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Claim submission fax: 1-248-733-6060 Customer Service: Phone (toll-free): 1-800-638-3120 Website: myuhcvision.com • Claim questions • Benefit questions • Verify eligibility • Physician verification Employee Assistance Program (EAP) Phone (toll-free): 1-888-887-4114 Website: myuhc.com Employer support available: • Management consultationsAttn: Fiscal 400 South Fourth St, Suite 201 Minneapolis, MN 55415 ATTACHMENT FAX# - Nursing Facility PMAP Forms, Certified Patient Assessment (CPA) & Rule 25 Assessment

Fax form(s) to 1-248-733-6085 ATTN: HP Inc. Employee Claims; Be sure to include the following (in English or accompanied by an English translation): Employee name and Social Security number or Alternate ID; Original receipts; Patient's name and date of birth; ... 6085 Serial Numbers: Location: Serial number plate on the tractor's console on the ...612-321-3786: Attn: Claim 400 South Fourth St, Suite 201 Minneapolis, MN 55415 CLAIMS FAX# – Claim Adjustment Requests, Claim Reconsideration Requests, Medical248-733-6070 for UnitedHealthcare clinical submissions OptumHealth Physical Health regional office indicated on your Plan Summary 5 Complete the Patient Status Report (PSR) x Your office will receive a PSR each month containing a list of all patients whose treatment plan is ending within the next 30 days.Title: 2016 Claims Submission Notice for Maryland Plan Members Created Date: 1/20/2016 12:26:50 PMJefferson. Birmingham. At&t Local. 1-256-500. Jefferson. Birmingham. Bellsouth Telecomm Inc Dba South Central Bell Tel. Browse area code 256 phone numbers, prefixes and exchanges. The 256 area code serves Huntsville, Birmingham, Gadsden, Decatur, Anniston, covering 98 ZIP codes in 27 counties.

Please complete the form and mail to UnitedHealthcare; or fax to 248-733-6062, Attn: Group Information Update. Once this form is received in our office, the timeframe for updating the information is 3 to 5 business days. Incomplete forms will be returned and the information will not be updated. Please do not use this form for any

Monday – Thursday: 7:00am – 5:30pm. Friday: 7:00am – 5:00pm. Saturday – Sunday: Closed

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For fastest service, please fax completed claims forms to: 248-733-6085 Thou can also mail forms to: Claims Processing P.O. Case 30755 Salt Water Towns, UT 84130-0755

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612-321-3786: Attn: Claim 400 South Fourth St, Suite 201 Minneapolis, MN 55415 CLAIMS FAX# – Claim Adjustment Requests, Claim Reconsideration Requests, Medical

Fax #: (248) 733-6085. For Medical Claims: For Mental Health/Substance Use Claims: F. GUIDELINES FOR SUBMITTING CLAIMS TO UNITEDHEALTHCARE

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