CMS-1500

Submit CMS-1500 and UB04 Claims Electronically

Submitting CMS-1500 and UB04 Claims Electronically gives more benefits and advantages. Here are some guidelines for submitting these transactions electronically.

  • Single Page Claims: Claims without attachments are the simplest to file electronically. Identify those dropping to paper in your system and convert them to an EDI 837 transaction by applying the appropriate Payer ID. Contact your software vendor or clearinghouse if you need help.
  • Secondary/Coordination of Benefits (COB) Claims: UnitedHealthcare claims can be submitted electronically without the primary payer’s paper explanation of benefits (EOB). Your PMS or HIS may need to be updated if you don’t have the ability to send primary EOB information.
  • Medicare Crossover: When Medicare is the primary payer, a crossover statement is sent directly to UnitedHealthcare, eliminating the need for care providers to file the secondary claim when the member is enrolled in Medicare Crossover. Enrollment is automatic for eligible UnitedHealthcare commercial members.
  • Corrected Claims: Most corrected claims can be sent electronically using frequency code 7 on the 837 transaction to indicate the replacement of a previous claim.

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