What can we do to make the UnitedHealthcare Provider Manuals better for you? Click here to provide feedback.
You don't have time to spare: that's why we put all the documents you need in one place. Use the navigation items on the left to find what you're looking for fast.
HIPAA Claim Edits
UnitedHealthcare applies HIPAA edits to professional (837p) and Institutional (837i) claims submitted electronically. Visit the EDI Claim Edits page for more information including a complete list of edits, edits related to ICD-10 codes and applicable payers. Claims that reject for HIPAA edits will appear on a clearinghouse level report, enabling you to Identify and correct rejected Information prior to UnitedHealthcare receiving the claim.
UnitedHealth Group requires compliance with the requirements of federal and state laws that prohibit the submission of false claims in connection with federal health care programs, including Medicare and Medicaid. Click here (PDF 38.15 KB) to download our policy.