Electronic Payments & Statements User Guide

Contents Welcome to Electronic Payments & Statements (EPS)

– This guide will show you how to:

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Login to UnitedHealthcareOnline.com













– Login to UnitedHealthcareOnline.com

– UnitedHealthcareOnline.com website

– Register/login to EPS

– New EPS user

– Registered EPS users

– Closing EPS welcome page

– About OptumHealth Financial Services

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View and Print Remittance













– View Payments

– Payment Summary

– Remittance Detail

– Print Electronic Remittance Advice

– Download and save 835 files

– Open 835 file

– Claim Detail

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Search Remittance

















– Search by Date(s) of Service

– Search by your Patient Account Number

– Search by Subscriber ID

– Search by Patient Name

– Search by Payment Number

– Search by Zero Payment Claims

– Search by National Provider Identifier (NPI)

– Search by Claim Number

– Search Results

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Payer PRAs View and Print



– Printing Payer PRAs

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Maintain Enrollment

















– The Maintain Enrollment Feature

– View Current Enrollment Organization Information File

– Organization Tab

– Payers Tab

– Bank Accounts Tab

– National Provider Identifier Tab

– NPI Bank Accounts Tab

– Review Edits to Organization Information

– Print Enrollment Form

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Manage Users





– Manage Users tab

– Manage Users

– Add Users

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How to Use Your Claim Mapping Report

– Claim Mapping Report Definitions

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Balancing Provider Level Adjustments





















– Corporate Tax ID Owner Selection

– Explanation of Benefit search

– Status and Date search

– Search Results Display

– Individual EOB View and Print

– Contacting UnitedHealthcare Claims Center

– Payment Number Seach

– Search Results Display

– Individual EOB View and Print

– Contacting UnitedHealthcare Claims Center

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Welcome to Electronic Payments & Statements (EPS) EPS is easy! No need to upgrade your claims system. No need to auto-post. You choose to continue posting your claims manually or auto-post. With Electronic Payments and Statements (EPS) we deliver your Provider Remittance Advices (PRAs) electronically through UnitedHealthcareOnline.com. EPS allows your office faster payment, easier reconciliation, less paperwork and greater efficiency.

Enjoy the many benefits of EPS, including improved cash flow, online access to your PRAs at UnitedHealthcareOnline.com, automated posting capabilities, elimination of mail processing and check clearing time.

EPS offers many benefits:

Easier reconciliation, less paperwork, and greater efficiency — improving the way we do business.

 Faster payments by eliminating the need to deposit paper checks;  Direct deposit of your claim payments into your preferred checking account potentially allowing a reduction in bank and lock box fees;  Simplified processing and reconciliation by automating payment posting using the free 835/ Electronic Remittance Advice (ERA) or continue with your existing paper posting process using our Print PRA feature.

In this guide, you will learn about the following options for obtaining your remittance advice:  Downloading an electronic version of your remittance advice from UnitedHealthcareOnline.com, which can easily be integrated into your office’s computer billing software;  V iewing and printing hard copies of your remittance advice from UnitedHealthcareOnline.com to use for manual payment posting;  Receiving your remittance advice electronically from your clearinghouse vendor.



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Login to UnitedHealthcareOnline.com  nitedHealthcareOnline.com is UnitedHealthcare’s U secure website that provides access to Electronic Payments & Statements (EPS). From viewing your payments, searching remittance, and Payer PRAs. UnitedHealthcareOnline.com offers the tools that make the transition from paper PRAs and checks to electronic claims payments simple.

 Login to UnitedHealthcareOnline.com using your existing ID and password, OR  Obtain a UnitedHealthcareOnline.com ID and password, by clicking ‘New User’ in the upper right corner of the home page and following the prompts.

 



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UnitedHealthcareOnline.com Website  Select Claims & Payments and then select the link for Electronic Payments & Statements.

Register/login to Electronic Payments & Statements  Select your Corporate Tax ID Owner and Physician/ Provider Tax ID from the first two drop down boxes.

 

 Click Continue

 

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New EPS user  If you are not registered for EPS, the following EPS Enrollment Form will appear. You should only use this online form if you are designating a single checking account for deposit of all your UnitedHealthcare payments. If you plan on designating different checking accounts for different departments/ physicians within your Tax ID Number (TIN), please follow the instructions below.  UnitedHealthcare’s EPS product allows deposits to more than one checking account per Tax ID Number (TIN) using the National Provider Identifier (NPI). If you prefer to take advantage of this option, please complete and return our paper enrollment form, located in the ‘Related Links’ section of the ‘Electronic Payments & Statements’ page on UnitedHealthcareOnline.com.



