September 18, 2020
Beginning November 7, 2020, UnitedHealthcare (UHC) will transition the communication of initial claim denials to a consolidated Explanation of Denial statement that outlines all claim denials processed each day.
The new Explanation of Denial statement will replace the individual letters that are currently mailed for each separate claim denial, and instead give a daily line-by-line detail of the service(s) that have been denied and the reason for the denial.
This change—announced in UHC’s August 2020 Network Bulletin—only applies to claims that are denied in full for Medicare Advantage and commercial plans covered by UnitedHealthcare West. There will be no change to the notification process for approved or partially approved claims, which will continue to utilize a Provider Remittance Advice that outlines the charges submitted, benefits paid and member responsibility.
For additional information or questions regarding this change, contact UHC Provider Services at (877) 842-3210.