Starting May 1, 2025, UnitedHealthcare Community Plan of Ohio will deny claims received that do not contain a valid NPI of the ordering, referring and prescribing (ORP) health care professional.
If you are billing services involving an ORP health care professional, you must include the National Provider Identifier (NPI) number on your claim. Claims submitted without an NPI number will be denied with a Y42 denial and the following message(s):
If you receive a Y42 denial, please submit a corrected claim based on your UnitedHealthcare Provider Agreement timely filing deadline. If you do not submit a corrected claim on time, we will deny the claim for timely filing.
Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal.
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