Quickly learn how to bill UHC (United Healthcare) for mental health claims.

UHC (United Healthcare), also Optum, is the largest health insurance company in the US. You can contact UHC directly at: (877) 842-3210.

How to Bill United Healthcare

Once you have a copy of the client’s insurance card you should verify their eligibility and benefits directly with UHC. Even if a client has a UHC card, it doesn’t always mean their behavioral health benefits are administered by UHC.

Call UHC to inquire about the client’s mental health benefits: (877) 842-3210

Follow our benefits verification script to verify your paneling status with the client’s plan. Whether you are in-network or out of network you should ensure you are getting the correct benefits quoted and obtain authorization if it is required.

Alternatively if you are a United Healthcare provider you can also use the online portal: Provider Express, although we still recommend calling.

You can also have us at TheraThink handle it for you. We handle verification and claims with United Healthcare daily.

United Healthcare Claims Address: Where To Send UHC Claims

For most UHC plans, claims can be sent to:

Electronic Payer ID: 87726
Claims Mailing Address: P.O. Box 30755 Salt Lake City, UT 84130-0755
Phone Number: (888) 632-3862

We recommend filing electronic claims with the 87726 payer ID. Alternatively paper claims can be submitted with a CMS-1500 form.

What is UHC’s Timely Filing Limit (TFL)?

The timely filing limit for United Healthcare depends on the type of claim. Standard claims usually have a 90 day timely filing limit after the date of service. Re-submissions have 180 days after the original remit date. Corrected claims have 365 days after the remit date.

Do I Need To Be In-Network In Order to Bill UHC?

Not necessarily. This depends on the client’s insurance plan. UHC sells HMO, PPO, EPO, and POS plans. Some plans like PPO will still offer benefits for out of network providers.

We recommend calling and verifying the benefits to confirm the client’s plan and coverage.

How To Bill UHC HMO Plans

You must be in the UHC HMO network to see a client with an UHC HMO plan. These plans do not offer out of network benefits.

How to Bill UHC PPO Plans

PPO Plans generally do have out of network benefits. Ask about these when you verify eligibility & benefits.

How To Bill UHC EPO Plans

These behave like UHC HMO, except with a larger network. Make sure you verify you are in the UHC EPO network before you see a client.

How To Bill UHC Medicare Plans

UHC offers several different Medicare advantage plans. Call and verify the eligibility to confirm coverage and benefits.

UHC Dental

UHC Dental plans do not have behavioral health coverage. DO NOT bill these plans.

How to Bill United Healthcare EAP

Some insurance plans will offer EAP (Employee Assistance Program) as a benefit administered by United Healthcare. These plans require authorization and will only cover a set amount of visits. They do not require a co-pay. In these cases, you can bill the same as you would a routine visit, but add the EAP modifier code, HJ.

After the EAP visits are exhausted, visits will fall under the normal behavioral health insurance umbrella.

How to Bill United Healthcare Telehealth

United Healthcare’s Telehealth Modifier Code is: 95. This should be used on all Telehealth claims.

Which CPT Codes Should I Use to Bill United Healthcare?

Mental Health Providers will use:

1. 90791
2. 90834
3. 90837

This is a Nightmare!

We can help you sort out these sorts of things without your input whatsoever.  Our expertise comes in handy daily when parsing out these carve out policies (in all states).  Learn how we can handle your mental health billing today.