If a provider sends you a bill that you were not expecting, we recommend calling UMR at 855-858-6860 to break down the charges and confirm your financial responsibility. Should there be an error, UMR can assist with reprocessing the claim.
Common reasons to receive an unexpected bill:
The provider you saw was out of network
You have not met your annual deductible yet
A provider performed additional services not part of a standard office visit
The provider's billing department did not appropriately enter your insurance information
The claim contained billing or coding errors
UMR has not processed the claim yet
If calling in, having the bill in hand is best. Verify that the information on the bill is correct (e.g. date of service and provider name).
Deadlines for Reprocessing Claims
Try your best to call as soon as possible. There is usually a 6-month time frame where claims can be reprocessed.
Filing a Claim Appeal
After contacting UMR member services, you decide to file a claim appeal.