57080. EDI Payer ID #39026 Admission type code for inpatient claims. fm1$"dxTC@ps\ U}? Australia 0000112306 00000 n 0000179233 00000 n Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances Subject: Includes line of business, plan name and payer ID . Lebanon 0000008173 00000 n Burkina Faso 0000115087 00000 n 0000003410 00000 n Paper Claims . Cameroon 0000048781 00000 n Consulting Employer group number: The number assigned to the subscriber's employer group located on the member's ID card. Nova Scotia %PDF-1.6 % 0000023307 00000 n P.O. Trust Niue United Kingdom Utah 0000162699 00000 n Professional Institutional. 0000138268 00000 n Antigua and Barbuda Canada 0000123653 00000 n Engineering/Technical Staff 0000004015 00000 n Need to submit transactions to this insurance carrier? 13337. Professional Institutional. 315. All dental claims should be mailed to GEHA at the appropriate address below: If the patient has Medicare primary coverage, mail to GEHA: Dental Plans. Delaware 0000005887 00000 n 0000001043 00000 n Tonga Transparency & Provider Search Costa Rica 0000174831 00000 n FLORIDA UBC HEALTH FUND All medical claims should be submitted electronically using the network EDI numbers as listed below for each network. 0000006751 00000 n Cyprus Virgin Islands Norway Cook Islands Iraq Qatar India EDI Submitter: 44054 Medical Practice Management Ohio Gabon Need access to the UnitedHealthcare Provider Portal? Italy Office Manager 0000148268 00000 n Analyst/Administrator Angola Germany Engagement & Experience 0000073502 00000 n UMR payer ID 39026, if your clearinghouse is not Optum . Finance/Accounting United States Medical Record Retrieval & Clinical Review Comoros P.O. 0rT* If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. Birmingham, AL 35283-0724. UHC Provider Services Phone: (844) 586-7309. Newfoundland and Labrador Benin Marshall Islands All dental claims should be submitted to EDI: 44054. Rendering/attending provider NPI (only if it differs from the billing provider) and authorized signature. 0000145948 00000 n 322 0 obj <>/Filter/FlateDecode/ID[<304D90465B8F264FB3821BFEF410E30F><42BF6E1904DCEB468D2C308771CC1222>]/Index[299 38]/Info 298 0 R/Length 114/Prev 222343/Root 300 0 R/Size 337/Type/XRef/W[1 3 1]>>stream 0000002334 00000 n 0000147922 00000 n 0000087379 00000 n Antarctica Namibia Director French Guiana If you have claims for GEHA FEHB members and Medicare is the primary plan, GEHA participates in CMS Coordination of Benefits Agreement (COBA) Program and will receive claims and the Medicare primary benefit information electronically from the Coordination of Benefits Contractor (COBC). French Southern Terr. -- Other Locations -- Jordan 0 Billing provider tax identification number (TIN), address and phone number. Hawaii Only for claims where the submit claims to address on the medical ID card is a CoreSource . Box 30783, Salt Lake City, UT 84130-0783 Alabama Viet Nam -- Please Select -- Authorization, if applicable, should be sent in the 2300 Loop, REF segment with a G1 qualifier for electronic claims (box 63 for UB-04). Pharmacy Solutions Dental is listed separately, if applicable. Romania Radiology Payer ID: 39026 . 0 Payer Name Payer ID Type Services; UMR - Wausau: 39026: commercial: UB04 1500 ERA Eligibility: More Info Member Engagement Solutions Zimbabwe, State/Location 0000087889 00000 n Original submission is indicated with a 1 in claim frequency box or resubmission code (box 22). xref Clinical Decision Support Solutions 0000144676 00000 n startxref hb``Xo:1Gl$ 4"c0ax`L^ H^;wxlO8.dVa,Pe8h6?RJ% kS; qTgaU`p*`b`a::*CX^C(($!!,719w !IC!1KO#k*X~b^1lH-fxfg=39X9bB;Y\"Y2lXZfLpFQYeR2#`*\(6 _4 Administrative/Human Resources Please note: The networks listed below should be used for claims based on services performed in 2020. Palau Pitcairn Mayotte All medical claims should be mailed to the addresses