• Please note that NPI number(s) included on your EPS enrollment form will be validated against NPI number(s) you have previously submitted to UnitedHealthcare. If you have not submitted your NPI number(s) to UnitedHealthcare, please refer to UnitedHealthcareOnline.com > Tools & Resources > National Provider Identifier. (link to https://www. unitedhealthcareonline.com/b2c/CmaAction.do?c hannelId=dbd2ac4073508310VgnVCM100000294ab 10a____)  Complete all fields requested. It is strongly recommended that you confirm the appropriate Routing Transit Number and Account Number with your financial institution. Incorrect entries will delay your EPS enrollment and payment.

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Registered EPS users

The resources link provides access to:

 If you are already registered with EPS, a splash page will display, letting you know that you are going to Optumhealthfinancialservices.com. Then you’ll be brought to the EPS Welcome Page.

 FAQs

 The EPS Welcome Page offers you links to View Payments, Search Remittance, Payer PRAs, Maintain Enrollment and Manage Users.

 Help  User Guide  Contact Us

 

Closing the EPS welcome page

About OptumHealth Financial ServicesSM

 To return to UnitedHealthcareOnline.com, click the logo in the upper left corner of the screen. Alternatively, you can use the Logout button in the upper right corner of the welcome page.

 OptumHealth Financial Services is dedicated exclusively to meeting the health care financial needs of consumers, employers, health plans and professionals. Our products and services are transforming health care, to make it simpler, more efficient and more affordable. OptumHealth Financial Services includes OptumHealth BankSM, Member FDIC, and Administration Resources Corporation.



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View and print remittances View payments Review summary level information for payments  Select the View Payments tab to display the Payment Summary

 



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Payment summary  Payments display from the past 30 days as a default  Select the Quick Search drop-down box to change payments display to the last 60 days or 90 days.  F ilter payments to view by National Provider Identifier (NPI) or TIN by choosing the appropriate selection in the ‘Filter Payments’ drop-down box located near the top of the page. (Applicable only if your organization designated payments by NPI number(s) during the EPS enrollment process. If you are already enrolled, but wish to designate future payments by NPI, please see page 7 for more information)  Sort payments by selecting the arrow icon next to the column header. Arrow up indicates ascending order and arrow down descending order.  V iew Remittance Details for a payment by locating the payment row and selecting the link for the corresponding Payment Number.  Download a HIPAA 835 file for a particular payment by selecting the link Download for the corresponding payment row.

 Print an electronic remittance advice (ERA) for a particular payment by selecting the link Print Request for the corresponding payment row. Adobe® Reader® is required to use this print feature. To download Adobe Reader, select the Adobe Reader icon.  V iew the Deposit Status of your payment. ‘Successful ACH’ will indicate your payment was sent electronically and has been deposited into your bank account. If your payment is returned, you will see a status of ‘Failed’. You will be contacted by the EPS team to correct the issue relating to this payment or by hovering over the Failed status, you can obtain the appropriate number to call for assistance. If no resolution to issue by third business day, EPS will mark this payment as ‘Successful Check’ and you will be receiving a paper check from your Payer’s bank.  Print the entire Payment Summary page by selecting the button Print Payment Summary. From print preview, right click your mouse and choose the print command.

 



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Remittance detail After selecting the link Payment Number for a payment row, the Remittance Detail page will display all claims that are included in a particular payment.

 V iew a complete list of all Adjustment Reason and Remark Codes by selecting the column header link Adj Reason Code or RMK Code.

 Download a HIPAA 835 file for a particular payment by selecting the button Download 835.

 Print either the Adj Reason Code or RMK Code list by right clicking on the page and selecting print.

 Print an electronic remittance advice (ERA) for a particular payment by selecting the button Print Request.

 View any Provider Level Adjustments (PLBs) associated with a payment by selecting the last page and scrolling to the bottom of the page.

 Return to Payment Summary by selecting the button Return to Payment Summary.

 V iew PLBs by scrolling or to view full list without scrolling, select the button Print Request and print the last page.

 View Additional Details for a specific claim by selecting the Claim Number link for that claim.  View the Explanation of a specific Adjustment Reason or Remark Code by selecting the code link for that claim.

 



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Print electronic remittance advice  Print an electronic remittance advice (ERA) by selecting the link Print (or Print Request - ERAs that exceed 2500 pages can be made available for printing by clicking the Print Request link).  The File Download dialog box will appear. Select Open.

 Adobe Reader will open and display the ERA.  Select the Print icon to print the ERA.  Adobe Reader is required to use this print feature. To download Adobe Reader, select the Adobe Reader icon.

Download and save 835 files  Download the 835 file by selecting Download 835 from the Download 835 column.

 The 835 file is now available to upload to   your Practice Management System.

 The File Download dialog box will appear. Select Save.

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Open an 835 file  Depending on which Windows operating system is running on your computer, a new window will open with information on software available to open your file.

 Select from the available software to open your .dat file.

