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Required information
When you request payment of benefits, you must provide UnitedHealthcare with all of the following information:
  • The employee's name and address
  • The patient's name and age
  • The group number stated on your ID card
  • The name and address of the provider of the service(s)
  • A diagnosis from the physician
  • An itemized bill from your provider that includes the current procedural terminology (CPT) codes or a description of each charge
  • The date the injury or sickness began
  • A statement indicating either that you are, or you are not, enrolled for coverage under any other health insurance plan or program (If you are enrolled for other coverage, you must include the name of the other carrier(s).)
Failure to provide all the information listed above may delay any reimbursement that may be due to you.
For medical benefits claims, the above information should be filed with UnitedHealthcare at the address on your ID card. When filing a claim for outpatient prescription drug benefits, your claims should be submitted to:
ATTN: Claims Department
P.O. Box 29077
Hot Springs, AR 71903