Texas Medicare: Claims process change

On Jan. 1, 2023, we changed the claims submission process for patients assigned to a Southwestern Health Resources (SWHR) primary care provider enrolled in the following health maintenance organization (HMO) UnitedHealthcare® Medicare Advantage plans in the Dallas Fort-Worth area:

• AARP® Medicare Advantage®
• UnitedHealthcare Dual Complete®
• UnitedHealthcare Group Retiree
• UnitedHealthcare Medicare Ally

This change won’t affect your UnitedHealthcare contract or Participation Agreement, and you’ll continue to be a network provider for these patients. 

Submit 2023 Date of Service Claims

You can submit claims by:

• Electronic: Payer ID 87726
• Mail: 
  • UnitedHealthcare Dual Complete (HMO-POS D-SNP) Groups HCFAC3-OUL and HCFAO4-OE7:
    P.O. Box 30765, Salt Lake City, UT 84130 – 0765
  • All Others:
    P.O. Box 30975, Salt Lake City, UT 84130 - 0975

Submit 2022 Date of Service Claims

SWHR contracted or SWHR employed health care providers should submit 2022 claims to UST HealthProof by one of the following ways:

• Electronic: Payer ID 83245
• Mail: UST HealthProof, P.O. Box 317, Sidney, NE 69162-0317

Non-SWHR contracted health care providers should submit 2022 claims to UnitedHealthcare by one of the following ways: 

• Electronic:  Payer ID 87726
• Mail: UnitedHealthcare, P.O. Box 30975, Salt Lake City, UT 84130-0975
• Groups HCFAC3-OUL, HCFAO4-OE7: UnitedHealthcare, P.O. Box 30765, Salt Lake City, UT 84130-0765

Utilization Management Services

You will continue to submit prior authorization and referral requests for utilization management services to Southwestern Health Care Management in one of the following ways:

• Online: Acuity Connect 
• Call: 855-359-9999
• Fax: 888-965-1964

Learn more

Please visit UHCprovider.com and sign in to the UnitedHealthcare Provider Portal to check coverage dates, policy information and get a copy of the member ID card.

Questions

If you have questions, please call Provider Services at 877-842-3210.

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