This information (other than the National Health Insurer Report card results) has been provided to the AMA by UnitedHealthcare and is current as of December 2012.
The AMA, Federation of Medicine and UnitedHealthcare collaborate to help simplify the administrative relationship between physicians and UnitedHealthcare. Learn more about these achievements and the ongoing collaboration.
Provider home page
Contracted Fee Schedule - Registration required.
Select Claims & Payments/Fee Schedule Look up.
Select Reimbursement Policies. Please note that UHC does not list the following information online:
- Patient assignment of benefits to a non-participating physician
Payer-Specific Claim Edits
Registration required for Claim Estimator
Claims Estimator – Registration required
This service will help you with pre-determination of estimated benefits, as well as estimated bundling logic and policy rules.
- UnitedHealthcare uses the Claim Reconsideration (registration required) process as the first step for claims reprocessing requests. Requests can be submitted via telephone, mail, e-mail or online.
- For formal Appeal situations, where the provider did not agree with the outcome of the Claim Reconsideration, a written Claim Appeal should be submitted and this process is defined on page 63 of the Physician, Health Care Professional, Facility and Ancillary Provider 2012 Administrative Guide for Commercial and Medicare Products.
Learn about electronic notifications that are available, including prior authorization verification
Electronic health care transactions
- Electronic Claims Submission (EDI)
Learn about the EDI transactions that are available, including Electronic Funds Transfer/Electronic Remittance Advice
- Claims status (registration required)
- Eligibility (registration required)
- Prior Authorization and Notifications
Radiology and Cardiology Notification Programs require registration.
Also view the pre-authorization and pre-certification requirements as defined on page 17 of the "Physician, Health Care Professional, Facility and Ancillary Provider 2012 Administrative Guide for Commercial and Medicare Products."
National Health Insurer Report Card
Review the NHIRC for this year and past years to see how UnitedHealthcare stacks up on a variety of critical metrics.
Health Insurer Financial Information:
Health insurer financials
The AMA has compiled a resource that highlights health insurer SEC filing data since 2006. This resource provides information based on company filings for the seven largest national publicly traded health insurers: Aetna, CIGNA, Coventry, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem.
Health insurer state fines
The AMA has compiled a resource that lists the fines health insurers have incurred in each state and the reasons for the fines. This resource underscores the importance of reporting unfair payer practices.
Health insurer CEO compensation
The AMA has compiled a resource that highlights health insurer SEC filing data, including CEO compensation since 2006. This resource provides information based on company filings for the seven largest national publicly traded health insurers: Aetna, CIGNA, Coventry, Health Net, Humana, UnitedHealthcare and WellPoint/Anthem.