P.o. box 30559 salt lake city ut 84130 of Technology
Hurricane, Utah is a beautiful and vibrant city known for its breathtaking natural landscapes and outdoor recreational opportunities. With its growing popularity, the real estate m...1. Discuss network and non-network care provider options with the UnitedHealthcare member and provide them with a copy of UnitedHealthcare’s Laboratory and Pathology Services Consent Form. This is a separate form from the Member Advance Notice Form for the Involvement of a Nonparticipating Provider. PCA--1-002365-06222016-06242016. …Salt Lake City, Utah, is a vibrant and bustling city with a rich history and stunning natural landscapes. Whether you’re visiting for business or pleasure, getting around the city ...Or mail the completed form to: Provider Dispute Resolution PO Box 30539 Salt Lake City, UT 84130. NOTE: This form is for claim disputes and reconsiderations only. To submit a formal appeal, please see the instructions listed on the back of your explanation of payment (EOP). *Provider Name:P.O. Box 30945 Salt Lake City, UT, 84130-0945. Discover disputes are typically resolved within 30 to 60 days, though more complex issues may take a little longer. How to Dispute a Charge on a Discover Card Online. Log into your online account on Discover's website. Click on "Activity & Statement" at the bottom of the page.PO Box 30541. Salt Lake City, UT 84130-0541. Benefits . provided by: Your UMR e . ady to elp you! Monday through Friday, 8 a.m. - 8 p.m. CST. Your employer has hired us to assist in managing your benefits plan. For . example, we help new employees sign up to receive health benefits.You may ask us in writing at Optum Bank, P.O. Box 271629, Salt Lake City, UT 84127-1629 to stop payment on a Check drawn on your HSA that has not yet been paid by us. We will honor any written stop payment request from you which is received by us at least two business days before the Check is presented to us for payment.Discover the best graphic design consultant in Salt Lake City. Browse our rankings to partner with award-winning experts that will bring your vision to life. Development Most Popul...Kaiser Foundation Health Plan of Washington. Attn: Provider Reconsideration ACN-2. PO Box 30766. Salt Lake City, UT 84130-0766. FAX: 844-660-0747 *Required fieldsP.O. Box 30788 Salt Lake City, UT 84130 Midwest Indiana Ohio Optum Care Claims P.O. Box 30781 Salt Lake City, UT 84130 Tristate New York Optum Care Claims P.O. Box …Mail. Preferred Care Network P.O. Box 30448, Salt Lake City, UT 84130-0448Get in contact with UnitedHealthcare about AARP Medicare Advantage plans, Medicare Supplement Insurance plans, Medicare prescription drug plans and more.P.O. Box 30783 Salt Lake City, UT 84130-0783 UHC Provider Services Phone: (877) 343-1887 If the patient has Medicare primary coverage, mail to GEHA: GEHA FEHB Medical P.O. Box 21542 Eagan, MN 55121. UnitedHealthcare Choice Plus (all 50 states) EDI Payer ID #39026 UnitedHealthcare Shared Services P.O. Box 30783, Salt Lake City, UT 84130-0783Regence Blue Shield of Utah. Regence Blue Shield of Utah main address is PO Box 30271 , Salt Lake City, Utah 84130-0271, main phone number 800-762-6004. This is the best Regence Blue Shield of Utah phone number where you can speak to a real person and get assistance with your medical insurance issue.P.O. Box 30512 Salt Lake City, UT 84130-0512 Processed Claims: Optum Behavioral Health Solutions P.O. Box 30757 Salt Lake City, UT 84123 By fax Send via secure fax to: 1-855-312-1470 Reason for Reconsideration Request On the form, you will select 1 of 8 reasons for the request:PO Box 30781 Salt Lake City, UT 84130-0781 After you've filed a reconsideration through paper mail, questions and updates on the request are available by calling 866-565-3468. Medicare Denials: If a claim was denied by Medicare and you feel it to be in error, you have the right to appeal the decision to Medicare.Are you considering buying real estate in Hurricane, Utah? If so, you’re in luck. Hurricane UT is a beautiful city with a booming real estate market. Hurricane UT is experiencing s...P.O. Box 30539. Salt Lake City, UT 84130. Need help? Contact the Provider Inquiry