Posted in Insurance, Training, Updates

UHC: Colorado Medicare Advantage Plans (HMO) Administrative Changes

What is the change: Optum Care, an affiliate of UHC will now manage the following services for some UnitedHealthcare Medicare Advantage HMO members in Colorado:

  • Member eligibility verification
  • Prior authorization requests
  • Hospital inpatient notifications
  • Claim submissions

The members that are affected will have a new process for verifying benefits, obtaining prior auths and new PAYER ID, etc. (please see below)

Who is affected: members who chose Optum Care NetworkOptum Colorado Springs or New West Physicians primary care provider (PCP) will be managed by Optum Care:

  • Optum Colorado Springs
  • Optum Care Network Denver (Physician Alliance of the Rockies)
  • Optum Care Network South
  • Optum Care Network North
  • New West Physicians

To verify the benefits: You can verify UnitedHealthcare member eligibility online or by phone: 

To request a prior auth: Prior authorization is required for certain services based on the member’s plan. Request prior authorization at least 14 days before the planned date of elective services in one of the following ways:

To submit claims:

Inpatient Hospital: Call 888-685-8491 to notify Optum Care of hospital admissions within one business day of the admission.

Further questions? : call UHC at  866-574-6088

#UHCmedicareadvantage #coloradouhc #optumcare

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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