March 11, 2021
Area(s) of Interest: Payor Issues and Reimbursement
The California Medical Association (CMA) has received numerous complaints from physicians regarding the recent loss of payment remittance advice (PRA) access through the UnitedHealthcare (UHC) electronic payment solution, Optum Pay.
As part of changes related to Optum’s rollout of Optum Pay Premium, a new paid subscription version of its free Optum Pay basic service, physicians not subscribing to Optum Pay Premium have reported they are unable to access all PRA information through the basic service. This contradicts information from UHC, which indicated that providers would always retain access to 30 days of claims payment data through the free basic portal.
CMA and other state and specialty societies have expressed concerns to UHC regarding the loss of access to this information. In response to stakeholder feedback, UHC has said it will be modifying the basic service and will provide more information on the changes in the very near future.
In January 2020 Network News, UHC advised that Optum was introducing Optum Pay Premium, a new paid subscription version of its free Optum Pay basic service meant to expand payment functionality and claim detail information for physician practices. The premium service allows access for an unlimited number of assigned users to all payment remittance advices in a PDF format.
However, the premium service comes with a subscription cost of 0.5% per payment ($5 for every $1,000 in payments). UHC had offered all providers a free trial of the new premium version through February 28, 2021, so they could decide whether to opt-in to the premium service or remain with the basic Optum Pay functionality. But providers were assured that they would continue to have access to 30 days of claims payment data through the free basic portal.
UHC on Wednesday, March 10, announced it would be making changes to Optum Pay’s basic functionality to address these concerns. Details on the changes are expected as soon as Friday, March 12. CMA will publish an update as soon as the details are available.
In the meantime, UHC has advised that providers may also obtain payment information through the UHC Document Vault function through the UHC portal. CMA has confirmed with UHC that remittances can be located in Document Vault under the PRA folder by searching under Check ID, Creation Date, TIN, Expiration Date, Provider or Check ID.
For more information regarding Optum Pay, please see the Optum Pay website. For more information regarding UHC’s Document Vault or accessing remittance advice information, see UHC’s resource on obtaining PRAs.