Resolution Team (PIRT) to discuss a medical record request or review findings. Mountain West Arizona/Utah. 1-877-370-2845 / Monday − Friday, 8 a.m. - 8 p.m., MT. Why are medical records requested? Claims are identified by Optum Payment Integrity asSINCLAIR OIL CORPORATION is a liquor premise in Salt Lake City licensed by Colorado Department of Revenue (DOR) Liquor and Tobacco Enforcement Division. The doing business as (DBA) name is SINCLAIR OIL CORPORATION. The license number is #01-82673-0000. The physical location is at Po Box 30825, Salt Lake City, UT 84130. The license type is Master File (Business).Clinical Guidelines. Vaccine Claim Submission. Claims and Pre Treatment/Pre Authorization Submission Addresses: PTE/Prior Authorizations (Except Solstice Benefits) Dental …P.O. Box 31364 Salt Lake City, UT 84131-0364. Author: Marinan Group inc. Created Date: 10/28/2020 1:58:34 PM ...PO Box 30991 Salt Lake City, Utah 84130-0991 1-800-903-5253 • You or your representative, including an attorney may submit a Formal Appeal up to 60 days after the date on the notice of the adverse action. • You or your representative may submit a Formal Expedited Appeal within 10 days of the adverse action.PO Box 212 Minneapolis, MN 55440-0212. Payer ID: 41161. Behavioral Health . Medica Behavioral Health (MBH): 1-800-848-8327. Medica Behavioral Health PO Box 30757 Salt Lake City, UT 84130. Payer ID: 87726. Dental (Medicaid Families and Children only) Delta Dental PO Box 9120 Farmington Hills, MI48333-9120P.O. Box 30978 Salt Lake City, UT 84130 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.comPlease fll out the following information when you are requesting a review of an adverse beneft determination or claim denial by UMR. If you are appealing on behalf of someone else, please also include the Designation of Authorized Representative form …UMR – Claim Appeals PO Box 30546 Salt Lake City, UT 84130 – 0546. 877-805-1990 (T) 877-291-3248 (F) www.UMR.com.P.O. Box 30552 Salt Lake City, UT 84130-0552. United Healthcare Dental Claims Unit P.O. Box 30567 Salt Lake City, UT 84130-0567. ... Salt Lake City, UT 84130-0567. Solstice Benefits P.O. Box 19199 Planation, FL 33318. UMR P.O. 30541 Salt Lake City, UT 84130-0541. Blue Shield of California Claims Address: For membership outside Orange County ...Medical Services Appeals and Grievances: Mail: UnitedHealthcare Appeals and Grievances Department PO Box 30883 Salt Lake City, UT 84130-0883P.O. Box 30567 Salt Lake City, UT 84130-0567. Blue Cross Blue Shield of North Carolina Dental Claims UnitedHealth Group PO Box 30568 Salt Lake City, UT 84130-0568. Blue Shield of California Dental Claims Unit PO Box 272540 Chico, California 95927-2540. APIPA PO Box 30751 Salt Lake City, UT 84130.Claims: EDI #USN01, UHC Global, PO Box 30526, Salt Lake City, UT 84130-0526 Call USNAS Care Management at 844-251-8341 for plan required prior authorization. FAILURE TO CALL FOR PRIOR AUTHORIZATION MAY REDUCE BENEFITS.Or mail the completed form to: Provider Dispute Resolution PO Box 30539 Salt Lake City, UT 84130. NOTE: This form is for claim disputes and reconsiderations only. To submit a formal appeal, please see the instructions listed on the back of your explanation of payment (EOP). *Provider Name:P.O. Box 30567 Salt Lake City, UT 84130-0567. Blue Cross Blue Shield of North Carolina Dental Claims UnitedHealth Group PO Box 30568 Salt Lake City, UT 84130-0568. Blue Shield of California Dental Claims Unit PO Box 272540 Chico, California 95927-2540. APIPA PO Box 30751 Salt Lake City, UT 84130.PO Box 30989 . Salt Lake City, UT 84130 . Written provider appeals: UnitedHealthcare I March Vision Care . Attn: Medicaid Vision Appeals . PO Box 30988 . Salt Lake City, UT 84130 . Please do not send any claims or appeals to 6601 Center Drive West, Suite 200, Los Angeles, CA 90045.P.O. Box 30192, Salt Lake City, UT 84130-8212 800-538-5038 selecthealth.org Does the member have other insurance? Yes q q No If yes, and both policies are SelectHealth, please list the other Subscriber ID# ... ANYTOWN, UT 80000 AMOXICILLIN 500MG CAP PFIZER ndc-00055-5555-55 JOHN SMITH MD FILL#2 REFILLS-CALL 24 HOURS IN ADVANCE THANK YOU RX ...PO Box 30541. Salt