Claims Payer List - UnitedHealthcare

Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances

Line of Business (LOB)

Commercial Commercial Commercial Commercial Commercial Commercial Commercial Commercial Commercial Commercial Commercial Commercial * Commercial

Commercial

Commercial Commercial Commercial Commercial

Brand Name / Plan Name or Region Arnett Health Plan Bind Harvard Pilgrim Harvard Pilgrim Passport Connect Neighborhood Health Partnership (NHP) The Alliance UMR UnitedHealthcare UnitedHealthcare / All Savers Alternate Funding UnitedHealthcare / All Savers Insurance UnitedHealthcare / Definity Health Plan UnitedHealthcare / Empire Plan UnitedHealthcare / Oxford UnitedHealthcare / UnitedHealthcare of the Mid-Atlantic, MD IPA, Optimum Choice and MAMSI Life and Health (formerly MAMSI) UnitedHealthcare / UnitedHealthcare Plan of the River Valley (formerly John Deere Healthcare) UnitedHealthcare / UnitedHealthcare Shared Services - UHSS (formerly UHIS) UnitedHealthcare / UnitedHealthcare StudentResources UnitedHealthcare / U.S. Networks and Administrative Services

Medical Dental Payer ID Payer ID

87726

25463

04271

87726

87726

88461

39026

39026

87726

81400

81400

87726

87726

06111

87726

87726 39026 74227 USN01

95378 39026

Commercial

UnitedHealthcare West / UnitedHealthcare of CA, OK, OR, TX, WA and PacifiCare of AZ, CO, NV

87726

Commercial Commercial Commercial Commercial

Dental

UnitedHealthcare West / Encounters (formerly PacifiCare) UnitedHealthOne / Golden Rule UnitedHealthOne / UnitedHealthcare Life Insurance Company (formerly American Medical Security) UnitedHealthOne / UnitedHealthcare Life Insurance Company - Golden Rule UnitedHealthcare Dental (formerly OptumHealth Dental, Dental Benefit Providers/DBP and DBP of California)

95958 37602 81400 37602

CX001 52133

Medicaid, Dual SNP

UnitedHealthcare Community Plan / AZ, Long Term Care, Children's Rehabilitative Services (CRS)

03432

Medicaid, Dual SNP

Dual SNP Medicaid Medicaid, Dual SNP, MIChild Medicaid, Dual SNP

Medicaid, Dual SNP

Medicaid, Dual SNP Medicaid, Dual SNP Medicaid, Dual SNP Medicare, Retirement Medicare, Retirement Medicare, Retirement

UnitedHealthcare Community Plan / CA, DC, DE, FL, GA, HI, IA, KY, LA, MA, MD, MS, NC, NE, NM, NY, OH, OK, PA, RI, TX, VA, WA, WI (some are formerly AmeriChoice or Unison plans) UnitedHealthcare Community Plan / KS UnitedHealthcare Community Plan / KS - KanCare

UnitedHealthcare Community Plan / MI (formerly Great Lakes Health Plan)

UnitedHealthcare Community Plan / MO UnitedHealthcare Community Plan / NJ (formerly AmeriChoice NJ Medicaid, NJ Family Care, NJ Personal Care Plus) UnitedHealthcare Community Plan / TN (formerly AmeriChoice TN: TennCare, Secure Plus Complete) UnitedHealthcare Community Plan / UnitedHealthcare Dual Complete (formerly Evercare) UnitedHealthcare Community Plan / UnitedHealthcare Long Term Care (formerly Evercare) AARP Hospital Indemnity Plans insured by UnitedHealthcare Insurance Company AARP Medicare Supplement Plans insured by UnitedHealthcare Insurance Company AARP MedicareComplete insured through UnitedHealthcare / WellMed

87726 87726 96385 95467 86050 86047

95378 87726 87726 36273 36273 WELM2

COB Y Y Y N N Y Y Y Y Y Y Y Y

Y

Y Y Y N

Y

Y Y Y Y

N

Y

Y

Y Y

Y

Y

Y

Y Y Y N Y Y

?2020 UnitedHealthcare Services, Inc.

