Read UHCEX550780_Oxford_eSolutions092611.pdf text version

UnitedHealthcare's Electronic Solutions for Oxford Products

Quick Reference Overview

Providing you options

UnitedHealthcare strives to make it easy for physicians and other health care professionals to do business with us. We offer a variety of electronic delivery options that provide you with timely information, help streamline your practice workflows and potentially save you time and money. This document provides an overview of electronic transaction options for Oxford products, including free, low-cost and multi-payer options. submit and receive transactions free of charge. Online data entry is also available. To learn more, visit, call (860) 257-2030, email [email protected] or attend a free training seminar (refer to the training seminars section of this document).

Post-n-Track® is a multi-payer solution that allows you to

CareTracker PM is a Web-based practice management

Electronic Data Interchange (EDI)

EDI is an advanced form of electronic business-to-business communication that links your computer system with UnitedHealthcare/Oxford as well as other health plans and government payers. Patient information is transferred between physicians and payers securely and efficiently in a standardized format. With EDI you can: · heckpatienteligibilityandbenefits c · ubmitandcheckreferrals,authorizationsand s notifications · submitclaimsandcheckclaimstatus Both participating and non-participating physician/ facility claims are accepted electronically. For more information about submitting claims through EDI, go to > Providers or Facilities > Tools & Resources > Manage Your Practice > Administrative Ease > Electronic Data Interchange (EDI). Scroll down to EDI Claim Submission Guidelines. UnitedHealthcare works with multiple clearinghouses to support EDI exchanges. UnitedHealthcare's preferred clearinghouse is OptumInsightTM (previously Ingenix®), a UnitedHealth Group company, but you can use any clearinghouse you choose.

system that automates transactions such as eligibility, claim status and claims submission to 1,000 national payers. To learn more, visit, call 1-800-347-0845, email [email protected] or attend a free training seminar (refer to the training seminars section of this document).

What's available on


· · · · · · · · Patienteligibilityandbenefits Claimstatus Precertificationrequiredinquiry Referralandprecertificationstatusandsubmission

Tools & Resources

Policiesandprotocols Administrativeguides Pharmacyandlaboratoryresources C rosswalkofHealthInsurancePortabilityand AccountabilityAct(HIPAA)claimadjustment/ remark codes · ormsincluding:ParticipatingProviderClaimReview F Request,DemographicUpdates,ClaimResearchProjects

Clinician Resources

OptumInsight offers a secure, easy-to-use path to almost every commercial and government payer. For more information, visit or call 1-888-445-8745.

· linicalprogramsinasthma,heartdisease,depression, C diabetes and rare chronic care · Patientsafetyandhealthquestionnaire · Geriatricresources is there when you need it is available during normal business hours. To minimize inconvenience, regular maintenance is scheduled during off-peak times and the website may not be available: · uesdaythroughFriday:2a.m.to3a.m.ET T · eekends:1p.m.Saturdayto6a.m.MondayET W

Need Assistance?

· uickReferenceGuidesareavailableat Q > Providers or Facilities > Tools & Resources > Manage Your Practice > Administrative Ease > Quick Reference. · allourWebHelpDeskat1-800-811-0881 C to speak with a knowledgeable representative from 8 a.m. to 6 p.m. ET. You can also send a detailedemailthroughtheContactOxfordlinkon

How to get started on

· hysiciansandotherhealthcareprofessionalscan P immediately access the site by clicking "Providers" ontheleftnavigationbarandthenon"NeedtoRegister?" TaxIdentificationNumber(TIN)anddateofbirth arerequired. · acilitiesshouldcallourWebHelpDeskat F 1-800-811-0881, to obtain login information.

Electronic Solutions Support Team

Oxford Express® (1-800-666-1353)

This automated system allows you to use your phone to check eligibility,claims,precertificationrequestsandreferrals. ReferralscanalsobesubmittedthroughOxfordExpress.

We have a dedicated team of professionals with an in-depth understanding of EDI available to assist you MondaythroughFriday8:30a.m.to5p.m.ET.If youhavequestions,issuesorjustwanttoexplorethe benefitsofEDI,pleasecall1-800-599-4EDI(4334).

Electronic Explanations of Benefits (EOBs) and direct deposit

OnceenrolledinPNCRemittanceAdvantage,yourclaim payments will be deposited into the bank accounts you designate. EOBs can be viewed or printed from a secure onlinearchive.Youcanalsodownload835filesorreceive them through your clearinghouse for auto-posting. To get started,callPNCat1-877-597-5489,option1,orreferto the training seminars section of this document.

Training seminars

We regularly offer live instructor-led webcast training seminars to help you get started. Go to > Providers or Facilities > Tools & Resources > Manage Your Practice > Administrative Ease > Electronic Solutions Training Schedule for more information and to register.

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© 201 United HealthCare Services, Inc. 1 UHCEX550780-000


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