How do I check claim status on UHCdental.com?
After signing in to UHCdental.com, you’ll be brought to the Dashboard page where you’ll find a summary of claims submitted within the past 30 days. Click “More” to find older claims. You can also search for claims by date or member information.
How far back can I check a claim?
You can review claims history up to 2 years from the current date.
Can I view a claim if the patient was seen by a provider not affiliated with my office?
We cannot show claims that were not paid to your office due to privacy restrictions. To determine a member’s out-of-pocket costs, you can check if a service was previously rendered. First, verify the member’s eligibility on the Eligibility Search page. You can find it under Search in the navigational bar. Next, go to the Benefit Details page to view the benefit breakdown.
What is the UnitedHealthcare Payer ID?
The Payer ID for UnitedHealthcare commercial plans is 52133. If your patient is a Medicaid member, the Payer ID will be different. Contact our Provider Services team at 800-822-5353 for more information.
Can I submit claims online?
Yes. You may submit all claims for commercial and Medicare Advantage plans online at UHCdental.com. After signing in, go to:
You can also go to Claim Information on the pre-sign in page and use the Dental Claim tool. Note, the system will not pre-populate the fields with member information using this tool.
Do claims go through a dental review process?
Yes. Depending on the services performed, a dental consultant will be selected from a team of dentists to review the claim. The consultant will base all decisions on criteria specific to the American Dental Association (ADA) code. Go to the UnitedHealthcare Dental Utilization Review Guideline for more information about the criteria.
What is the turnaround time for processing claims?
Claims that are submitted with all the necessary information will be processed in 30 days. Please review our guidelines for claims attachments to assist in timely payment of claims.
How do I submit pre-treatment estimates (PTEs) for review?
You can submit PTEs, or prior authorizations, electronically on UHCdental.com or by paper.
Additional information may be required.
I submitted a claim for services rendered and received a letter stating my patient has not paid the premium for their health plan. How will the claim be processed?
If the patient is an Essential Health Benefit (EHB) member (i.e., they purchased the plan through Marketplace) and is not current on their premium payment, we may hold the claim. We’ll notify you of this by mail when the claim is submitted. If the premium is not paid after a 90-day grace period, we will deny the claim. At that point, the member is fully responsible for the services rendered.
When should I submit a corrected claim?
A corrected claim should be submitted if the original services paid based on the following examples of incorrect information:
How do I submit a corrected claim?
A corrected claim should only be submitted when an original claim or service was paid based upon certain incorrect information. A corrected claim must be submitted to initiate an adjustment of the original claim. Depending on what information needs to be changed, the corrected claim may result in a recovery being generated.
Corrected claims must include the following:
Mail the corrected claim form with any required documents (i.e., x-rays, narrative, etc.) to:
UnitedHealthcare Claims
P.O. Box 30567
Salt Lake City, UT 84130
Which states require disclosure of prior authorization statistics for pre-service review?
Only Arkansas requires prior authorization reporting. The following links comply with the state’s regulatory requirement, which mandates disclosure of information for services that require pre-service review.
Does UnitedHealthcare have a specialty referral process for DHMO and DC plans?
Yes. Many DHMO and DC plans have a specialty referral process. The process may differ depending on the plan. Please contact our Provider Services team at 800-822-5353 for more information.
How can I submit supporting X-rays online?
You can upload supporting documents online to DentalXChange, Tesia and FastAttach from NEA, powered by Vyne.
Can I enroll for direct deposit?
Yes. You can enroll your organization for direct deposit of claim payments. To learn about electronic payment solutions, review our Electronic payment enrollment webpage. To enroll in free ACH, visit UHCdental.epayment.center/register or call 855-774-4392. For other electronic payment options, such as Virtual Credit Card or ACH+, contact Zelis at 877-828-8770.
What is the difference between fee schedule and the Treatment Plan Cost Calculator?
The fee schedule page on UHCdental.com shows the current fee schedule in real time. The Treatment Plan Cost Calculator shows the pricing of the claim as of the member’s date of service.
Can I view a previous fee schedule?
No. You are unable to view inactive fee schedules.
Do you support coordination of benefits (COB)? What is the process?
Yes. We follow this process for COB claims:
When are claims subject to COB?
Claims are subject to COB when we are notified that other insurance exists. If we are the secondary insurance carrier, previously paid amounts are applied against the allowable amount.
Do you administer COB according to the birthday rule?
Yes. We apply the birthday rule when administering COB for dependents covered under multiple plans. If both parties have the same birthday, we determine which plan has covered the patients longer.