 



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Claim detail After selecting the link Claim Number for a payment row, the Claim Detail page will display all service level and adjustment information for a single claim.  Each adjustment will display on a row corresponding to the appropriate service.

 Print the Claim Detail by selecting the button Print Claim Detail.  Return to the Remittance Detail by selecting the button Return to Remittance Detail.

 



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Search remittance  Select the Search Remittance tab to display seven search options.

 

 Search for payments and claims by Date(s) of Service, Account Number, Subscriber ID, Patient Name, Payment Number, or Zero Payment Claims, National Provider Identifier (NPI) or Claim Number.

 Select the radio button for the search option desired.  Search Criteria Definitions are available for more information by selecting Click here link.

 Use Search Remittance to look up claim data for the past 13 months.

 

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Search by Date(s) of Service  Select the radio button for Date(s) of Service  Select the Calendar icon to enter the Start Date and End Date.

 Optional Secondary Search is to enter the Rendering Provider Last Name.  Reset/Clear Search at anytime by selecting a different radio button or by selecting the button Search Remittance.

 

Search by your Patient Account Number  Select the radio button for Account Number  Enter an Account Number

 Optional Secondary Search options available by Date of Service or Payment Date.

 



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Search by Subscriber ID  Select the radio button for Subscriber ID  Enter Subscriber ID

 Optional Secondary Search options available by Date of Service or Payment Date.

 

Search by Patient Name  Select the radio button for Patient Name

 Date of Service and Payment Date are optional.

 Enter Patient Last Name and First Name

 



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Search by Payment Number  Select the radio button for Payment Number

 Enter a Payment Number

 Select the radio button for Check Number or Electronic Payment Number

 

Search by Zero Payment Claims  Zero Payment Claims may be adjustments, denials, or member responsibility claims.

 Select the Calendar icon to enter the Start Date and End Date.

 Select the radio button for Zero Payment Claims.

 Entering the Patient’s Last Name is optional.

 Select the radio button for either Date of Service or Payment Date.

 



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Search by National Provider Number (NPI)  If your organization is directing payments to multiple checking accounts under a single Tax Identification Number (TIN), you can view payments by NPI.  Select the radio button for NPI.

 Select the radio button for either the Date of Service or Payment Date.  Select the Calendar icon to enter the Start Date and End Date.

 

Search by Claim Number  Select the radio button for Claim Number

 Enter a Claim Number

 



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Search Results  Displays claims that match the chosen search criteria.  Select the link Payment Number to view the Remittance Details.  Select the Claim Number link to view the Claim Details.

 Select the Print Search Results button to print information.  W hen the print preview page displays, right click and choose the Print Command.  Select the button New Search to begin a new search.

 



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Payer PRAs View and Print  From the EPS Welcome Page, select the Payer PRAs tab.

 Individual PRAs for the past 15 business days are available using the Payer PRAs feature.

 You may view and print up to 500 PRAs at a time.

 

Printing Payer PRAs  Locate the desired payment date.  Select the link segment to open the PRA files for that payment date (PRA files are available for the past 15 business days).



 

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 The Payer PRAs processing screen displays while PRAs are downloading from the server.

 Upon completion of the download, Adobe Reader will launch containing up to 500 PRAs.

 

 Select the Print icon and ‘OK’ to print the EOBs.  To close Adobe Reader, select the Close Window “X” box on the upper right corner.

 The Print All PRA page is still open behind in a separate window. You can print additional PRA files, if required.

 



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Maintain enrollment  Select the Maintain Enrollment tab to update existing enrollment details, such as: organization information and primary and secondary contacts.

 

View current enrollment organization information file  Select Edit to begin updates.

 



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Organization tab  Enter changes to Organization Information, then click Continue, Cancel or Finish.

 

Payers tab  Select the payers you wish to receive direct deposit from.

 



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Bank Accounts tab  To update Organization Bank Accounts Information, please call 866-UHC-FAST (842-3278) and select prompt 5.

 Note: Changes to Organization Bank Accounts Information must be submitted in writing.  Select Continue, Cancel or Finish.

 

NPI tab  To update EPS payments to route to different bank accounts based on NPI, please call 866-UHC-FAST (842-3278) and select prompt 5.

 Note: Changes to NPI information must be submitted in writing.  Select Continue, Cancel or Finish.

 



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NPI Bank Accounts tab  To update EPS payments to route to different bank accounts based on NPI, please call 866-UHC-FAST (842-3278) and select prompt 5.

 Note: Changes to NPI information must be submitted in writing.  Select Cancel or Finish.

 

Review edits to organization information  If more changes are necessary, select Edit.

 Select Cancel to exit Maintain Enrollment.

 If information is correct, select Submit.

 



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Print enrollment form

Return to EPS Welcome Page

 Select Print Enrollment Form.

 Select Return to Home Page.

