June 6: Several documents going paperless

Affects Kentucky and Washington, D.C., Medicaid plans

Starting June 6, 2025, we’ll no longer mail claim letters and virtual card payment (VCP) statements.¹ Instead, you’ll be able to access and submit them 24/7 in the UnitedHealthcare Provider Portal.

In addition, you’ll be required to submit claim reconsiderations and medical pre- and post-service appeals electronically.

These changes affect most² network health care professionals (primary and ancillary) and facilities that provide services to UnitedHealthcare Community Plan (Medicaid) members in Kentucky and Washington, D.C.

If you use an outside vendor, such as a revenue cycle management company, please ensure they’re aware of the following changes and digital workflow options.

How to access your claim letters and VCP statements

1. Document Library in the UnitedHealthcare Provider Portal:
    You can access letters and other documents for up to 24 months in this secure repository. 

• From any page on UHCprovider.com > Sign In
• Enter your One Healthcare ID 
  • Users who don’t have a One Healthcare ID: Visit our portal registration page to get started
• In the portal menu, select Documents & Reporting > Document Library. Then, select the appropriate folder:
  • Claim Letters
  • Payment Documents 

• Notifications: When new documents are available in Document Library, an email notification will be sent to the address on file, which is typically the Primary Access Administrator. However, now they can also give others the ability to edit email notification preferences in the Document Delivery Settings section of the portal. 
• Need to notify multiple staff members? Document Library notifications are limited to 1 email address per letter type. If multiple staff members require notification, the Primary Access Administrator can consider using a group email address.
• There’s no need to wait for a notification. Although we let you know when a new letter is available, we recommend you make it a part of your regular process to check Document Library for new letters and actions needed.
• You can also check out the Profile & Settings Overview for information on updating your email notification preferences

How to submit a pre-service appeal 

Use the Prior Authorization and Notification tool through the UnitedHealthcare Provider Portal:

• From any page on UHCprovider.com, select Sign In at the top-right corner
• Enter your One Healthcare ID
  • New users who don’t have a One Healthcare ID: Visit our portal registration page to get started
• In the menu, select Prior Authorizations
• Scroll down to “View Status of existing submissions, drafts and make updates” and click “Search Existing Submissions & Drafts”
• Find your service reference number (SRN) and expand to see the details
  • If the details show the coverage status as “Not Covered/Not Approved,” you’ll see the “File a Pre-Service Appeal or a Grievance” link
  • You can also click on the SRN to see the original case details, as well as the “File a Pre-Service Appeal or a Grievance” link under the coverage status section
• Once you click the link, a new tab will open that takes you to the instructions page
• You will be guided through the submission process and prompted to upload any supporting documents, review your information and submit
• Use Advanced Filter to search Document Library for your pre-service appeal decision letters

How to submit claim reconsiderations, post-service appeals

Use one of the following options:

    1. UnitedHealthcare Provider Portal:

• From any page on UHCprovider.com > Sign In
  • Enter your One Healthcare ID 
    • Users who don’t have a One Healthcare ID: Visit UHCprovider.com/access to get started
  • In the menu, click Claims & Payments > Look up a Claim to search by the claim number and click Act on Claim