Tools/Codes
Creating a case or checking the status of an authorization
What is "ICUE?"
IFP
What is "Individual Family Plan"?
A set rate you pay for prescriptions, doctor visits, and other types of care.
What is "Copay"?
UnitedHealthcare will not reimburse services determined to be Incidental, Mutually Exclusive, Transferred, or Unbundled to a more comprehensive service unless the codes are reported with an appropriate modifier.
What is "Rebundling Policy - Policy Number 2024R0056B"
Member ID: 122596751
Claim ID: R24A38931500
Pending
Checking the status of a reconsideration
What is "PIQ"?
HIPAA
What is "Health Insurance Portability and Accountability Act"?
A percentage of the cost of a service
What is "Coinsurance"?
Maternity care includes antepartum care, delivery services, and postpartum care. This policy describes reimbursement for global obstetrical (OB) codes and itemization of maternity care services
What is "Obstetrical Policy - Policy Number 2024R0064A"
Member ID: 124602519
Claim ID: 23G265883700
Denied - This claim is a duplicate of a previously submitted claim for this member.
Place of Service - 02
What is "Telehealth"?
CLIA
What is "Clinical Laboratory Improvement Amendments"
The amount of money you have to pay for covered services before your insurance begins to contribute toward the costs (before the co-share kicks in)
What is "Deductible"?
Services billed with the 96 or 97 modifier
What is "Habilitative & Rehabilitative Services Policy - Policy Number 2024R9052A"
Member ID: 124855311
Claim ID: R23E97393100
Paid $62.47; Copay $10.00
An application/tool that allows you to check if the claim was received by UHC and also displays the journey of the claim
What is "ECHO?"
PIQ
What is "Provider Information Queues"
This is the maximum amount of money you’ll pay in a policy year. When you hit your maximum, your insurance provider pays 100% of all covered services for the remainder of the year.
What is "Out-of-Pocket"?
CPT code 97153 was billed with 40 units was denied as exceeding the daily frequency.
What is "Maximum Frequency Per Day Policy - Policy Number 2024R0060C"
Member ID: 123399452
Claim ID: R23A62034900
This service is not covered under the member's current benefit plan.
Type of Bill 1-3-1
What is "Hospital-Outpatient-Corrected Claim"?
What is "Integrated Clinical User Experience"?
This is the fixed amount you pay your insurance provider for coverage. Typically, this is a monthly fee.
What is "Insurance Premium"?
Services are live, interactive audio and visual transmissions of a physician-patient encounter from one site to another using telecommunications technology.
What is "Telehealth/Virtual Health Policy - Policy Number 2024R0046"
Member ID: 122540677
Claim ID: 22G757145102
Denied - Proc 99233 unbundles to Proc 99291 on Claim ID 22G589632100