United Health Care, Optum, United Behavioral Health – What’s The Deal?

This short article will explain how these insurance companies relate, what questions to ask to make sure you’re in network, and how to file claims.

Please note: YOU ARE NOT ON THE UHC WEBSITE

United Health Care (UHC), Optum, and United Behavioral Health (UBH) are all “Optum” companies which handle mental health claims.

All of these companies use the same Payer ID to file claims (87726), so they all end up in the same place at the end of the day.

But it’s important to do your due diligence to ask if you are in network for all of these plans.

We are happy to do all of this frustrating, time-wasting work for you with our mental health billing service.  If you’d like to skip the pain that is insurance billing, reach out!

Call Optum, United Health Care, and UBH and Ask If You’re Paneled!

Easier to be certain than to be wondering what the deal is!

Always call each insurance company and ask directly.

United Health Care, Optum, and United Behavioral Health Phone Numbers

United Health Card Provider Phone Number: (877) 842-3210

Tip:  Say representative, I don’t have it, and press “0” to get a real human as fast as possible.

Optum Provider Provider Phone Number: (800) 888-2998

United Behavioral Health Provider Phone Number: (800) 888-2998

If you want to never have to make these sorts of calls, consider our billing service for help.

Claims Address For All UHC, UBH, and Optum

P.O. Box 30755
Salt Lake City UT 841300755

And that’s it!

Call to verify network status and you’ll be ready to accept all three in no time!

Other United Health Care Billing Considerations

Some United Health Care now requires providers to obtain authorization for 60 minute therapy sessions.  If you intend to see a client for longer than 45 minutes, you’ll want to obtain prior authorization to do so.

You can do this by calling them at the above phone numbers.  Or you could contact us at TheraThink about our mental health insurance billing service and offload the hassle completely.

We do eligibility and benefits verification for our providers every day of the week.  Happy to help!

United Health Care, UBH, Optum Network Payer ID List

The United Health Care network is very large covering commercial, medicaid, and medicare policies in a variety of states.  This exhaustive list will help you narrow down where to file your United Health Care claims based specifically on the name of the policy.

Commercial

Plan NamePayer ID
Arnett Health Plan87726
Bind25463
Harken Health43313
Harvard Pilgrim04271
Harvard Pilgrim Passport Connect87726
Neighborhood Health Partnership (NHP)87726
The Alliance88461
UnitedHealthcare87726
UnitedHealthcare / All Savers Alternate Funding81400
UnitedHealthcare / All Savers Insurance81400
UnitedHealthcare / Definity Health Plan87726
UnitedHealthcare / Empire Plan87726
UnitedHealthcare / Oxford06111
UnitedHealthcare of the Mid-Atlantic, MD IPA, Optimum Choice and MAMSI Life and Health (formerly MAMSI)87726
UnitedHealthcare Plan of the River Valley (formerly John Deere Healthcare)87726
UnitedHealthcare Shared Services (formerly UHIS)39026
UnitedHealthcare StudentResources74227
UnitedHealthcare West / UnitedHealthcare of CA, OK, OR, TX, WA and PacifiCare of AZ, CO, NV87726
UnitedHealthcare West / Encounters (formerly PacifiCare)95958
UnitedHealthOne / Golden Rule37602
UnitedHealthcare Life Insurance Company (formerly American Medical Security)81400
UnitedHealthcare Life Insurance Company – Golden Rule37602
OptumHealth Behavioral Solutions (formerly United Behavioral Health and PacifiCare Behavioral Health)87726
OptumHealth Behavioral Solutions of NM87726
OptumHealth Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutions and United Resource Networks)41194
OptumHealth Physical Health – includes Oxford41161
UMR39026

Medicaid

Plan NamePayer ID
UnitedHealthcare Community Plan / AZ, Long Term Care, Children’s Rehabilitative Services (CRS)03432
UnitedHealthcare Community Plan / CA, DC, DE, FL, GA, HI, IA, LA, MA, MD, MS, NC, NE, NM, NY, OH, OK, PA, RI, TX, VA, WA, WI (some are formerly AmeriChoice or Unison plans)87726
UnitedHealthcare Community Plan / KS – KanCare96385
UnitedHealthcare Community Plan / KY87726
UnitedHealthcare Community Plan / MI (formerly Great Lakes Health Plan)95467
UnitedHealthcare Community Plan / MO86050
UnitedHealthcare Community Plan / NJ (formerly AmeriChoice NJ Medicaid, NJ Family Care, NJ Personal Care Plus)86047
UnitedHealthcare Community Plan / TN (formerly AmeriChoice TN: TennCare, Secure Plus Complete)95378
UnitedHealthcare Community Plan / UnitedHealthcare Dual Complete (formerly Evercare)87726
UnitedHealthcare Community Plan / UnitedHealthcare Long Term Care (formerly Evercare)87726
Health Plan of Nevada76342
Health Plan of Nevada – Encounters76343
Medica94265
Rocky Mountain Health Plans (RMHP) / CO – Professional claimsSX141
Rocky Mountain Health Plans (RMHP) / CO – Institutional claims84065
Sierra Health and Life76342
Sierra Health and Life – Encounters76343

