UnitedHealthcare pays clean electronic claims within 15 business days for in-network providers. Paper claims take 30 business days. These timelines apply to commercial plans; Medicare Advantage follows CMS rules requiring payment within 30 days of receipt.
Day 1: Claim received and logged. Days 2-5: Automated adjudication for clean claims. Days 6-15: Payment processed for electronic claims. Days 16-30: Paper claim processing window. If claim pends for review, add 10-15 business days to the standard timeline.
| CARC Code | Reason | Primary Cause | Fix |
|---|---|---|---|
| CO-29 | Timely filing exceeded | Claim filed after 90-day INN / 180-day OON deadline | Submit within 45 days for safety margin |
| CO-4 | Procedure code inconsistent with modifier | Modifier mismatch on claim line | Verify modifier before submission |
| CO-16 | Claim differs from payer records | Authorization data mismatch | Cross-check auth number on claim |
If payment is delayed past 30 days, contact UHC Provider Services at 1-877-842-3210. For payment disputes, submit a reconsideration within 60 days of the remittance advice date. Include the claim number, expected payment amount, and contract reference.
Log into the UHC provider portal at uhcprovider.com. Navigate to Claims, then Claim Status. Search by patient ID or claim number. Status updates within 24 hours of adjudication.
Compare the EOB line items against your contract fee schedule. If underpaid, file a payment dispute within 60 days of the remittance date. Include the contract rate and the EOB showing the discrepancy.
Yes. Enroll through Optum Pay at optumpay.com. EFT deposits arrive 2-3 days faster than paper checks and include electronic remittance advice (ERA).
Altair tracks claim payment timelines across all payers and flags delays before they become write-offs.