Filing an out-of-network claim with UnitedHealthcare
If you live in one of the states listed below and are filing an out-of-network claim that is not paid in full, complete a UnitedHealthcare Medical Claim Form. Please follow the steps listed below to be sure your claim is processed correctly.
- District of Columbia
- New Mexico
- North Carolina
- North Dakota
- South Carolina
- South Dakota
- West Virginia
Follow the steps listed below to be sure your claim is processed correctly:
- When completing the UnitedHealthcare Medical Claim form,
use your complete UnitedHealthcare ID number (e.g., xxxxxxxxGEHA) as reflected on the front of your member ID card.
- Indicate UHC GRP# 78-360001 on the claim submission if that field is not already filled in.
- Make sure that the patient and member information is clearly identified on each page of your claims submission.
- If you paid out-of-pocket for your services, you should include paid in full and to reimburse member on each claim.
- Once you have completed the UnitedHealthcare Medical Claim form, mail your form to the appropriate address below.
- If you have not paid your out-of-network bill in full, mail your claim form to:
UnitedHealthcare Shared Services
P.O. Box 30783
Salt Lake City, UT 84130-0783
- If you have already paid your out-of-network bill in full, mail your claim form to the address below. In addition, submit your dental, Medicare prime and all other claims (such as Medicaid and prescription claims) to GEHA at:
P.O. Box 21542
Eagan, MN 55121