s ahead.
| Upcoming transitions | Timing |
|---|---|
| Massachusetts and Mississippi UnitedHealthcare Community Plan: Medical pre- and post- service appeal submissions | May 1, 2024 |
| Florida and Massachusetts: UnitedHealthcare Community Plan medical claim letters | May 1, 2024 |
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Already transitioned
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| Document type and impacted market(s) | Effective date |
|---|---|
| Massachusetts:UnitedHealthcare Community Plan virtual card payment (VCP) statements | Feb. 2, 2024 |
| New Jersey:UnitedHealthcare Community Plan claim letters | Feb. 2, 2024 |
| Washington:UnitedHealthcare Community Plan virtual card payment (VCP) statements and claim letters | Feb. 2, 2024 |
| UnitedHealthcare Community Plan:Claim reconsideration and medical pre- and post-service appeal submissions | Feb. 1, 2024 |
| Commercial, Medicare Advantage and Dual Special Needs Plan (D-SNP) plans:Pre-service appeal submissions | Dec. 1, 2023 |
| Arizona:UnitedHealthcare Community Plan overpayment letters | Nov. 3, 2023 |
| Michigan, Minnesota, Missouri, North Carolina, Ohio, Rhode Island and Texas:UnitedHealthcare Community Plan virtual card payment (VCP) statements | Nov. 3, 2023 |
| Minnesota, New York and North Carolina:UnitedHealthcare Community Plan claim letters | Nov. 3, 2023 |
| Tennessee:UnitedHealthcare Community Plan overpayment letters, virtual card payment (VCP) statements | Nov. 3, 2023 |
| Wisconsin:UnitedHealthcare Community Plan provider remittance advice (PRAs) and virtual card payment (VCP) statements | Oct. 6, 2023 |
| Arizona:UnitedHealthcare Community Plan appeal letters | Sept. 8, 2023 |
| Michigan, Mississippi, Missouri, Ohio, Rhode Island, Tennessee, Texas and Wisconsin:UnitedHealthcare Community Plan claim letters | Sept. 8, 2023 |
| Mississippi:UnitedHealthcare Community Plan medical claim-related letters | Sept. 8, 2023 |
| Commercial plans:Claim letters | Aug. 4, 2023 |
| Medicare Advantage Plans:Claim letters | July 14, 2023 |
| Michigan:UnitedHealthcare Community Plan provider remittance advice (PRAs) and medical claim-related letters | June 2, 2023 |
| Washington:UnitedHealthcare Community Plan appeal decision and overpayment letters | June 2, 2023 |
| Florida, Kentucky, Maryland, Massachusetts, Minnesota, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Texas and Washington, D.C.:UnitedHealthcare Community Plan appeal decision and overpayment letters | May 12, 2023 |
| Commercial and Medicare Advantage Plans:Reconsideration and appeal submissions | Feb. 1, 2023 |
| Commercial and Medicare Advantage Plans:Virtual card payment (VCP) statements | Feb. 3, 2023 |
| Medicare Advantage, UnitedHealthcare Community Plan and Dual Special Needs Plan (D-SNP) plans:Pre-service appeal submissions | November 2022 |
| Hawaii and Wisconsin:UnitedHealthcare Community Plan overpayment letters | Nov. 4, 2022 |
| Tennessee, Virginia and Wisconsin:UnitedHealthcare Community Plan appeal decision letters | Nov. 4, 2022 |
| Commercial and Medicare Advantage Plans:Overpayment notification letters | Sept. 23, 2022 |
| Arizona, Missouri and Washington: UnitedHealthcare Community Plan prior authorization and clinical decision letters | Sept. 9, 2022 |
| Kentucky, Missouri, Ohio and Washington, D.C.: UnitedHealthcare Community Plan PRAs | Sept. 9, 2022 |
| Minnesota: Medical claim-related letters for commercial and Medicare Advantage plans | Sept. 9, 2022 |
| Prior authorization and other clinical letters | June 17, 2022 – Central, Northeast and Southeast regions April 1, 2022 – West region June 4, 2021 - Utah |
Important considerations
Each of these transitions may require a change to way you work today. We encourage you to start sharing this information and review our digital solution options. If you work with an outside vendor for your mail processing, such as a revenue cycle management company, please discuss how this change may affect your contract or processing arrangements.
Digital updates and workflow changes are announced in Network Newsat least 90 days prior so you have time to prepare.
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Explore digital solutions
Going digital means less paper and a faster workflow. Our 3 solutions are here to help make that a reality.
Application Programming Interface (API)
Automation technology to access comprehensive real-time data on a timetable you set. Data can be distributed to your practice management system, proprietary software or any application you prefer.
Get started Application Programming Interface (API)
Electronic Data Interchange (EDI)
Electronic connectivity to submit single or batch transactions for multiple members and payers without manual data entry or signing in to multiple payer portals.
Discover EDI Electronic Data Interchange (EDI)
UnitedHealthcare Provider Portal
Self-service platform to check eligibility and benefits, manage prior authorization requests, submit claims, request reconsiderations and appeals, and access documents and reports.
Learn more UnitedHealthcare Provider Portal
Which options best fit your needs?
Our digital solutions comparison guide compares the benefits of each to help you choose which are right for you.
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