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Claims and payments

We have online tools and resources to help you manage your practice’s claim submissions and payments.

 

Need to submit a claim, check status or submit a reconsideration request? Use the Claims and Payments tool found within the UnitedHealthcare Provider Portal.  For more information, visit our Claims, billing and payments page.

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If you are not satisfied with the outcome of a claim reconsideration request, you may submit a formal claim dispute/appeal using the process outlined in your Care Provider Manual.

 

  • A formal claim dispute/appeal is a comprehensive review of the disputed claim(s), and may involve a review of additional administrative or medical records by a clinician or other personnel
  • We generally complete the review within 30 calendar days. However, depending on the nature of the review, a decision may take up to 60 days from the receipt of the claim dispute documentation. We’ll contact you if we believe it will take longer than 30 days to render a decision.
  • Please allow 10 business days from the submission date to enable us to begin processing the review before requesting a status update

 

Additional state requirements may apply. Please consult the applicable state Provider Administrative Guide or Manual for more details or contact the provider services center.

Member dental plan and benefit information can be found at UHCCommunityPlan.com/LA and myuhc.com.

 

Dental benefits for enrollees under age 21 

Dental Benefits for enrollees under the age of 21 may be managed by DentaQuest or Managed Care of North America (MCNA). Both providers are premier dental benefits administrators that provide exceptional service to State Agencies and managed care organizations for Medicaid. For benefits, claims, provider enrollment, direct deposit issues, demographic changes, NPI information, etc., contact: 

  • MCNA: 855-701-6262
  • DentaQuest: 855-229-6848

 

Dental benefits for enrollees over age 21

We provide dental benefits for enrollees over 21 through value-added benefits. Enrollees over age 21 get up to $500 per year for routine dental exams, X-rays and cleanings. For benefits, claims, provider enrollment, direct deposit issues, demographic changes, NPI information, etc., contact:

  • UnitedHealthcare Community Plan: 866-675-1607

 

Additional benefits are available through DentaQuest and MCNA. For detailed information, please refer to the dental plan comparison chart.

There are 2 options available for care providers who are enrolled to receive electronic payments from UnitedHealthcare — Automated Clearing House (ACH)/direct deposit and virtual card payment (VCP). Both options are facilitated by Optum Pay, a full-service payment and remittance solution. You can learn more about these options on our Electronic payment options page.

Using Electronic Data Interchange (EDI) for all eligible UnitedHealthcare transactions can help your organization improve efficiency, reduce costs and increase cash flow. We encourage you to use the following tools and resources to help you get started with electronic transactions.

Fee Schedules are available from the State of Louisiana Department of Health & Hospitals.

 

View the latest fee schedules

Member vision plan and benefit information can be found at UHCCommunityPlan.com/LA and myuhc.com.

 

Vision for members under 21 years of age

March Vision Care is the vision vendor for UnitedHealthcare and provides routine vision services including:

  • Services and exams for vision correction and refraction error
  • Eyewear, contacts if the only means to restore vision

 

For all other vision services, please call UnitedHealthcare Community Plan at 866-675-1607.

 

Vision for members over 21 years of age

March Vision Care is the vision vendor for UnitedHealthcare and provides routine vision services. Additional vision and services will be provided to complement the limited Medicaid vision benefit. Services include:

  • One routine eye exam every 2 years; and 
  • $100 allowance for frames/lenses every 2 years

 

Note: Vision services performed by an optometrist are reimbursable for routine and non-routine services. Claims must be submitted to March Vision Care for processing. This is due to the expanded scope of the services the Louisiana Board of Optometry now allows optometrists to perform in the office setting.

 

March Vision Care contact information

Phone: 844-52-MARCH or 844-526-2724
Online: marchvisioncare.com/providerreferenceguides.aspx

 

Mailing address for March Vision claims:

Claims Processing Center


6701 Center Drive West, Suite 790


Los Angeles, CA 90045

A PRA is generated for every processed claim and includes relevant details about how the claim was processed.