Reminder: Balance billing is not permitted

We want to remind you that balance billing UnitedHealthcare members is not permitted. Information on the restrictions of balance billing is outlined on page 141 in the 2024 UnitedHealthcare Care Provider Administrative Guide. Search “balance billing” in the guide for examples of prohibited payment requests. 

Members are responsible for paying copays, deductibles and coinsurance amounts for covered services. A bill or payment should not be collected, or lien imposed on a member, for any amount outside of such responsibility. You’re encouraged to review the terms of your UnitedHealthcare Participation Agreement to ensure you understand your contractual rights for billing for covered services.

Members’ rights should they receive a balance bill

Members who receive a bill or lien from a participating provider for covered services outside of their required cost share, may file a complaint with UnitedHealthcare and/or their state representatives. If that happens, we’ll address the issue on the member’s behalf and may need to take action, per the terms of your UnitedHealthcare Participation Agreement.  

Help ensure payment for your services

Before you provide services to members, please be sure to check member eligibility and benefits and prior authorization requirements. You can use the UnitedHealthcare Provider Portal to check eligibility and benefits or submit a prior authorization request. To sign in to the portal, go to UHCprovider.com and select Sign In at the top-right corner. 

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