Forms and information to navigate the credentialing process

• Disclosure of ownership and control interest
  Regulatory information requiring facilities and businesses to disclose ownership and control interest prior to payment for any services rendered to Medicare or Medicaid enrollees

• FAQ on Geminiopen_in_new
  

• Joining the UnitedHealthcare Hearing Networkopen_in_new
  Learn how simple and easy it is to join our network and complete the credentialing and recredentialing processes

• Practice and provider demographic change formopen_in_new
  

• Provider credentialing open_in_new
  Understanding the credentialing and re-credentialing processes

• Change of ownership/tax information change formopen_in_new
  Tax ID forms require a minimum of 30 days advanced notice

• Understanding the credentialing process

• Registration portal attestation access applicationopen_in_new
  

• Sonova account applicationopen_in_new
  
  
• Relate^4.0 BTE and Earmold order formopen_in_new

• Relate^4.0 RIC and Custom Ear Piece order formopen_in_new

• Relate^4.0 UP BTE and Earmold order formopen_in_new

• Relate^3.1 Custom order formopen_in_new

• Relate Loss and Damage Claim formopen_in_new
  
  
• UnitedHealthcare Hearing Prescription formopen_in_new
  Complete this form if a referred patient has a health plan that requires a prescription/written recommendation
  
  
• EPIC Hearing Prescription formopen_in_new
  Complete this form if a referred patient has a health plan that requires a prescription/written recommendation
  

• Release of Information form
  • UnitedHealthcare Hearing Release of Information form (English)open_in_new
  • UnitedHealthcare Hearing Release of Information form (Spanish)open_in_new
  • EPIC Hearing Release of Information formopen_in_new

• Virtual Services Consent form
  
  • UnitedHealthcare Hearing Virtual Services Consent form (English)open_in_new
  • UnitedHealthcare Hearing Virtual Services Consent form (Spanish)open_in_new
  • EPIC Hearing Virtual Services Consent form (English)open_in_new
  • EPIC Hearing Virtual Services Consent form (Spanish)open_in_new

• Medical Waiveropen_in_new

Member opt-out waivers 
Follow the proper opt-out procedureopen_in_new to ensure opt-out waivers are used within acceptable parameters.
Select the correct opt-out waiver based on a member’s plan type and submit.

• UnitedHealthcare Hearing Opt-out member waiver formopen_in_new

• EPIC Hearing Opt-out member waiver formopen_in_new

• AARP UnitedHealthcare Opt-out member waiver formopen_in_new

• Authorization processopen_in_new 
  Discover how the UnitedHealthcare Hearing authorization process works

• Get to know our 2025 hearing programsopen_in_new
  Learn about the different programs and how they set you up for success in 2025
  
  
• Get to know UnitedHealthcare Hearingopen_in_new
  Learn more about who we are and how we work together to meet the hearing health needs of patients

• How UnitedHealthcare Hearing is different from UnitedHealthcareopen_in_new
  Better understanding these 2 entities can make caring for patients and running your practice easier
  
  
• In-person care process and member journeyopen_in_new
  Explore the services and process for in-person care

• Provider Portal fact sheetopen_in_new
  Overview of key information and benefits of using the web portal

• UnitedHealthcare Hearing Network Provider quick reference guideopen_in_new

• Acceptable Member Opt-Out Waiver usageopen_in_new
  Learn about the acceptable parameters for submitting a member opt-out waiver

• Electronic Payment Registration Process through PaySpanopen_in_new
  Learn how to register for direct deposit of professional fees from UnitedHealthcare Hearing to reduce costs, speed secondary billings, improve cash flow and reduce paper usage.

• Fee scheduleopen_in_new
  

• Hearing tests and unauthorized billingopen_in_new
  A closer look at hearing test requirements and billing parameters with UnitedHealthcare Hearing

• Lifestyle Selection Toolopen_in_new

• Loss & Damage processopen_in_new 
  Follow this process to help patients manage Loss & Damage claims

• Pediatric programopen_in_new
  Meeting the unique needs of the pediatric population

• Provider practice attestation user guideopen_in_new
  Use this guide to help complete your attestation every 90 days within the UnitedHealthcare Hearing Provider Portal

• Receiving more referrals from UnitedHealthcare Hearingopen_in_new

• Recommended provider status dispute formopen_in_new
  
  
• Regional representatives contact informationopen_in_new

• Trial period, returns and exchangesopen_in_new
  Learn about trial periods and how to process a hearing aid return or exchange

• Warranty and repairopen_in_new
  Understanding hearing aid warranties and repair details
  
  
• When ordered hearing aids are never fitopen_in_new
  What to do if you are unable to schedule a member’s fitting appointment for hearing aid devices that have been ordered

• Relate® hearing aids product and software introductionopen_in_new
  Get trained on Relate^4.0 hearing aids and new fitting software

• Office of Inspector General exclusion database search quick reference guideopen_in_new


• Provider Portal trainingopen_in_new
  Explore this self-paced training course to learn how to navigate the provider portal effectively
  
  
• UnitedHealthcare Hearing – Fraud, Waste and Abuse (FWA) and general compliance training moduleopen_in_new
  Explore this educational course designed to inform providers about our FWA and compliance programs