HOME HEALTHCARE RECONCILIATION ON UNITED HEALTH PORTAL

1. HOW TO GET PROVIDER INFORMATION FOR RECONCILIATION
• Click on the United HealthCare (UTC) Portal to sign in with the assigned user name and password.
• Click on claims and payments

• SELECT YOUR CLAIMS OR TICKET SEARCH CRITERIA has a drop down, click on provider information

• SELECT ADJUDICATED CLAIM STATUS, click ALL

• Select range (custom date)

• Add the range of the service date you’re working with

• Click on Search
• All information about that range of service date pops up

• Click on Export to CSV (this should be monthly)

2. RECONCILAITION
• On the excel sheet you sort by LAST NAME
• Create a filter under status which includes Finalized, Denied, Pending, Multiple statuses and In process.

• Colour each of the aforementioned statuses with a preferred colour

• Check for repeated claims that have same clients name, same service dates, same amount and delete but leave the one that has the most recent process date.

• PLEASE NOTE: In a case where it’s the same clients name, same service dates and same amount but different statuses (FINALIZED or DENIED) please “delete” the denied claim.

• It is advisable to copy all denied claims and paste them on a different sheet because that’s what you will be working with. While on the sheet, create a new column called REASONS
• Copy the Member ID, go to UHC Portal, go to SELECT YOUR CLAIMS OR TICKET SEARCH CRITERIA, select Patient Account Number or Claim Number and submit search.

• Investigate the reasons for denial, copy and paste the reason on the DENIAL SHEET.