You are subject to both the main guide and this supplement. This supplement controls if it conflicts with information in the main guide. If there are additional protocols, policies or procedures online, you will be directed to that location. Refer to the main guide for anything not found in this supplement.
Starting Dec. 1, 2020, rolling out over the next 24-36 months, employer groups previously sold under the name All Savers®
Alternate Funding will now be sold under the new product name UnitedHealthcare Level Funded for the following states:
Request prior authorization for services as described in the Outpatient radiology notification/ prior authorization protocol section of Chapter 7: Medical management
Health plan ID card
Members receive health plan ID cards with information that helps you submit claims. The cards list the claims address, copayment information and phone numbers.
Our claims process
Follow these steps for fast payment:
Notify UnitedHealthcare Level Funded.
Prepare a complete and accurate claim form.
For UnitedHealthcare Level Funded members, submit electronic claims using Payer ID number 87726. Submit paper claims to the address on the member’s ID card.
For contracted care providers who submit electronic claims and would like to receive electronic payments and statements, call Optum Financial Services Customer Service line at 1-877-620-6194 or visit Optumbank.com > Partners > Providers.
Claim reimbursement (adjustments)
If you think your claim was processed incorrectly, call the number on the member’s ID card. If you find a claim where you were overpaid, send us the overpayment within 30 calendar days. If we find a claim was overpaid, payment is due within 30 calendar days.
If you disagree with our decision regarding a claim adjustment, you may appeal.
Claim reconsideration, appeals and disputes
Claim reconsideration does not apply to some states based on applicable state legislation (e.g. Arizona, California, Colorado, New Jersey or Texas). For states with applicable legislation, any request for dispute will follow the state specific process.
There is a two-step process available for review of your concern. Step one is a claim reconsideration. If you disagree with the outcome of the claim reconsideration, you may request a claim appeal (step two).