Provider Electronic Payment Options
Choose how you want to be paid
You have 2 options for receiving payments from UnitedHealthcare. Both are facilitated by Optum Pay, a full-service payment and remittance solution used by all sizes and types of health care organizations. Both payment options integrate with financial management systems, which can help reduce the time spent on administrative tasks related to posting and reconciling payments.
Automated Clearing House (ACH)/Direct deposit
Also referred to as electronic funds transfer (EFT).
- Claim payments are deposited directly into your bank account(s)
- Payments can be routed by taxpayer identification number (TIN), payer and National Provider Identifier (NPI) number
- There’s no charge for the deposit
Virtual card payment (VCP)
VCPs are processed as a credit transaction through the same terminal used for patient copays.
- A virtual card is issued for each new claim payment
- Bank account information is not required
- Transactions are subject to the vendor’s terms, conditions and fees
- The VCP statement shows how to process the transaction
Paper checks
To help speed up payments to your practice, we’re transitioning from paper checks to electronic payments when allowed by state and federal law. We’ll notify you in advance so you can select your preferred electronic payment option.
- Automated Clearing House (ACH)/Direct deposit
- Virtual card payment (VCP)
Choose how you want to review payment information
There are 3 ways to review your provider remittance advice (PRA) and other payment documents. Choose the one that works best for your practice or facility.
| 1. Document Library |
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Health care professionals and facilities can access Document Library in the UnitedHealthcare Provider Portal for one-off requests and day-to-day payment reconciliation.
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| 2. Electronic Data Interchange (EDI) |
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Electronic Remittance Advice (ERA)/835 EDI transactions can be set up to receive PRAs electronically for ACH and VCPs.
Contact your clearinghouse to request direct delivery of your UnitedHealthcare 835 files. Once we receive the request for 835s from your clearinghouse/EDI vendor, it takes about 30 days to set up delivery of the ERA/835. |
| 3. Optum Pay | |
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| Basic portal | Premium portal |
Enables easy access to core payment data at no cost to those enrolled in ACH through Optum Pay.
This option may be best for organizations that receive all 835 files from a clearinghouse and routinely auto-post claim payments. |
Provides enhanced functionality, robust search tools and extended historical data. Available for 0.5% fee per ACH payment.
This option may be best for organizations that work with a third-party billing service or have significant claim volume. |
Frequently asked questions
Have the following information on hand to start the enrollment process for EFT/ACH or VCP:
- Organization name, mailing information and TIN
- Contact information for your designated Optum Pay contacts
- Your organization’s federal W-9 form
- For the EFT/ACH option:
- Banking information
- A voided check or bank letter for each account where payments will be deposited
Once you’ve gathered the necessary information on your organization, take the next steps to enroll in VCP or EFT/ACH. If your practice or health care organization already receives VCPs or is enrolled in ACH/direct deposit, there is no action you need to take.
How long will it take to process my application for ACH/direct deposit/EFT?
The standard processing time takes about 10 business days. However, it may take longer if Optum Pay has questions or issues with the submitted documentation. If that happens, Optum Pay will email the health care professional for information. The application will be pended until the health care professional responds.
How can I track ACH/direct deposit/EFT payments?
As payments and remittances are processed, you’ll receive an email notification with a link to Optum Pay. Sign in to Optum Pay and click on View Payments to review all claims and remittance information.
Do I use a different ID to sign in to Optum Pay from what I use to sign in to the UnitedHealthcare Provider Portal on UHCprovider.com?
No. Once you’re enrolled in Optum Pay, you can use your One Healthcare ID to sign in to UHCprovider.com and Optum Pay.
Are there any fees for using Optum Pay services?
It depends on which Optum Pay option you choose, basic or premium access:
- Basic: Available at no cost to health care professionals and facilities who enroll in ACH/direct deposit/EFT
- Premium: Fee is 0.5% per ACH/direct deposit/EFT
Is our practice required to sign up for ACH/direct deposit?
