Digital solutions for Revenue Cycle Management companies
We know that Revenue Cycle Management companies (RCMs), billing services and business vendors perform many types of work on behalf of health care professionals. Our goal is to make it easier for you to work with us, reduce the time it takes for you to perform claim and clinical activities and, ultimately, help you get paid faster.
To do this, we offer 3 digital solutions to help to fit your needs: Application Programming Interface (API), Electronic Data Interchange (EDI) and the UnitedHealthcare Provider Portal.
Find the member’s cost share, deductible or out-of-pocket responsibility
Determine network and tier status
View claims information for multiple UnitedHealthcare plans
Access letters, remittance advice documents and reimbursement policies
Access claim, prior authorization letters and provider remittance advice for most Medicare and commercial members, including UnitedHealthcare West. View letters and take action before letters arrive in the mail.
Check the status of your notification and prior authorization requests – including those made by phone
Check the status of a referral request
Proven results that’ll save on time and cost
The Council for Affordable Quality Healthcare (CAQH), a nonprofit alliance, is the leader in creating shared initiatives to streamline the business of health care. The 2020 Council for Affordable Quality Healthcare (CAQH) Index shows that the average cost to conduct transactions manually is consistently higher than the cost of electronic transactions for health care professionals and health plans.1
Please note: Use and compatibility of digital solutions and resources may be subject to certain limitations or requirements. Please review all relevant materials for details. Please also review your participation agreement for any obligations and rights regarding electronic connectivity and transactions.