(Claim reconsiderations don’t apply to some states based on applicable state law.) There is a 2-step process for network health care professionals and facilities if they don’t agree with the outcome of the original claim payment or denial. In the menu, click Claims & Payments > Look up a Claim to search by the claim number and click Act on Claim.If you are a new user and don’t have a One Healthcare ID, visit /access to get started.Sign in to the portal with your One Healthcare ID and password.Go to > Select Sign In at the top-right corner.Please share the following changes and digital workflow options with your team, including outside vendors, such as revenue cycle management companies. This does not affect pre-service clinical appeals. This change affects most* network health care professionals (primary and ancillary) and facilities that provide services to commercial and UnitedHealthcare® Medicare Advantage plan members. 1, 2023, you’ll be required to submit claim reconsiderations and post-service appeals electronically. May make it easier for health care professionals to meet reconsideration and appeal timely filing deadlines by eliminating mail timesĪs a result, beginning Feb.Eliminates postal delays, lost mail, and processing time for UnitedHealthcare to receive and scan the documents into our system.In 2023, our work to replace paper with digital tools will shift to eliminating paper you send to us. Updates: Article now includes additional benefits to digital submissions, reconsideration and appeals-specific training guide, updated instructions for accessing API Marketplace and Medicare Supplement plan exclusion. Affects network commercial and Medicare Advantage health care professionals and facilities
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