listed below for each network. For physicians, the state license number should be entered as a seven-digit number "A0nnnnn." Idaho Access product updates and information, ask questions, learn about best practices & benchmarks, and connect with experts & peers. ICD-10-CM codes are used for procedure coding on inpatient hospital Part A claims. If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. France Learn more about the data we collect or request your data be removed, Choosing Who Can See My Confidential Medical Information, Copyright 2023 Managed Health Network, LLC. Nicaragua UnitedHealthcare Shared Services Visit Ability to register today to begin submitting MHN claims for free. %PDF-1.7 % 0000061377 00000 n MHN also accepts electronic submission of both Professional and Institutional claims through Emdeon. Box 21542, Eagan, MN 55121 Puerto Rico A. Claims Address For All UHC, UBH, and Optum P.O. 0000011777 00000 n For all other uses, Level I Current Procedural Terminology (CPT-4) codes describe medical procedures and professional services. Submission through UHC provider portal Find forms for medical claims, patient eligibility, ERA, and EFT payment information. Virgin Islands (British) For a more optimal geha.com experience, please click. Direct Care Broker or Supplier Contracts: Accredo, AeroCare, Apria, Bayada, BioScrip, Byram, CardioNet, Coram, DJ Orthopedics, DynaSplint, Edgepark, First Call Pharmacy, Hoveround, InfuSystem, Insulet, Interim, KCI, Liberator/Bard Care, Lincare/American Home Patient, Hanger, Optum Women's and Children's Health, Maxim, McKesson, The Med Group, Medtronic, National Seating and Mobility, NE Express, NuFactor, Option Care, Orthofix, Respirtech, Rotech, 180 Medical, Exception: Providers contracted with VGM Homelink submit claims to Homelink: For more information about Emdeon services, call (877) GO-WebMD (469-3263) or visit: Consolidated Billing: All charges for the patient stay should be included on the same bill, this includes therapy/treatment and ancillary services. 0000002850 00000 n The Provider Services # is 1-877-658-0305. . El Salvador 0000115424 00000 n 0000112488 00000 n For information on submitting claims, visit our updated Where to submit claims webpage. Palau Military Americas Saudi Arabia Payer ID: 39026 United Health Shared Services (on back of card) Payer ID: 39026 . EDI All institutional claims require the following mandatory items: This is not meant to be a fully inclusive list of claim form elements. West Virginia Panama 610647538. CD Plus. Marshall Islands 314. Alberta Home Health Agency 0000097318 00000 n Kenya Optum receives 837I (institutional claims) and 837P (professional claims) and routes them to UMR. payer id claim office # type name address city st zip 36273 e aarp unitedhealthcare all claim office addresses 38265 e admin systems research asr all claim office addresses . Palestinian Territory, Occupied For information on submitting claims, visit our updated Where to submit claims webpage. Phone: (800) 821-6136 0000171350 00000 n Box 981707, Chief Executive Officer Arkansas A complete claim is a claim, or portion of a claim that is submitted on a complete format adopted by the National Uniform Billing Committee and which includes attachments and supplemental information or documentation that provide reasonably relevant information or information necessary to determine payer liability. * 0000003576 00000 n Other, Subscribe to Change Healthcare Communications. Chief Financial Officer * 0000003049 00000 n India Wyoming 376 0 obj <> endobj 0000158914 00000 n Rwanda GEHA-ASA Hospital Employed Practice If you do have electronic claim submission capabilities, please submit claims electronically. Military Europe/ME/Canada Turkey UnitedHealthcare Shared Services Payer 835 List Payer ID Payer Name 59069 21st Century Health (MedsavUSA)(NJ) 74237 32 Dental (PO Box 9150, Austin, TX) 20413 3P Administrators (Onalaska, WI) 37283 AAG-American Administrative Group (Lubbock, TX) AARP1 AARP Dental Insurance Plan (Mechanicsburg, PA) 52133 ACEC Health Plans (SLC, UT) 61425 ACEC-Healthplan Payer ID: 39026 Student Insurance Harvard Pilgrim Health Care/ StudentResources . Use Healthcare Common Procedure Coding System (HCPCS) Level I and II codes to indicate procedures on all claims, except for inpatient hospitals. Germany Guyana CD Discount. Electronic Interchange Group Professional Commercial Payer List Payer ID Claim Office # Type . Note: Payers sometimes use different payer IDs depending on the clearinghouse they're working with. Administrator COMMERCIAL. Sudan 0000007887 00000 n If the subscriber is also the patient, only the subscriber data needs to be submitted. 0000175066 00000 n Claims: EDI # 39026, UMR, PO Box 30541, Salt Lake City, UT 84130-0541 Vision Claims: Spectera Vision, PO Box 30978, Salt Lake City, UT 84130 This card must be presented each time services are requested. Independent Practice Affiliated with Hospital 0000118735 00000 n 0000008125 00000 n CD Plus. Michigan TRICARE EAST ALL CLAIM OFFICE ADDRESSES: VAPCC E: TRIWEST HEALTHCARE ALLIANCE ALL CLAIM OFFICE ADDRESSES: 39026 E: UMR . Mozambique 0000167211 00000 n 0000004845 00000 n Other, Bed Size ]m4hq51l^XNFsZb jB"l! California The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), is currently used to code diagnostic information on claims. Mexico Contact us. 0000001766 00000 n Kyrgyzstan Croatia Jamaica CLAIM.MD 0000074376 00000 n Individual Contributor Mississippi Imaging Center h[]~L0wHv8vqt~*rH7,3tizC]oIzYNJmkm*U Tuvalu Togo Admitting diagnosis required for inpatient claims. Vanuatu If you have claims for GEHA FEHB members and Medicare is the primary plan, GEHA participates in CMS Coordination of Benefits Agreement (COBA) Program and will receive claims and the Medicare primary benefit information electronically from the Coordination of Benefits Contractor (COBC). 39026 52180 Unicare Life & Health Insurance Company 80314 35198 34638 . @=&F]`00Rx@ 6Z IMPORTANT NOTE: We require that all facility claims be billed on the UB-04 form. 0000028199 00000 n Cal-Optima Direct. 0000103511 00000 n Kiribati Samoa 270/271: Eligibility and Benefit Inquiry and Response. Payment Accuracy Solutions Hungary Care Management/Population Health Chief Compliance Officer 0000158331 00000 n Ambulatory/outpatient surgery claim: If implantable devices are included on the claim, one of the following must be submitted for each implant billed on the claim form: o Copy of the manufacturer invoice; or o Copy of the medical record's implant log. Virginia 0000081280 00000 n Czech Republic Macedonia San Marino Virgin Islands (U.S.) Independent Practice Not Affiliated with Hospital %%EOF Martinique Colombia 0000147653 00000 n Iran 0000168686 00000 n In order to ensure claims are submitted correctly, providers must use the following Payer IDs: 68069 for Medical Services. Emergency Medical Service Military Pacific 0000119628 00000 n 0 Universal product number (UPN) codes as required. 392 0 obj <>/Filter/FlateDecode/ID[<2B6FDBD48D83564DAD4FC2DD51BA67C7>]/Index[376 30]/Info 375 0 R/Length 96/Prev 321559/Root 377 0 R/Size 406/Type/XRef/W[1 3 1]>>stream If you have any questions about payer ID numbers, please contact Harvard Pilgrim Health Care's Electronic Data Interchange (EDI) team at . Coordination of benefits (COB): When we are the secondary payer; the provider must submit the claim and a copy of the explanation of medical benefits/explanation of benefits (EOMB/EOB) from the primary carrier to Health Net for payment consideration. OptumRX EDI Payer ID 39026 hb``c``a`e`2AX@u@ 1-199 Chief Information Officer PO box 29133 Chile The members ID card will indicate the Payer ID to use for claims submissions. hbbd```b``:"-T0w"1 #Xed;fd0DGHm RLHee`bd`d M" Hge 0 BA= Value-Based Care Solutions, Solution Type Singapore United States Swaziland Together, we are accelerating the journey toward improved lives and healthier communities. New Hampshire endstream endobj 11728 0 obj <>/Filter/FlateDecode/Index[236 11458]/Length 191/Size 11694/Type/XRef/W[1 1 1]>>stream COMMERCIAL. Bravo Health - Cigna Healthspring. 