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Claim Reconsideration Request

A Claim Reconsideration Request is typically the quickest way to address any concern you have with how we processed your claim. With a Claim Reconsideration Request, we review whether a claim was paid correctly, including if your provider information and/or contract are set up incorrectly in our system, which could result in the original claim being denied or reduced.

There are several ways to submit a Claim Reconsideration Request.

1. Electronic Claim Reconsideration Request on Optum Cloud Dashboard (preferred method). By using this method, you can:

  • Submit requests with or without attachments
  • Reduce the overall turnaround time for the request.
  • Receive immediate confirmation and a unique tracking number to show we received your request.
  • Check submission status throughout the process.

To register for access to the Optum Cloud Dashboard, see the Administrator Registration and Importing Users Quick Reference Guide.

Additional information on Optum Cloud Dashboard can be found here.

2. Electronic Claim Reconsiderations without attachments on UnitedHealthcareOnline.com.
By using this method you can:

  • Reduce the overall turnaround time for the request.
  • Receive immediate confirmation and a unique tracking number to show we received your request.

To learn more about submitting claim reconsiderations without attachments, please refer to the Claim Reconsideration Quick Reference Guide.

3. To mail in paper Claim Reconsideration requests, complete the "Claim Reconsideration  form" located in the Tools & Resources section below.

Where to send Claim Reconsideration Requests:

  • For UnitedHealthcare and UnitedHealthcare West, if your Claim Reconsideration Request is for a Commercial or Medicare member, send the paper Claim Reconsideration Requests to one of the following:

-The address on the Explanation of Benefits (EOB) or the Provider Remittance Advice (PRA)
-The claim address on the back of the member's ID card

  • For UnitedHealthcare Empire Plan, send to:  
    P.O. Box 1600
    Kingston, NY 12402-1600
  • For UnitedHealthcare Community Plan, if your Claim Reconsideration Request is for a Medicaid/Chip member, go to: 
    UnitedHealthcare Community Plan Claim Reconsideration Mailing Addresses

 

  Tools & Resources