 



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Manage Users  From the EPS Welcome Page, select the Manage Users tab.

 You can add, edit or delete users for your Organization.

 

Review edits to organization information  The Manage Users feature allows you to view, add or delete users for EPS access.  Users active for EPS display under the User List.  Selection of an individual from the User List populates the user’s information within the data fields and the TIN grid below.

 You are able to view which TIN’s the user is associated to, the user’s access level (whether Administrator or General, for Optum portal access) and if they receive email notifications (for the TIN or specific TIN/NPI).

 



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Add User  Selection of the Add User button, allows you to add a new user to your Organization.  A unique User Name will be created and emailed along with the pre-registration url for self-service registration to the EPS Optum portal.

 Upon entry of all required data and selection of Save, pre-registration materials will be triggered for the newly added user.  Upon the new user successfully completing their registration process, their name will then appear as an active user on the User List within the Manage Users tab.

 



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How to use your Claim Mapping Report In addition to the Electronic Remittance Advice, we have an optional Claim Mapping Report. This report can be used as a helpful tool when reconciling your Provider Level Adjustments (PLBs). If you would like to receive this report or additional information on using this tool, please contact 866-UHC-FAST and select option 5.

Locating the Payer Claim Control Number/PLB Number  In the column labeled Payer Claim Control Number/ PLB Number, locate the adjustment you want to reconcile. Locating the Unconsolidated Payment Trace Number  In the column labeled Unconsolidated Payment Trace Number, identify the corresponding trace number.

  Claim Mapping Report definitions



Column heading

Definition

Payer ID

UnitedHealthcare’s Tax ID Number

Provider ID

Provider’s Tax ID Number

NPI Number

Provider’s unique National Provider Identifier

Consolidated Payment Amount

Total amount deposited in your organization’s bank account.

Consolidated Payment Date

Date the payment is deposited into your organization’s bank account - generally the same date as the unconsolidated payment date.

Consolidated Payment Trace Number

Trace/Payment number assigned to the payment.

Unconsolidated payment amount

Dollar amount associated with the unconsolidated (or original) EOB.

Unconsolidated payment date

Date the payment is deposited into your organization’s bank account generally the same date as the consolidated payment date.

Unconsolidated payment trace number

Trace/Payment number assigned to the unconsolidated (or original) EOB in order to view the original EOB at UnitedHealthcareOnline.com

Payer Claim Control Number/PLB Number

Number assigned by UnitedHealthcare for a specific claim or reference number for a specific PLB adjustment. This allows your organization the ability to reference a specific claim or PLB adjustment.

Patient Control Number

Patient account number assigned by your organization to identify a patient.

Claim Charge Amount

Total amount billed to you for a specific claim.

Claim Payment/Adjustment Amount

Amount paid to your organization for a specific claim (based on a fee schedule) or Adjustment. The total of this column will tie to the deposit.

Claim date

Date of Service

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Balancing Provider Level Adjustments Locate the Electronic Payment ID number/Unconsolidated Payment Trace Number from your Claim Mapping Report for the associated explanation of benefit (EOB) that contains the Provider Level Adjustment.

 From the Post Login Home Page, select Claims & Payments, then from the drop down menu, select the link for Electronic Payments & Statements.

Corporate Tax ID Owner selection

Explanation of Benefit search

 Select your Corporate Tax ID Owner from the drop down box, then click Continue.

 Select the radio button to search by either Status and Date or Payment Number.

 

 

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Status and date search  Select Physician/Provider Tax ID from the drop down box, select Status from drop down box and enter EOB Start and End Dates, then click Search.

  Search results display  Payment Status — refers to the status of the claim - Deposited -E  OB Only (Zero Payment Claims)  Status Date — the date the claim was paid



 Payment Number — refers to the claim or trace number from your Claim Mapping Report.  V iew and print individual EOBs by selecting the link View EOB (Adobe Reader Required).

 

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Individual EOB view and print  V iew and print individual EOBs by selecting the Print Icon button on the Adobe Reader Menu Bar.

  Contacting UnitedHealthcare Claims Center If the EOB does not include all the detailed history for the COB (Coordination of Benefits) in question, please call the number on the back of the member’s health care ID card to reach the UnitedHealthcare Claims Center and ask for the Electronic Payment Numbers associated with the adjustment(s).



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Payment Number search  Select the Physician/Provider Tax ID from the drop down box, enter a Payment Number, then click Search.

  Search results display  Payment Status ­— refers to the status of the claim - Deposited -E  OB Only (Zero Payment Claims)  Status Date — the date the claim was paid

 Payment Number — refers to the claim or trace number from your Claim Mapping Report.  V iew and print individual EOBs by selecting the link View EOB (Adobe Reader Required).

 

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Individual EOB view and print  V iew and print individual EOBs by selecting the Print Icon button on the Adobe Reader Menu Bar.

 



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