Medicare

Plan NamePayer ID
AARP Hospital Indemnity Plans insured by UnitedHealthcare Insurance Company36273
AARP Medicare Supplement Plans insured by UnitedHealthcare Insurance Company36273
AARP MedicareComplete insured through UnitedHealthcare / WellMedWELM2
AARP MedicareComplete insured through UnitedHealthcare (formerly AARP MedicareComplete from SecureHorizons)87726
AARP MedicareComplete insured through UnitedHealthcare / Oxford Medicare Network87726
AARP MedicareComplete insured through UnitedHealthcare / Oxford Mosaic Network87726
Medica HealthCare Plans / FL78857
OptumCare / AZ, UT (formerly Optum Medical Network & Lifeprint Network)LIFE1
OptumCare Network of ConnecticutE3287
Preferred Care Partners / FL65088
UnitedHealthcare Community Plan / UnitedHealthcare Dual Complete – Oxford Medicare Network87726
UnitedHealthcare Medicare / Care Improvement Plus (CIP), XLHealth87726
UnitedHealthcare Medicare / UnitedHealthcare Chronic Complete (formerly Evercare)87726
UnitedHealthcare Medicare / UnitedHealthcare Group Medicare Advantage87726
UnitedHealthcare Medicare / UnitedHealthcare MedicareComplete (formerly SecureHorizons)87726
UnitedHealthcare Medicare / UnitedHealthcare MedicareDirect (formerly SecureHorizons) 8787726
UnitedHealthcare Medicare / UnitedHealthcare Nursing Home Plan (formerly Evercare)87726
WellMedWELM2

Source: https://www.uhcprovider.com/content/dam/provider/docs/public/resources/edi/Payer-List-UHC-Affiliates-Strategic-Alliances.pdf

7 Comments

  1. Beth Rudegeair LCSW July 12, 2018 at 7:40 am #

    I saw a client whose insurance card said Blue Cross Blue Shield (Anthem). The initial benefits check revealed that she had insurance through Anthem. However, I was denied payment for four sessions, and paid for two. The client said her insurance was through Optum, When I attempted to call Optum I got transferred from one number to another and yet another, ending up at the same number with which I started. Admittedly I became frustated. The address listed on her card was the one I sent claims to, and was paid twice. If the client had not mentioned Optum, I would never had known. Now I am out of time to get paid. Help! Can this be called an exception to the 90 day rule?
    Thank You,
    Beth

    Reply

    • Denny August 8, 2018 at 10:54 am #

      I would attempt to appeal with a written cover letter explaining this exact thing you just posted!

      Reply

    • Britt October 18, 2018 at 6:24 am #

      If you submit the claims with ANY denials that you have received it will be considered.

      Reply

    • Jolene December 15, 2018 at 9:39 am #

      I am a billing specialist and this is an issue that we have had many times at my counseling center. Optum often is the third party payer for mental health and substance abuse benefits with commercial insurances such as BCBS & Aetna. To always be on the safe side, verify all insurances for mental health prior to the patient being seen. Even though we have had issues with the commercial insurances quoting mental health benefits and even paying some like they did with you, they would deny the rest and then refuse to pay. Even if I did a written appeal to the commercial insurance (because we are not contracted with UBH/Optum). They will put the blame back on the member stating that they should have known their own benefits. It is super frustrating, but still appeal, and then when that denial letter comes, you can explain to the client that they will have to do their own member appeal which sometimes holds more weight than the provider appeals. This has worked sometimes for members who are willing to go the extra mile to help you get paid. If the member refuses, you still can bill them and be in the right.

      Reply

      • Denny December 15, 2018 at 10:03 am #

        We stop many of these problems proactively before they arise and do quite well. We have a number of “not to do’s” with Optum plans that we encourage our providers to follow — more of that guidance at https://therathink.com/billing-service

        Reply

    • Donna January 9, 2019 at 2:57 pm #

      Unfortunately, this is not an exception. It happens quite often too many of us.

      Reply

    • Shirley Higgins June 25, 2020 at 6:44 pm #

      Definitely appeal that in writing and include as much info as you can to back why you are late and they may make an exception for you. Call the customer service number to find out where to send the appeal.

      Reply

Leave a Reply