0000153036 00000 n 0000161773 00000 n Peru 0000002289 00000 n 0000129651 00000 n 0000000016 00000 n 0000097431 00000 n 2023 Government Employees Health Association, Inc. All rights reserved. Payer Name Change Healthcare Payer ID Payer-assigned Payer ID Connectivity Type Available Authorization Required 1199SEIU Family of Funds 1199NB 1199N1 13162 Both Portal A & I Benefit Plan AIBPL1 93044 Portal AARP 36273 X12 No Absolute Total Care CNTENE 68069 X12 No Algeria Trinidad and Tobago Korea (South) 0000087773 00000 n UnitedHealthcare accepts the following claim types from both participating and non-participating care providers: If you arent submitting claims electronically, or arent using EDI for all available transactions,go to EDI Connectivityfor more information and help getting started, 2023 UnitedHealthcare | All Rights Reserved, EDI 835: Electronic Remittance Advice (ERA), EDI 270/271: Eligibility and Benefit Inquiry and Response, EDI 276/277: Claim Status Inquiry and Response, EDI 278: Authorization and Referral Request, EDI 278I: Prior Authorization and Notification Inquiry, EDI 278N: Hospital Admission Notification, Sign in to the UnitedHealthcare Provider Portal, Health plans, policies, protocols and guides, The UnitedHealthcare Provider Portal resources. Hong Kong Billing/Coding Original submission is indicated with a 1 in claim frequency box or resubmission code (box 22). 0000147306 00000 n This ID is used to submit claims electronically through our system. 0000008078 00000 n Uganda 0000160789 00000 n Pharmacy Benefit Solutions UPIN or state license number: Six-digit universal provider identification number (UPIN) or state license number of all attending providers. In addition, submitting electronically reduces postage and other paper related expenses and supports improvement to your overall . Chief Technology Officer -- Please Select -- Kazakhstan Sweden Senior Vice President Including the correct 5-digit payer ID helps avoid having your claim rejected due to listing an incorrect payer. Cuba These may be different when submitting Amerigroup EDIs in Availity. $UZZNl)Q,nB=&X"HZic2lc[J"*yDO3.o8T*feoXRz`4U !x*w$Jn(*Pmfk[wv$(=MKi3T|}G)WoKP 2Jl*N|Jd-EIAM}+>@rATf@MWX&3O5S-kLB)[MA=Ln5-IWEdVZTQ Every day without smoking counts! 0000004338 00000 n Radiology Other United Health Care Billing Considerations Some United Health Care now requires providers to obtain authorization for 60 minute therapy sessions. UHC Provider ServicesPhone: (877) 343-1887, UnitedHealthcare Choice Plus (all 50 states) hbbd```b``z"s@$","Yl0&&1d kfj LA{\qz2XDf% N0{13E $400]~l 0 Mongolia Mauritius 39026 e umr (formerly umr wausau) all claim office addresses 79480 e umr harrington all claim office addresses Thailand !C8>}t}W>qWW_{_wOo~_}yJf. Solomon Islands 0000006920 00000 n Tokelau 0000080665 00000 n UnitedHealthcare Shared Services Box 30783, Salt Lake City, UT 84130-0783 0000005075 00000 n Papua New Guinea Western Sahara Inpatient institutional claims must include admit date and hour and discharge hour (where appropriate), as well as any Present on Admission (POA) indicators, if applicable. A Submit paper claims to the address on the back of the member ID card. San Antonio, TX 78229, Part B RX Claims Address: New Zealand General Management Mail claims to: Behavioral Health Systems, Inc. P.O. GEHA FEHB Medical -- Please Select -- Washington Healthcare Data & Analytics Solutions SAGE TECHNOLOGIES Saint Anthony PHO STA01 ST ANTHONY PHO Saint Marys Health Plan All other providers use their state-assigned license number without modifications. Physician Practice Management Heard/McDonald Isls. 0000049490 00000 n Puerto Rico Patient Access & Financial Clearance Solutions Slime Party - Because Slime is Fun for Adults, Too! 0000087924 00000 n 0000049637 00000 n Teachers Health Trust 2950 E. Rochelle Avenue Las Vegas, NV 89121. The type of bill code used must correspond to the facility, Medicare certification and state license held by the billing entity. 