Page 1 of 3

Smart Edits

Y N N N Y N N Y N N Y Y Y

Comments former payer id 95440

former payer id 64159

Y

former payer id 52148

Y

former medical payer id 95378

N

N

N

effective 3/1/2020

Y

former payer id 95959, 95962, 95964, 95999

N

N

N

N

N

N

Y

former payer id 04567, 25175, 86002, 86003, 86048, 86049, 95378

Y

Y

Y

Y

Y

former payer id 86001

Y

Y Y N N N

05/22/2020

Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances

Line of Business (LOB)

Brand Name / Plan Name or Region

Medical Dental Payer ID Payer ID

Medicare, Retirement

Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Medicare, Retirement Multiple Multiple Multiple Multiple Multiple Multiple Multiple

Other

Other

Other

Other

AARP MedicareComplete insured through UnitedHealthcare (formerly AARP MedicareComplete from SecureHorizons) AARP MedicareComplete insured through UnitedHealthcare / Oxford Medicare Network AARP MedicareComplete insured through UnitedHealthcare / Oxford Mosaic Network Medica HealthCare Plans / FL OptumCare / AZ, NV, UT (formerly Optum Medical Network & Lifeprint Network) OptumCare Network of Connecticut Preferred Care Partners / FL UnitedHealthcare Community Plan / UnitedHealthcare Dual Complete - Oxford Medicare Network UnitedHealthcare Medicare / Care Improvement Plus (CIP), XLHealth UnitedHealthcare Medicare / UnitedHealthcare Chronic Complete (formerly Evercare) UnitedHealthcare Medicare / UnitedHealthcare Group Medicare Advantage UnitedHealthcare Medicare / UnitedHealthcare MedicareComplete (formerly SecureHorizons) UnitedHealthcare Medicare / UnitedHealthcare MedicareDirect (formerly SecureHorizons) UnitedHealthcare Medicare / UnitedHealthcare Nursing Home Plan (formerly Evercare) WellMed Health Plan of Nevada Health Plan of Nevada - Encounters Medica Rocky Mountain Health Plans (RMHP) / CO - Professional claims Rocky Mountain Health Plans (RMHP) / CO - Institutional claims Sierra Health and Life Sierra Health and Life - Encounters OptumHealth Behavioral Solutions (formerly United Behavioral Health and PacifiCare Behavioral Health) OptumHealth Behavioral Solutions of NM OptumHealth Complex Medical Conditions (CMC) (formerly OptumHealth Care Solutions and United Resource Networks) OptumHealth Physical Health - includes Oxford

87726

87726 87726 78857 LIFE1 E3287 65088 87726 87726 87726 87726 87726 87726 87726 WELM2 76342 76343 94265 SX141 84065 76342 76343

87726

87726

41194

41161

COB

Y

Y Y Y N N Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y

Y

Y

Y

Y

Other

UnitedHealthcare / NDC Home Infusion Specialty Pharmacy Claims - NDC claims only

UHNDC

N

Other Vision

Veterans Affairs / Community Care Network (CCN) March Vision

VACCN

Y

52461

N

Smart Edits

Comments

Y

Y

former payer id 06111

Y

former payer id 06111

Y

N

N

Y

Y

Y

former payer id 77082

Y

Y

Y

Y

Y

N

N

N

N

N

N

N

N

N

former payer id 33053

N

N

former payer id 52190

N

former payer id 41159, 41160

Applies only to 837P claims. Before

submitting an EDI file using Payer ID

UHNDC, you must successfully complete

N

specific EDI testing. Contact your clearinghouse to begin the testing

process. Refer to NDC Claim Submission

or call UnitedHealthcare EDI Support at

800-842-1109 for more information.

See delivery schedule for effective

dates of each region. Region 1: CT, DC,

DE, MA, MD, ME, NC, NH, NJ, PA, RI,

N

VA, VT, WV Region 2: IA, IL, IN, KS,

KY, MI, MN, MO, ND, NE, OH, SD, WI

Region 3: AL, AR, FL, GA, LA, MS, OK,

PR, SC, TN, USVI

N

?2020 UnitedHealthcare Services, Inc.

Page 2 of 3

05/22/2020

Claims Payer List for UnitedHealthcare, Affiliates and Strategic Alliances

Line of Business (LOB)

Vision

UnitedHealthcare Vision

Brand Name / Plan Name or Region

* change or addition to previously published list

Medical Payer ID applies to Professional (CMS-1500) and/or Institutional (UB-04) claims COB = Coordination of Benefits; indicates secondary/COB claims accepted electronically Smart Edits = Apply to electronic claims submissions; Not applicable to DSNP lines of business

Medical Dental Payer ID Payer ID

00773

COB N

Smart Edits

N

Comments

?2020 UnitedHealthcare Services, Inc.

Page 3 of 3

05/22/2020

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