Lake City, UT 84130-0541 1-800-826-9781 Dentist's statement of actual services. EPSDT. Provider ID No. Prior Authorization No. Patient ID No. 4. Patient name. 5. Relation to insured ... Name of school and city where located if patient is age 19 or older and a full-time student 9. Employee's name and address 10. Employee's ...P.O. Box 5290 Kingston, NY 12402-5290. Community Plan Behavioral health P.O. Box 30760 Salt Lake City, UT 84130-0760. ACC/DD/Dual Complete 800-445-1638. Dual Complete® (HMO D-SNP) Attn: Provider claim disputes P.O. Box 31364 Salt Lake City, UT 84131-0364. General claim disputes P.O. Box 31364 Salt Lake City, UT 84131 …PO Box 30541 Salt Lake City, UT 84130-0541; If you are applying for reimbursement for charges from a dentist, contact United Concordia Dental (UDC) at 1-866-851-7568 to request a claim form, and return the completed claim form to UDC at: United Concordia Companies, Inc. Dental Claims PO Box 69421 Harrisburg, PA 17106-9421How to File an Appeal. If you disagree with our decision on your claim, you or your authorized representative can submit an Appeal Form to: Attn: Appeals. Select Health. P.O. Box 30192. Salt Lake City, UT 84130-0192.P.O. Box 30531 Salt Lake City, UT 84130 . 2 | P a g e BH2536_Billing Appendix 122019 Optum Maryland Please see the section on Paper claim submission for more specific instructions for use of CMS-1500 and UB-04 claim forms. Customer Service Claims Assistance Optum Maryland has a dedicated customer service department with staff available five ...P.O. Box 30978 Salt Lake City, UT 84130 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.comOr mail the completed form to: Provider Dispute Resolution PO Box 30539 Salt Lake City, UT 84130. NOTE: This form is for claim disputes and reconsiderations only. To submit a formal appeal, please see the instructions listed on the back of your explanation of payment (EOP). *Provider Name: *Provider TIN: Provider Address: Provider Type: MD.Claims: EDI # 39026, UMR, PO Box 30541, Salt Lake City, UT 84130-0541 Vision Claims: Spectera Vision, PO Box 30978, Salt Lake City, UT 84130 This card must be presented each time services are requested. Printed: 10-03-2019 Call UMR at the member customer service number listed on this ID Card for plan required prior authorization.Everything you need to know about Salt Lake City International Airport [SLC], including hotels, transiting, car rental, parking, and more. We may be compensated when you click on p...This organization is not BBB accredited. Credit Cards and Plans in Salt Lake City, UT. See BBB rating, reviews, complaints, & more. PO Box 30769 Salt Lake City, UT 84130-0769. CloseOct 1, 2023 · Preferred Care Partners, Inc. P.O. BoPO Box 30758 . Salt Lake City, UT 84130 . Overnight
Health Tips for Lottery housing long island
PO Box 30788 Salt Lake City, UT 84130-0788 Appeals process for non-contracted Medicare providers ... PO Box 14165 Lexington, KY 40512-4165 Fax: 1-800-949-2961 For additional information on the Non-contracted Appeal and Dispute processes including a form that may be usedStreet Address City State ZIP Home Ph# ( ) Work Ph# ( ) Provider ... P.O. Box 30192 Salt Lake City, UT 84130-0192 Phone 844-208-9012 selecthealth.orgAmerican Diabetes Association 2451 Crystal Drive, Suite 900 Arlington, VA 22202 For donations by mail: P.O. Box 7023 Merrifield, VA 22116-7023 1-800-DIABETES (800-342-2383)PO Box 30783. Salt Lake City, UT 84130. Fax: 866-427-7703. To expedite the claim, please send to the attention of the individual you talked with about this matter (if applicable). How to file a clinical appeal. ... PO Box 31270 Salt Lake City, UT 84131. Fax: Urgent Appeal Fax Line: 1-866-748-7304UnitedHealthcare Provider Appeals P .O . Box 30559 Salt Lake City, UT 84130-0575 You must submit your appeal to us within 12 months (or as required by law or your participation agreement), from the date of the original Explanation of Benefits (EOB) or Provider Remittance Advice (PRA) . Attach all supporting materials such as Customer-specific ...University of Utah Health Plans Attention: Claims Department PO Box 45180 Salt Lake City, UT 84145-0180. Check Claims Status Online. Wondering if a claim was