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Customer Service


Out-of-Area Coverage


Use of Health Care Services

Customer Service FAQs

How can I reach Customer Service?
You have a number of options to have your questions answered. You can call the Customer Service number on the back of your UnitedHealthcare ID card between the hours of 8 a.m. and 5 p.m. Monday to Friday. For TTY/TDD hearing impaired, use your TTY machine and call 711. You will need to provide the 800 number listed on the back of your insurance card.

Benefit information is available through the automated Customer Service line 24 hours a day, 7 days a week. After calling the Customer Service number on the back of your ID card, you can access:

  • Dates of eligibility for yourself or a family member
  • Your plan name (such as Heritage Choice, Heritage Select, or AmeriChoice  hawk-i)
  • Medical and pharmacy copayments, coinsurance, and status regarding deductible and out-of-pocket maximum amounts (if applicable)
  • Coordination of benefits information, if you have other health coverage

After each prompt, you must enter the date of service and date of birth of the member you are inquiring about. You can also order ID cards using this automated system. As always, you have the option of speaking to a Customer Service Representative during regular business hours or you can leave a voice mail after hours for a representative to return your call the next business day.

You can also e-mail us by using the Contact Us page of our website.

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How do I use Member e-Services?
Member e-Services allows eligible members (18 years of age and older) to:

  • View your claims status
  • View your Explanation of Benefits
  • View eligibility and benefits
  • Order ID cards
  • View Subscriber Agreement or Certificate of Coverage (for members of insured plans only)
  • Change address, phone number, and primary care physician (if applicable under the member’s benefit plan)

Members of insured benefit plans will not receive paper copies of their Subscriber Agreement or Certificate of Coverage after a renewal or effective date. Members will receive a letter outlining how to access e-Services and explaining how they can request a Subscriber Agreement or Certificate of Coverage.

In addition to being able to view your Explanation of Benefits (EOBs) online, you can subscribe to receive EOBs online. If you subscribe, UnitedHealthcare will no longer send paper EOBs to you. By subscribing to this service, you will receive an e-mail notification when new EOBs become available with a link to access each specific EOB. This service will also allow you to browse and/or search your past EOBs.

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What if I lost my ID card and don’t have the Customer Service number?
View our phone listings on our Contact Us page to see what customer service number you should call. You can order an ID card by calling Customer Service or logging in to Member e-Services.

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How do I order additional ID cards for family members?
You can order additional ID cards by dialing the Customer Service number on the back of your ID card and selecting the ID card option. We have an easy-to-use self-service system for the quick processing of your request. During normal business hours, a Customer Service Representative can assist you if you have any questions. You can also request ID cards using Member e-Services on the UnitedHealthcare Web site. You will receive two additional ID cards for each order.

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What if I have special language needs?
If English is not your primary language, we can assist you or family members with questions about your health benefits. To find out about our translation services, please call your local Customer Service number. Spanish-speaking members will be offered the option of speaking with one of our bilingual representatives. Members needing help in other languages should indicate the specific language needed.

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How do I find out if a provider is in-network for my plan?
You can access our online provider directory or contact Customer Service at the toll-free number on the back of your ID card.

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Why am I responsible for a portion of my lab charges?
Depending on your benefit plan, you may be financially responsible for a portion of provider fees, such as a deductible or coinsurance requirement.

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Why does my Explanation of Benefits (EOB) say I owe a copayment when I paid at the doctor?
Your EOB is not a bill, but will always reflect the amount you owe to the provider for that service. Many providers require you to pay copayments and any applicable coinsurance and deductibles at the time you receive the services. Any amounts owed will be billed by the provider. 

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Does UnitedHealthcare offer individual coverage?
For individual coverage, call Golden Rule, a UnitedHealthcare company, at 1-866-304-9899 or complete their online form.

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What do I need to do to change my provider?
You can view the most current, up-to-date list of network providers on our online Provider Directory. If you have any questions regarding whether a provider is accepting new patients, you should contact the provider's office.

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What can I do if I have a problem or complaint?
We hope you will be completely satisfied with your health plan. But if you should ever have a complaint or problem regarding the quality, accessibility, adequacy of facilities, or timeliness of services under the plan, or you wish to dispute a coverage decision, please call Customer Service. If we cannot resolve the issue to your satisfaction, you have access to a grievance and appeals process.

  • Your satisfaction with our network of providers is very important to us. If you are unhappy with the quality of medical care or service that you have received from your provider or their office staff, please call Customer Service. Customer Service will work with you to resolve your complaint or assist you in finding another provider.

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Will my medical records be kept private?
We understand that your health is your own private business. We can assure you that we will treat your medical and claim records and information in a confidential manner.

UnitedHealthcare respects your privacy and is required by federal law to comply with the Health Insurance Portability and Accountability Act and Privacy regulations (45 C.F.R. Parts 160-164, collectively “HIPAA”). HIPAA allows for use and disclosure of your protected health information for health care operations and payment without your prior written consent. The following is a list of some of the allowed uses and disclosures, but is not an all inclusive list:

  • Claim processing
  • Performing peer review, utilization review, and medical audits
  • Administration of any programs established by us for quality health care and control of health care costs

UnitedHealthcare has taken important steps to protect your privacy:

  • Our employees have been trained to understand the importance of safeguarding your privacy. In fact, they sign confidentiality agreements to ensure they will carry out our established policies.
  • Employees only have access to information needed to perform their job functions.
  • Your oral, written, and electronic information is protected through data system security features and through established policies and procedures.
  • Our contracted practitioners and providers follow state and federal confidentiality and privacy laws and regulations. They are committed to protecting your medical information.
  • UnitedHealthcare Suppliers must sign Business Associate Agreements if they receive personal health information for purposes of plan administration, such as use of measurement data to improve quality.
  • It is our policy not to release member specific health information to employers unless allowed by law.

You also have rights related to the privacy of your health care information:

  • You have the right to approve the release of personal health information in special circumstances.
  • You have a right to request authorization for another individual to access your health care information who, under law, does not already have authorization to access the information.
  • You have the right to access your claim records received by UnitedHealthcare from health care providers.
  • You have the right to request restrictions on your health care information.

You can take comfort in knowing that privacy is important to us. We encourage you to call Customer Service if you have questions about our privacy policies and practices.

You can view the Privacy Notice for members of insured benefit plans by clicking here.




 
Popular Links
- Lab Corp (use to find laboratory services out of your local service area)
- National Committee for Quality Assurance (NCQA)
- NCQA HealthChoices
- Compare Hospital and Provider Quality

 


Find a Physician or Facility


Find a Physician

Search our online directory to Find a Physician or Facility. For a paper provider directory or assistance finding a provider, please call the Customer Care number on the back of your health plan ID card.


 
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