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Provider Website
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Where to go:
- uhcprovider.com
- Policies: uhcprovider.com/policies > Commercial Policies
- Provider news and updates: uhcprovider.com/news
- Note: You must register to access some of the features available to you. Go to uhcprovider.com/access.
Advance Notifications, Prior Authorizations, Admission Notifications
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Where to go:
- EDI: See EDI transactions and code sets on uhcprovider.com/edi.
- We accept EDI 278 submissions directly to UnitedHealthcare or through a clearinghouse. Be sure to include the CPT codes for your request.
- Online: uhcprovider.com/paan
- Phone: 1-877-842-3210
- See member’s ID card for specific service contact information.
Appeals: Urgent Appeals and Standard Pre-Service Appeals
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Where to go:
- Urgent appeals fax:
Medical: 1-801-994-1083
Pharmacy: 1-801-994-1058 - Standard appeals address:
UnitedHealthcare
P.O. Box 30559
Salt Lake City, UT 84130 - Standard appeals fax:
Medical: 1-801-938-2100
Pharmacy: 1-801-994-1345
Breast Pumps
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Where to go:
- Lincare: 1-855-236-8277;lincare.com
- Byram Medical: 1-877-902-9726;byramhealthcare.com
- Edgepark Medical: 1-888-394-5375;edgepark.com
Cardiology
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Request prior authorization of cardiology services as described in the Outpatient cardiology notification/prior authorization protocolsection of this guide.
- Diagnostic catheterization
- Electrophysiology implants
- Echocardiogram
- Stress echocardiogram
Where to go:
- Online:uhcprovider.com/paan
- Information:uhcprovider.com/cardiology
- Phone: 1-866-889-8054
Chiropractic Services Information
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Where to go:
- ALIVI
3511 NW 91st Ave.
Doral, FL 33172
(Address ID 003138529) - Phone: 1-786-441-8500
- Fax: 1-305-675-2353
Claims
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Where to go:
- EDI: uhcprovider.com/edi (Payer ID: 87726)
- The ERA Payer ID number is also changing to 87726. If you would like to receive 835 ERA files for NHP, or if you currently receive 835 ERA files for NHP under Payer ID 95123 or 96107, contact your vendor to enroll under Payer ID 87726. The health plan ID card for members who have transitioned indicates Payer ID 87726.
- Online: UnitedHealthcare Provider Portal at uhcprovider.com > Sign In. Then, select Claims & Payments from the menu.
- Information: uhcprovider.com/claims (policies, instructions and tips)
- Phone: 1-877-842-3210 (follow the prompts for status information)
Claims (Paper)
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Where to go:
UnitedHealthcare
P.O. Box 740800
Atlanta, GA 30374-0800
Durable Medical Equipment/Respiratory and Commodity Services
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(Oxygen, CPAP, hospital beds, standard wheelchairs)
Where to go:
- Apria: 1-855-613-8303;apria.com
- Lincare 1-855-236-8277;lincare.com
- Rotech: 1-877-623-5272;rotech.com
EDI Support
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Where to go:
- Online:uhcprovider.com/edi
- Phone: 1-866-509-1593
Eligibility Verification
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- Verify primary care physician
- Verify eligibility and benefits
- Check claim(s) status
- Obtain status of referrals
- Office visit copay
- Inpatient copay
- Prescription drug copay (if applicable)
Where to go:
- EDI: Transactions 270 (Inquiry) and 271 (Response) through your vendor or clearinghouse
- Online:UnitedHealthcare Provider Portal at uhcprovider.com > Sign In. Then, select Eligibility from the menu.
- Phone: 1-877-842-3210
Home Health Services
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Where to go:
- Lincare: 1-855-236-8277;lincare.com
- Byram Medical: 1-877-902-9726;byramhealthcare.com
- Edgepark Medical: 1-888-394-5375;edgepark.com
Home Infusion Services (including enteral)
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Where to go:
- Orsini Health: 1-800-240-9572;orsinihealthcare.com
- Express Scripts: 1-855-315-3590;accredo.com
- Option Care Infusion: 1-800-683-5252;optioncarehealth.com
Insulin Pumps and Supplies National Vendors
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Where to go:
- MiniMed Distribution Group (Medtronic): 1-800-933-3322 minimed.com
Medical Supply Providers (Disposable supplies, ostomy, urological, incontinence supplies)
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Where to go:
- Byram Medical: 1-877-902-9726;byramhealthcare.com
- Edgepark Medical: 1-888-394-5375;edgepark.com
- Medline: 1-800-633-5463;medline.com
- McKesson: 1-855-404-6727;mckesson.com
Mental Health Services Prior Authorization (Optum)
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Where to go:
- Phone: 1-800-817-4705
Outpatient Injectable Chemotherapy and Related Cancer Therapies
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Where to go:
- Online: uhcprovider.com/oncology
- Phone: 1-888-397-8129
Pharmacy (OptumRx)
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Where to go:
- Online:professionals.optumrx.com> Prior Authorizations
- Prior Authorization: 1-800-711-4555
- Specialty Pharmacy Customer Service: 1-888-739-5820
Physical, Occupational and Speech Therapy (OptumHealth)
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Where to go:
- Phone: 1-800-873-4575
- Fax: 1-248-733-6070
Podiatry Foot and Ankle Network (FAN)
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Where to go:
- ALIVI
3511 NW 91st Ave.
Doral, FL 33172
(Address ID 003138529) - Phone:1-786-441-8500
- Fax:1-305-675-2353
Prior Authorization and Advance Notification
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Where to go:
- EDI: Transactions 278A and 278N
- Online: uhcprovider.com/paan
- Phone: 1-877-842-3210 (if you do not have access to electronic services)
- Information: uhcprovider.com/priorauth
Radiology / Advanced Outpatient Imaging Procedures:
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Request prior authorization of radiology services as described in the Outpatient radiology notification/prior authorization protocolsection of this guide.
CT scans, MRIs, MRAs, PET scans, nuclear medicine studies, including nuclear cardiology
Where to go:
- Online:uhcprovider.com/paan
- Phone:1-866-889-8054
- Information:uhcprovider.com/radiology
Radiation Therapy
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Where to go:
- Online: UnitedHealthcare Provider Portal at uhcprovider.com > Sign In.
- Select the Submission and Status link under the Radiology, Cardiology and Radiation Oncology section.
- Select service type: Radiation Oncology
- Phone: 1-877-842-3210
- Information: uhcprovider.com/oncology >Radiation Therapy Services
Substance Use Services
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Where to go:
- Optum
- Phone: 1-800-817-4705
Case Management
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Where to go:
- Congenital Heart Disease: 1-877-842-3210
- Kidney Resource Services: 1-877-842-3210
- Ventricular Assist Devices: 1-877-842-3210 or fax 1-855-282-8929
- Transplant Resource Services: 1-877-842-3210 or fax 1-855-250-8157
