Accuracy and efficiency in the claims payment and premium billing processes is an opportunity for providers to advance their goals. Through member compliance, UnitedHealthcare can strive for even greater goals that improve user experience.
How this will impact members
Our Group Policies and Group Enrollment Agreements ("GroupContract") specify the time frame required to submit member level eligibility changes. Among these include additions, terminations, reinstatements and other changes, however, they are not always received in time. Changes to the group's eligible employees and the employees' dependents must be received by us according to the time frame indicated in the group's contract.
Timely changes will help ensure that systems reflect accurate information at the time of claim payment and premium billing. This will reduce the potential for adjusting and reprocessing claims, as well as the need for employers, employees, and physicians to contact our service teams for these types of issues. Ultimately, this helps make the health care system more efficient for all. After open enrollment or enrollment changes, please ensure that clients review their invoices and enrollments census or forms to ensure no one was left off our added in error. From there, members have sixty days to retro back to the effective date.
This policy will be strictly enforcedandapplies to all UnitedHealthcare fully-insured commercial group customers unless prohibited by state law or Consolidated Omnibus Budget Reconciliation Act (COBRA).
Providing a timely notice
Please ensure that UnitedHealthcare customers review each monthly invoice upon receipt and that member level eligibility changes are submitted promptly, according to thetime frame specified in the Group Contract. It is imperative that customers understand this policy.
Employers can submit member level eligibility changes through their respective employer portal (uhc.com, uhcwest.com, mynhp.com,) website. They may also contact the broker and employer hotline at 1-888-842-4571 firstname.lastname@example.org or their dedicated client service manager.
Member efforts are appreciated and greatly support this policy. Please contact a UnitedHealthcare Sales representative with any questions.