Overpayment letters won’t be mailed after Sept. 23
Beginning Sept. 23, 2022, we will no longer print and mail overpayment notification letters sent directly by UnitedHealthcare for most1 commercial and UnitedHealthcare® Medicare Advantage plans to network health care professionals and facilities (primary and ancillary) including:
Overpayment identified – Notifying you that UnitedHealthcare paid too much on a processed claim
Overpayment reconsideration requests – Acknowledging UnitedHealthcare received your request to review our overpayment determination
Overpayment reconsideration decision – Providing the outcome of the reconsideration review and outlining what happens next
Please note: This change includes letters sent by Optum for payment accuracy reviews they perform on behalf of UnitedHealthcare. It does not include overpayment letters sent by any other vendor. Those letters will continue to be mailed. Most will include both the vendor and UnitedHealthcare logos, and explain their review was done on our behalf.
View overpayment letters 1 of 3 ways Instead of letters in the mail, you’ll be able to view them digitally 24/7 through either the UnitedHealthcare Provider Portal or an Application Programming Interface (API) system-to-system data feed.
Please share these changes and digital workflow options with those who are affected, including outside vendors such as revenue cycle management companies.
Then, click Document Library and select the Overpayment Documents folder
Use Advanced Search and search by Check ID or Claim No. to help you find what you need
Notifications: When new letters are available in Document Library, an email notification will be sent to the address on file, which is typically the Primary Access Administrator
Need to notify multiple staff members? Document Library notifications are limited to 1 email address per letter type. If multiple staff members require notification, the Primary Access Administrator can consider using a group email address. See our Paperless Delivery Options for Primary Access Administrator for more information.
View using API: You should consider API if you have significant claims volume and either automate correspondence intake or prefer an option other than looking up individual items in Document Library. Data can be pulled into your practice management system, portal or any application you prefer. API requires technical programming between your organization and UnitedHealthcare.
Enroll in Direct Connect: This free tool, available on the UnitedHealthcare Provider Portal, helps you review and resolve overpaid claims quickly and easily. Use Direct Connect to reduce letters and calls from UnitedHealthcare and your work with third-party vendors. Here’s how it works:
All initial overpayment notification letters will post to Document Library
Subsequent communications, including reminder notifications and disagreements with overpayment findings, will be done via Direct Connect. You can also use the tool to submit refunds.
To enroll, email firstname.lastname@example.org. Please include the requestor’s name, as well as the organization’s tax ID number (TIN), physical address and mailing address.
What’s ahead in paperless Later this year and throughout 2023, we’ll continue to move more communications from print to digital including claim attachment submissions through an EDI 275 transaction and member ID cards for commercial plans. All transitions will be announced in Network News at least 90 days before mailings end to give you time to prepare for the change. For the most up-to-date information, exclusions and full schedule, go to UHCprovider.com/digital.
1At this time, the following overpayment letters will continue to be mailed to: All Savers, AARP®/Medicare supplement products, Behavioral Health, Optum VA Critical Care Network, Rocky Mountain Health, Sierra Health & Life, Student Resources, UHC Global, UHOne and UMR.
Please note: This announcement only applies to Medicare Advantage and commercial health plans. It does not apply to UnitedHealthcare Community Plan (Medicaid) health plans.