No. If you don’t sign up for ACH/direct deposit, you’ll continue to receive VCPs for services rendered. You can change your enrollment at any time to receive ACH/direct deposit payments. Note: VCPs already in process cannot be changed to ACH-direct deposit. Certain exemptions may apply.
I signed up for ACH/direct deposit. Why am I still receiving VCPs for UnitedHealthcare claim payments?
If you receive a VCP before activating an ACH direct deposit, you can either:
- Wait for the VCP to expire and we’ll send a paper check to the address on file
- Call the number on the virtual card statement and request a paper check
Is a VCP like a gift card or pre-loaded debit card?
No. Do not use the VCP number to pay for purchases. Use the 16-digit credit card number on your point-of-sale (POS) terminal as payment for services rendered to members.
What are the benefits of receiving a VCP?
- Members aren’t required to share their bank account information
- You can view VCPs electronically in Document Library
- You can process VCPs using your existing POS terminal
- You don’t need to wait for the delivery of physical checks
Are VCP limited to health care payments?
Yes. Each VCP is given a merchant category code specific to health care services or products. This prevents unauthorized POS redemptions for products that are not related to health care.
Does the VCP program apply to self-funded Administrative Services Only (ASO) clients? Can they opt out of the program?
Yes. Self-funded ASO plans are set up to receive claim reimbursements through the VCP program. If they choose to opt out, they will receive paper checks.
How will our practice receive VCPs if we use a lockbox?
Confirm with your lockbox service that VCPs are delivered electronically in the UnitedHealthcare Provider Portal and available for processing.
Are there fees associated with VCPs?
Each VCP is issued for the full amount of the claim payment. Merchant card processing fees may apply to VCPs. Contact your merchant processor or financial institution for information on specific terms, conditions and costs.
Do virtual cards expire?
Yes. The expiration date displays in the MM/YY format on the VCP statement. Unredeemed VCPs expire on the last day of that month. A paper check will be sent for the payment. Allow approximately 1–2 weeks.
What should I do if I enrolled in ACH/direct deposit but am not receiving payments?
If you’re not receiving direct deposit payments, you may need to reactivate your account. Please call the Optum Call Center at 877-620-6194 between 7 a.m. and 6 p.m. CT, Monday–Friday.
Will I receive the full payment amount on my virtual card?
Yes. VCPs are issued for the full claim payment amounts, just as checks, ACH/direct deposits and EFT transactions.
Should I process this payment as a credit or debit transaction?
Process VCPs as credit transactions. If you select debit, the transaction will decline.
Can I use Square or a non-traditional POS terminal to process VCPs?
Yes. Any device that is registered to your business and can process Mastercard payments can process a VCP.
What is my trans ID number?
The trans ID number is a mix of numbers and letters that identifies the specific payment transaction. It’s shown on your VCP below Payment Amount and to the left of the Mastercard logo.
Who do I contact if I need help or can’t process a VCP?
Call the number provided on the virtual card statement.
Why was my VCP declined?
VCPs may decline for several reasons, including the following:
- The amount entered doesn’t match the amount issued. Enter the exact amount of the payment displayed on the virtual card statement.
- The payment has expired. If your VCP expired, it will be automatically changed to a paper check and mailed to the address on file.
- An incorrect virtual card number was entered to redeem the payment. Double-check the payment information on the statement. A unique, single-use 16-digit virtual card number is issued for each payment.
- The POS was used to redeem the payment is not classified as a health care terminal. Each VCP is coded with a merchant category code specific to health care. This prevents unauthorized redemption by non-health care POS terminals. To classify a terminal for health care redemption, contact the merchant card processor. Enter the payer address and/or ZIP code located on the virtual card statement for billing purposes.
How do I process VCP underpayments and overpayments?
Process the payment for the exact amount displayed on the virtual card statement. If the payment issued is less than what is owed, follow standard appeal processes with the payer for the additional amount due. For overpayments, contact UnitedHealthcare for instructions. A VCP is considered an electronic payment and is treated the same as an ACH/direct deposit for overpay/underpay scenarios.