0000007492 00000 n The payer ID is typically a 5 character code, but it could be longer. Liechtenstein What type of plan is it? 0000073889 00000 n Box 21542, Eagan, MN 55121 Phone: (800) 821-6136 Pharmacy %%EOF Box 30783, 0000008030 00000 n 0000140914 00000 n EDI Claims. P.O. 2-2-22-UMR-WAUSAU-39026-Delayed-ERAs-Checks-Dated-1-20-22. submitting an EDI file using Payer ID UHNDC, you must successfully complete specific EDI testing. D.C. %%EOF <<5EBD9ADF93626F458FA1B929BDAFF42F>]/Prev 669182/XRefStm 1766>> land Islands To avoid possible denial or delay in processing, the above information must be correct and complete. Singapore Saint Lucia Services New Jersey Ireland Please contact Change Healthcare at 1 (866) 371-9066 with any questions regarding electronic claims submission. Primary diagnosis code and all additional diagnosis codes (up to 24 for institutional) with the proper ICD indicator (only ICD 10 codes are applicable for claims with dates of service on and after October 1, 2015). 0000127723 00000 n Salt Lake City, UT 84130-0783 Malta 0000147575 00000 n Cal-Optima Direct. It's never too late to quit smoking. Payer ID: 74227 ; Box 30783, Electronic claims filing allows for earlier detection of errors and drastically reduces the likelihood of claims being rejected or denied for payment and, more often than not, will result in faster processing. 0000153297 00000 n US Minor Outlying Is. Indiana <<78EFBF32BF92FB4DBD42CA49770C2094>]/Prev 183057/XRefStm 4015>> 0000103184 00000 n Uruguay Box 14621 Learn More ConnectCenter Payer List Access the Assurance EDI, Clearance EDI, and ConnectCenter payer information here. We use the National Uniform Billing Committee (NUBC) Official UB-04 Data Specifications Manual as the standard source for codes and code descriptions to be entered in the various form locators (FL). 0000097136 00000 n Russian Federation 0000007982 00000 n Cambodia Payer ID: 39026; Electronic Services Available (EDI) Professional/1500 Claims: YES: Institutional/UB Claims: YES: Eligibility: YES: Prime: Electronic Remittance (ERA) YES: ERA Enrollment Required . Micronesia 259. -- Please Select -- %PDF-1.7 % H[Gi$1~!Xv2X>U! Find, access, and login to your product application portal as a current customer.   Call to verify network status and you'll be ready to accept all three in no time! Estonia Enrollment 0000022830 00000 n China Sri Lanka Texas All dental claims should be submitted to EDI: 44054 If you do not have electronic claim submission capabilities, you can mail claims on standard HCFA, UB and dental claim forms. By continuing to use our site, you agree to ourPrivacy PolicyandTerms of Use. Bahrain Nebraska EDI Payer ID #39026 South Dakota P.O. For claims from this year, click Where to Submit Claims from 2021. If different, then submit both subscriber and patient information. EDI Payor #39026 Canada Training/Education Provider Network Optimization Solutions Share of cost is submitted in Value Code field with qualifier 23, if applicable. Please select Non-Participating Payor. Chief Medical Information Officer endstream endobj 205 0 obj <>/Filter/FlateDecode/Index[5 38]/Length 20/Size 43/Type/XRef/W[1 1 1]>>stream Eritrea 39026 39026: Y N: Commercial UnitedHealthcare: 87726 Y: Y . PO Box 30783 Hot Springs, AR 71903, Grievances & Appeals Department 200+, Practice Specialty

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