January 01, 2024

Locate your claim payment data with more ease

We’re pleased to announce a couple changes to the claim payment reconciliation process that will help improve your claims payment experience.

1. Locate payment-related data more quickly
Organizations that receive claim payments electronically through Automated Clearing House (ACH)/direct deposit will notice that all ACH claim payment documents now have the same payment number. This change helps ensure that the payment number listed on the provider remittance advice (PRAs) is consistent with the payment number on the following:

835 files
Electronic provider remittance advice (EPRAs)
ACH addenda records

This means you’ll now be able to easily find the payment-related data you need in both the UnitedHealthcare Provider Portal Document Library and Optum Pay™ Portalopen_in_new.

2. Streamline the reconciliation process
We’ll create separate 835 files and PRAs for payments and non-payments (e.g., denials and zero-dollar payments) for most UnitedHealthcare commercial plans.

This update helps you identify a payment file vs. non-payment file. These dedicated file types make it easier to:

Match transactions efficiently: You can focus on matching payments to claims in one file and identifying discrepancies or non-payments in another
Track the payment history: You can easily view data to see which files are payments vs. non-payments
Automate processing: Distinct data allows you to add rules and tailor specification requirements for handling non-payments
Reduce errors: Separate files minimize the risk of errors when completing reconciliation tasks for denials and claims that have an overpayment recovery applied