received? Finished processing? What was paid to the provider or what is member responsibility? Save yourself a phone call by checking claims status online.www.pcnhealth.comLisa Cahill, Credit Cards Moderator. @lisacahill • 02/01/24. The address for Discover general inquiries to the customer service department is: P.O. Box 30943. Salt Lake City. UT 84130-0943. If you're looking for the Discover payment address, that's: P.O. Box 6103.P.O. Box 30573 Salt Lake City, UT 84130-0573 Fax: 801-567-5498 Dental Issues Appeals/Grievance Coordinator . Grievance & Appeals Department P.O. Box 30569 Salt Lake City, UT 84130-5690 Fax: 714-364-6266 Mental Health Issues Behavioral Health . National Appeals Team Attn: Appeals Department P.O. Box 30512 Fax: 855-312-1470 Vision IssuesPlease fax or mail your completed form along with any supporting medical documentation to the address listed below. Fax: 877-291-3248. (Each fax will be reviewed in the order it is received by the Appeals Department) UMR – Claim Appeals PO Box 30546 Salt Lake City, UT 84130 – 0546.Please fax or mail your completed form along with any supporting medical documentation to the address listed below. Fax: 877-291-3248. (Each fax will be reviewed in the order it is received by the Appeals Department) UMR - Claim Appeals PO Box 30546 Salt Lake City, UT 84130 - 0546.PO Box 30766 Salt Lake City, UT 84130-0766 WebMD Payor ID 91051. Client Information. Service Area Definition: Alaska, Idaho, Montana, Oregon, Washington, and Wyoming. Groups. Group Name Group Number; 13 COINS ACQUISITION LLC COBRA: 5214699: 13 COINS ACQUISITION LLC DBA 13 COINS RESTAURANT: 5214600:Situated in the scenic and unique Salt Lake Valley, close to the Wasatch Mountains, Sandy is Utah’s fifth largest city. Outdoor sports enthusiasts have their… By clicking "T...Physicians are doing their best to provide high-quality patient care in a fragmented health system . . . Health & Human Service should target areas where fraud truly occurs to be most effective instead of adding onerous burdens on physicians. The administration should establish clearly defined goals for fraud efforts to appropriately target scarce resources …o UHC Preferred Complete Care FL-0003 (HMO C-SNP) H1045-018-000 - B5LLake Oswego, a beautiful city in Oregon, is known for its stunning landscapes and vibrant community. The weather in this region can be quite unpredictable, with sudden changes and ...This change: As a result, beginning Feb. 1, 2023, you’ll be required to submit claim reconsiderations and post-service appeals electronically. This change affects most* network health care professionals (primary and ancillary) and facilities that provide services to commercial and UnitedHealthcare® Medicare Advantage plan members.Salt Lake City International Airport is a bustling hub for travelers from all over the world. If you’re planning a trip to Salt Lake City and want to explore the surrounding area a...Uhc Appeal Form for Corrected Claim - Free download as PDF File (.pdf), Text File (.txt) or read online for free. This document is a claim reconsideration request form for UnitedHealthcare. It provides instructions for physicians, hospitals, and other healthcare professionals to request reconsideration of claims for commercial and Medicare plans administered by UnitedHealthcare.Contact Us. Taylorsville Redwood Campus Academic and Administration Building (AAB), Room 301 801-957-4222 [email protected]. Mailing Address. Salt Lake Community College Attn: Accounts Payable Mail Stop: AP PO Box 30808 Salt Lake City, UT 84130. Business Hours. Monday-Friday 8 a.m.-4:30 p.m.P.O. Box 30552 Salt Lake City, UT 84130-0552. Additional information may be required. PTEs are valid for 90 days from the decision date. How do I submit orthodontic claims? Most of our plans for orthodontic services are paid in 3 parts — upon banding, at de-banding and monthly by automatic payment until the orthodontic coverage is satisfied.P.O. Box 30384. Salt Lake City, Utah 84130-0384. Loans. Phone . Personal Loans . You can also apply for a loan or manage your loan account online. 1-844-273-1384. Mon - Fri: 9 am - 8 pm EST . ... P.O.Box 1270 Newark, NJ 07101-1270 . Bill Payment (Overnight) American Express. Attn: Express Mail Remittance Processing 20500 Belshaw Ave.Claim submissions should be in a HIPAA-compliant 837 I or P format. For paper submissions and correspondence, use: Mid-West Optum Care Claims. Indiana P.O. Box 30781. Ohio Salt Lake City, UT 84130. Mountain West Optum Care Claims. Arizona P.O. Box 30539. Colorado Salt Lake City, UT 84130.P.O. Box 5290 Kingston, NY 12402-5290. Community Plan Behavioral health P.O. Box 30760 Salt Lake City, UT 84130-0760. ACC/DD/Dual Complete 800-445-1638. Dual Complete® (HMO D-SNP) Attn: Provider claim disputes P.O. Box 31364 Salt Lake City, UT 84131-0364. General claim disputes P.O. Box 31364 Salt Lake City, UT 84131 …P.O. Box 30552 Salt Lake City, UT 84130-0552. United Healthcare Dental Claims Unit P.O. Box 30567 Salt Lake City, UT 84130-0567. ... Salt Lake City, UT 84130-0567. Solstice Benefits P.O. Box 19199 Planation, FL 33318. UMR P.O. 30541 Salt Lake City, UT 84130-0541. Blue Shield of California Claims Address: For membership outside Orange County ...P.O. Box 30884 Salt Lake City, UT 84130-0884. Provider Important Contacts
Top Travel Destinations in 2024
PO Box 30321 Salt Lake City Utah 84130-0321 US Telephone:+1 877 424 2449 Fax: +1 801 975 1846. Europe. Europe. InterContinental Hotels Group PLC Guest relations. Telephone:+44 (0)800 40 40 40 Toll charges apply to all calls. Asia, Middle East and Africa. Asia, Middle East and Africa.PO Box 34593. Seattle, WA 98124-1593 ... PO Box 30766. Salt Lake City, UT 84130-0766 Reconsiderations not related to Post service: Claims payment review & reconsideration process. Retroactive authorizations, extenuating circumstances, and provider reconsideration requests;How to Fill Out Forms Related to PO Box 30425. Filling out forms related to PO Box 30425 Salt Lake City Utah, requires attention to detail. Here's a step-by-step guide to ensure accuracy and completeness. Start with the basics: Include your full name, current address, and contact information at the top of the form. Ensure every detail matches ...Non-SWHR contracted health care providers should submit 2022 claims to UnitedHealthcare by one of the following ways: Electronic: Payer ID 87726. Mail: UnitedHealthcare, P.O. Box 30975, Salt Lake City, UT 84130-0975. Groups HCFAC3-OUL, HCFAO4-OE7: UnitedHealthcare, P.O. Box 30765, Salt Lake City, UT 84130-0765.Address: 4215 S 500 W / PO Box 30676 Salt Lake City, UT, 84130-0676. Phone: 801-268-4500. Toll Free: 800-888-4545. Fax: 801-268-4596. Website: steveregan.com Contact this Company. This company is located in the Mountain Time Zone and the office is currently Open. Get a Free ... Salt Lake City, Utah toFull info of Discover Bank in Salt Lake City, site, email, 5420 W 1730 S, Salt Lake City, UT 84104, (800) 347-7454Or mail the completed form to: Provider Dispute Resolution PO Box 30788 Salt Lake City, UT 84130. NOTE: This form is for claim disputes and reconsiderations only. To submit a formal appeal, please see the instructions listed on the back of your explanation of payment (EOP). *Provider Name: *Provider TIN:If you are unable to use the online reconsideration and appeals process outlined in Chapter 10: Our claims process, mail or fax appeal forms to: UnitedHealthcare Appeals. P.O. Box …Salt Lake City Area 801-297-7780. Toll Free 800-DMV-UTAH (800-368-8824) ... Utah State Tax Commission Motor Vehicle Division P.O. Box 30412 Salt Lake City, UT 84130. Express Delivery Utah State Tax Commission Motor Vehicle Division 210 North 1950 West Salt Lake City, UT 84116. Request a Meeting. DO NOT use this for routine …P.O. Box 30573 National Appeals Team . Salt Lake City, UT 84130-0573 Attn: Appeals Department . Fax: 801-567-5498 P.O. Box 30512 . Fax: 855-312-1470 . Dental Issues Vision Issues . Appeals/Grievance Coordinator Appeals/Grievance Coordinator . Grievance & Appeals Department P.O. Box 30978 . P.O. Box 30569 Salt Lake City, UT 84130P.O. Box 30559 Salt Lake City, UT 84130-0559. UHC Medicaid Paper Claim Reconsideration request Addresses/Fax numbers. UnitedHealthcare Community Plan AZ APIPA Claims PO BOX 5290 Kingston, NY 12402-5290 801-994-1224. UnitedHealthcare Community Plan CA PO Box 31365 Salt Lake City, UT 