As of January 1st, 2018 UnitedHealthcare Community Plan will no longer provide Medicaid and Long Term Care coverage in Delaware. For questions about 2018 services, members can call their new Health Plan Member Service’s phone number, it is on their ID card. If members have questions related to any services prior to January 1, 2018, members can call United Healthcare Community Plan member services at 1-877-877-8159.
This change doesn’t affect UnitedHealthcare Medicare, including Institutional Special Needs Plan (I-SNP) and Dual Complete Plan (DSNP) or UnitedHealthcare Commercial Plan members.
Healthcare Providers can continue to call Provider Services at 1-800-600-9007. For questions regarding behavioral health, please call 1-877-614-0484. For questions regarding Dental, please call 1-855-609-5152.
- Provider Information
- Behavioral Health Resources
- Claim Reconsideration and Appeals
- Claims and Member Information
- Clinical Practice Guidelines
- Cultural Competency Library
- Dual Complete (HMO SNP) Program
- Electronic Data Interchange (EDI)
- Medicare Part D Educational Materials
- Pharmacy Program
- Reimbursement Policy
Electronic Data Interchange (EDI)
EDI Support Services
EDI Support Services provides support for all electronic transactions involving claims and electronic remittances.
Electronic Payments & Statements (EPS)
EPS is our solution for electronic remittance advice (ERA) and electronic funds transfer (EFT). EPS allows you to access your explanation of benefits (EOBs) online and receive direct deposit of claim payments into your checking or savings account.
Faster payments, better cash flow
Eliminate mail delivery and check-clearing time to receive your payments 5 to 7 days faster.
Less work, more time
No more envelopes to open, paper checks to track or trips to the bank. More than 850,000 physicians, health care professionals, facilities and billing companies use EPS today for its easier reconciliation experience, reduced paperwork and the greater efficiency it brings to administration.
Use the link below to learn more, or call 866-842-3278, option 5.
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.