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FAQ - Network

When do I contact UnitedHealthcare versus contacting OptumHealth regarding my claims submissions?

You can determine who is processing your claims by looking at the Plan Summary. Listed on the right hand side of the Plan Summary you will find a section called "Claims Inquiry". This section will indicate if UnitedHealthcare Inc. or OptumHealth is processing your claims.

I can not locate my Plan Summaries. How can I get copies of plan summaries?

You can log into and print out the most recent Plan Summaries or fee schedules that you may be missing.

Who can I contact when I have demographic changes regarding my business? What constitutes a demographic change?

Listed on each Plan Summary on the right hand side is a section called "Provider Status Changes". This will list the mailing address and fax number that you can submit any demographic changes. Typical demographic changes would include the following: address updates, phone number and fax number changes, pay to address changing, etc.

Under what circumstances would I need to recontract with OptumHealth versus submitting an update or change?

The most common reason for needing to recontract with OptumHealth would be either changing employment or starting up your own business. Your OptumHealth contract is tied to the TIN and entity you were contracted with and is not transferable when you leave one employer or begin your own business.

I have questions regarding my reimbursement. Who can I contact?

Questions regarding your fee schedule would need to be addressed to the Network Development staff. You can call (800) 873-4575 and at the prompt say "extension". Press "1", then enter ext. 53413 to leave a message or email your questions to Questions can also be mailed to:

OptumHealth Network Development
PO Box 59329
Minneapolis, MN 55459-9745

I would like to negotiate my fee schedule with OptumHealth due to the unique specialties we offer. Is this something OptumHealth would be willing to consider?

OptumHealth establishes fee schedules that are competitive and take into consideration the various services and subspecialties provided by our network providers. The fee schedules are applied consistently among all providers. However, OptumHealth understands that in rare instances, there may be some PT/OT clinics that focus solely on certain sub-specialties. A review of your fee schedule may be warranted if the majority of your business is focused in the following areas: Lymphedema, Pediatrics, or Certified Hand Therapy. A detailed letter should be put together and emailed to or mailed to OptumHealth Care Solutions, P.O. Box 1459, MN010-W120, Minneapolis, MN 55440-1459. Upon receipt of your documentation, a Contract Manager will review the data to determine if any additional follow-up would be appropriate regarding a provider's fee schedule.

I would like to request additional one on one training regarding the use and benefits of the web site. Who can I contact regarding setting up this additional training?

Please email and indicate any areas of specialized training you would like to receive and the appropriate department will be in-touch.