84131-0365P.O. Box 3897. Little Rock, AR 72203. HealthChoice Appeals Unit. P.O. Box 30546. Salt Lake City, UT 84130. Please follow the steps below to make sure that your appeal at any level is processed in a timely manner: If applicable, send a copy of any letter regarding a decision of your appeal. Send a copy of the EOB with any relevant additional ...Medicare-Medicaid Appeals and Grievances Process. Your health plan must follow strict rules for how they identify, track, resolve and report all appeals and grievances. The following information applies to benefits provided by your Medicare benefit. The following details are for Dual Complete, Medicare Medicaid Plans, MA SCO and FIDE plans only.Medica Behavioral Health claims should be submitted to: Medica PO Box 30757 Salt Lake City, UT 84130 Electronic pay ID: 87726. Medica Chiropractic claims should be submitted to: Medica PO Box 212 Minneapolis, MN 55440-0212 Electronic pay ID: 41161.City State ZIP Ph# ( ) Date of Birth / / SelectHealth may share information about the SelectHealth member named above (check one): q For one year from the signature dateq For the length of the policyq Until this date / / ... P.O. Box 30192 Salt Lake City, UT 84130-0192 Phone: 800-538-5038 (toll-free) Fax: 801-442-6580 selecthealth.org. Created ...Post-Service Appeals - Designation of Authorized Representative. 115 W. Wausau Ave Wausau, WI 54401-2875. UMR Post Appeals PO Box 30546 Salt Lake City UT 84130-0546.1. Discuss network and non-network care provider options with the UnitedHealthcare member and provide them with a copy of UnitedHealthcare’s Laboratory and Pathology Services Consent Form. This is a separate form from the Member Advance Notice Form for the Involvement of a Nonparticipating Provider. PCA--1-002365-06222016-06242016. …How to get in some Salt Lake City skiing in a long weekend from the East Coast and still get in three days of skiing (plus après and hotel tips). “For sure, I thought you were gonn...Care Provider Administrative Guides and Manuals. add_alert. May 30, 2024 at 8:00 AM CT. For information on the Change Healthcare cyber response, find updated information on the Provider Portal. You can also learn more about the Temporary Funding Assistance Program on the Optum website open_in_new.PO Box 30989 . Salt Lake City, UT 84130 . Written provider appeals: UnitedHealthcare I March Vision Care . Attn: Medicaid Vision Appeals . PO Box 30988 . Salt Lake City, UT 84130 . Please do not send any claims or appeals to 6601 Center Drive West, Suite 200, Los Angeles, CA 90045.How to get in some Salt Lake City skiing in a long weekend from the East Coast and still get in three days of skiing (plus après and hotel tips). “For sure, I thought you were gonn...Utah. Salt Lake City. United Behavioral Health. PO Box 30755, Salt Lake City, Utah 84130. (800) 720-4158. Find and Insurance Provider Near Me.Or mail the completed form to: Provider Dispute Resolution PO Box 30781 Salt Lake City, UT 84130. NOTE: This form is for claim disputes and reconsiderations only. To submit a formal appeal, please see the instructions listed on the back of your explanation of payment (EOP). *Provider Name: *Provider TIN:P.O. Box 30991 Salt Lake City, UT 84130-0991 Payer ID: 95467. Member and Provider Complaints and Appeals Address. UnitedHealthcare Community Plan Attn: Complaint and Appeals P.O. Box 30991 Salt Lake City, UT 84130-0991. Overbilling and Refund Address. UnitedHealthcare Community Plan P.O. Box 740804 Atlanta, GA 30374.PO Box 30541 Salt Lake City, UT 84130-0541; If you are applying for reimbursement for charges from a dentist, contact United Concordia Dental (UDC) at 1-866-851-7568 to request a claim form, and return the completed claim form to UDC at: United Concordia Companies, Inc. Dental Claims PO Box 69421 Harrisburg, PA 17106-9421Calling Member Services at 800-538-5038. Submit claims to us via: Electronic Data Interchange (EDI) transactions. U.S. Mail to: P.O. Box 30192 SLC, UT 84130 (for Commercial/Medicaid/CHIP) P.O. Box 30196 SLC, UT 84130 (for Medicare claims ONLY) Monitor submitted claim status by: Using the Provider Benefit Tool. Learn more . providerexpress.com: • Demographic Updates • Guidelines an