Can UnitedHealthcare take money out of my bank account for an overpayment of claims?
No. Optum Pay will notify health care professionals of any changes or corrections to claims payments. UnitedHealthcare does not use Optum Pay to make claims adjustments. Please refer to Optum Pay Terms and Conditions for full details.
How do I issue a credit back to UnitedHealthcare for overpayment?
Do not use the virtual card to issue a credit. Instead, process the payment for the exact amount displayed on the virtual card statement and contact us for instructions on how to refund the overpayment.
Where do I return the virtual card if the payment is not for my practice?
Do not return the virtual card to us. Call the number on the bottom of the virtual card statement to correct your practice’s demographic information, then destroy the incorrect virtual card.
What should I do if a virtual card is lost or misplaced?
Sign in to Document Library and search by payment number to view your virtual card statement and payment documents.If you’re not already registered to use our self-service tools, go to UHCprovider.com/access. If you need help accessing Document Library, start a chat at UHCprovider.com/contactus.
Can I split a VCP to reconcile different accounts?
No. Claim payments cannot be split. You must process the VCP as 1 transaction for the specific claim.
Important notice regarding transition to electronic payments
To speed up payments to your practice, UnitedHealthcare is transitioning from paper checks to electronic payments when possible. Notifications are sent ahead of the transition to allow you time to select the electronic payment option you prefer:
- Automated Clearing House (ACH)/Direct deposit
- Virtual card payment
Can providers opt to receive paper checks for payments?
The following types of health care professionals and facilities may request an exemption from the electronic payment requirement and receive paper checks:
- Home- and community-based health care professionals
- Fire departments
- Non-emergency medical transport companies/vendors
- Rural health care clinics
- Native American health care facilities or tribal organizations
- Federally Qualified Health Clinics
- Oral surgeons contracted with UnitedHealthcare Community Plan
- Optum Behavioral Health (OBH) providers
Health care professionals and facilities that meet one of these criteria and want to request an exemption can refer to their virtual card statement for instructions.
In unique situations, UnitedHealthcare may pay health care professionals by paper check. Refer to the state exclusion criteria at the bottom of the virtual card statement for information.
What if the listed exemption categories aren’t applicable to my provider status and I prefer not to receive VCPs?
You can choose to receive claim payments by ACH/direct deposit/EFT instead of VCP. This alternative is also a safe, secure and fast way to get paid.
Why are some of my payments coming by paper check?
Paper checks may be sent for certain claim payments when VCP is not an option. If you prefer not to receive payments by check, enroll in ACH/direct deposit/EFT for a consistent payment experience.
- Processing your virtual card indicates your consent to receive and accept VCPs as payment in full
- Unspent virtual card funds are subject to state unclaimed property laws
- OptumHealth Financial Services, a UnitedHealthcare-affiliated company, provides payment services to the health care industry and offers various claim payment options. UnitedHealthcare-affiliated companies may receive transaction fees or other compensation related to some payment options.
- The VCP program is not available in the state of Kansas. KanCare providers must be enrolled in ACH/direct deposit or accept paper checks.
*Optum Pay is available for UnitedHealthcare commercial, UnitedHealthcare Medicare Solutions, UnitedHealthcare Oxford and UnitedHealthcare Community Plan.
Out-of-network health care professionals in Florida, New Mexico, New York and Oregon, as well as all network and out-of-network Utah, Vermont, Colorado, Georgia and New Jersey medical health care professionals and Indiana dental professionals, must consent to receive a virtual card payment. The processing of the virtual card is your consent to receive and accept virtual card payments. If you don’t consent, when you receive a virtual card, please call the number provided on your virtual card payment to arrange an alternative payment method.
Optum Pay® is provided by Optum Financial and its subsidiary Optum Bank®, Inc., Member FDIC.