Paperless updates for Michigan Medicaid

Effective June 2, 2023, we will no longer mail a number of key medical claim-related letters and documents for most¹ UnitedHealthcare Community Plan (Medicaid) plans in Michigan. Instead, network medical health care professionals and facilities will be able to view these letters 24/7 through several digital options:

Please share these changes and new digital workflow options with those who are affected, including outside vendors such as revenue cycle management companies.

Details on the portal digital options

To access the UnitedHealthcare Provider Portal, look for the Sign In button at the top right of any page on UHCprovider.com. Then, sign in with your One Healthcare ID and password. If you don’t have a One Healthcare ID, visit UHCprovider.com/access to get started.

1. Document Library 
   You can access letters, PRAs and other items for up to 24 months in this secure repository. When new letters are available in Document Library, an email notification is sent to alert you.

• In the portal menu, select Documents & Reporting > Document Library. Then select one of the following folders: 
  • Prior Auth 
  • Payment Documents
  • Overpayment Documents – Use Advanced Search and search by Check ID or Claim No. 
  • Appeals and Disputes – Use Advanced Search and search by Member Name, Member ID, or Case ID
• Use Advanced Search to search documents for any 90-day period up to 2 years 
• Need to change who receives the email notifications? When new letters are available in Document Library, an email notification is sent to the address on file, which is typically your organization’s Primary Access Administrator. The Profile & Settings Interactive Guide outlines how to update notification preferences. Document Library notifications are limited to 1 email address per letter type. If multiple staff members require notification, consider using a group email address.

2. TrackIt
   Found on the portal home page, TrackIt notifies you of prior authorization requests, claim status and other items that need attention. It also provides a direct link to view prior authorization decision and appeal letters quickly. If you use tools on our secure portal for claims and prior authorizations, you already have access to those items in TrackIt. Review the TrackIt Interactive Guide for more information.

3. Direct Connect 
   You can enroll in this free tool to review and resolve overpaid claims quickly and easily. Using Direct Connect reduces letters and calls from UnitedHealthcare and additional work with third-party vendors. To learn more and enroll, email directconnectaccess@optum.com. Please include the requestor’s name, as well as the organization’s tax ID number (TIN), physical address and mailing address.

Information on EDI, API and Optum Pay

• Electronic data interchange (EDI)
  Set up electronic remittance advice (ERA) 835 transactions using electronic data interchange (EDI) to receive your PRAs electronically. An additional benefit is the capability to auto-post payments into your practice management or hospital information system. Contact your clearinghouse to start the process. Note: ERA/835 setup takes about 30 days from when we receive the request.

• Application Programming Interface (API)
  API is a fully electronic digital solution that allows you to automate administrative transactions. This option is best for organizations that have the technical resources to program API or the ability to outsource implementation.

• To get started, go to API Marketplace and sign in to the marketplace with your One Healthcare ID and password
• On the Welcome screen, click the Start Registration Request button
• Select your organization type and click Register
• Enter the TIN, click Next, then follow the prompts for registration to schedule a meeting with an API Consultant
• Please allow 2 business days for an API Consultant to contact you

• Optum Pay: For payments facilitated by Optum Pay™, you can reconcile remittance data with basic portal or premium portal access. Visit UHCprovider.com/optumpay for details.
  

Questions?

Please contact UnitedHealthcare Provider Services at 877-842-3210, TTY/RTT 711, 7 a.m.–5 p.m. CT, Monday–Friday.

¹Letters will continue to be mailed to Behavioral Health professionals and facilities, and for Home and Community Based Services.

²These changes include the following overpayment letters:

Overpayment identified – Notifying you that UnitedHealthcare paid too much on a processed claim

Overpayment reconsideration requests – Acknowledging UnitedHealthcare received your request to review our overpayment determination

Overpayment reconsideration decision – Providing the outcome of the reconsideration review and outlining what happens next

This change includes letters sent by Optum for payment accuracy reviews they perform on behalf of UnitedHealthcare. It does not include overpayment letters sent by any other vendor. Those letters will continue to be mailed. Most will include both the vendor and UnitedHealthcare logos, and explain their review was done on our behalf.³The change does not impact the payment method for subscribers enrolled in Optum Pay™. You will continue to receive an electronic remittance advice (ERA)/835, but the paper PRA will no longer be mailed.

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