Issues With United Claims?
Are you having issues with submitted claims or any other insurer issues in which you followed the appropriate processes but are still at a standstill? There is another escalation option instead of appealing again. Please use the email address below to submit a ticket and keep the assigned ticket number handy. You will receive a response within 48 hours. If you are out of network, see the option below. If your issue is not resolved after using these two options, please email Heather K. Lopez, and if you are an in-network provider, please include the ticket number.
IN Network:
Reconsideration Requests – Redirection
Reconsideration process: outlined beginning on page 139 of the Provider Administrative Guide.
How to submit your reconsideration:
If you believe we incorrectly or underpaid you, the first step in addressing your concern is to submit a Claim Reconsideration Request.
- Online: Using the UnitedHealthcare Provider Portal. More information is available on com/claims > Submit a Claim Reconsideration or view the Quick reference Guide
- Paper: Use the Paper Claim Reconsideration Form on UHCprovider.com/claims. Mail the form to the applicable address listed on the EOB or PRA. The address may differ based on product. Include a copy of the original EOB or PRA. Please see applicable benefit plan supplement for specific contact information.
- Phone: To request an adjustment for a claim that does not require written documentation call the number on the member’s health care ID card.
Note: If you have a request involving 20 or more paid or denied claims and attachments are not required, aggregate these claims via UnitedHealthcare Provider Portal.
If you have tried one of these channels outline above and have not received resolution, you may send the information directly to the [email protected] mailbox which manages escalated claim issues. Download a copy of the template to submit all claims issues that have not been resolved with the reference number to this mailbox.
Out of Network:
Issues or claims for non-participating or non-network providers should be directed to the Provider Service Center. Provider Service Voice Portal at 877-842-3210 or submitting the request online at www.uhcprovider.com.
If you have questions about this or any other insurance concern, contact MSSNY’s Director of Physician Payment and Practice, Heather Lopez, at 518.3298.3532
