EDI Transaction Support Form
This form should be used to report EDI related issues only. For UnitedHealthcareOnline.com issues, contact the Help Desk at 866-842-3278.
  EDI Transaction Support Form
Use this form to report suspected problems with electronic submissions through a clearinghouse.

Examples of when to use this form:
  • Provider/Billing Service or Clearinghouse is receiving a rejection message.

  • Provider/Billing Service or Clearinghouse is experiencing formatting problems with the 837.

  • Provider/Billing Service or Clearinghouse checking claim status and claim is not on file.


  • = Required field     = Optional field
      1. Contact Information
      2. Please select the Product that this issue is related to:
      3. Please select the function that the issue is related to:
      4. Please provide a detailed explanation of the issue including the rejection message if available:
      5. Please complete the following information: