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Eligibility, Claims, and Reimbursement Resources

Check Claims and Eligibility Information

 

File claims and get quick online access to eligibility and claims status for your UniCare patients with Availity. You will also find benefits information and the status of the yearly deductible. If you do not already have an Availity account, register now.

For questions about claims:

1. Email us at UniCareProviderRelations@anthem.com or
2. Call UniCare Customer Service at 800-442-9300

See our Explore Our Plans page for links to detailed benefits information for UniCare members.

 

Filing Electronic Claims

 

UniCare complies with HIPAA 5010 Transaction Standards and Code Sets and with the electronic data interchange (EDI) standards for healthcare required by the Health Insurance Portability and Accountability Act (HIPAA). EDI is the computer-to-computer transfer of transactions and information. We encourage providers to submit claims electronically to improve productivity and efficiency.

UniCare has a strategic partnership with Availity to serve as our designated EDI gateway for all electronic data and transactions. Providers, billing services, and clearinghouses that wish to establish a direct connection can register to exchange EDI transactions at www.availity.com.  Learn more about filing electronic claims with UniCare.

 

Member ID Cards

 

To learn member copay amounts and other information, review our sample ID cards effective July 1, 2021 for each of our four plans.

 
 

Check Reimbursement Policies

 

Check UniCare’s reimbursement policies, which serve as a guide to help providers submit claims correctly and outline the basis for reimbursement if the service is covered by a UniCare member's benefit plan.

 

Important Information About Paper Claims Requirements

 

UniCare will return incomplete paper claims submitted on professional provider CMS 1500 Form (02/12 version) and institutional provider UB-04 Forms. Providers should ensure that paper claims are complete and follow data element usage, required fields, and valid code sets as defined in the National Uniform Claim Committee CMS-1500 Health Insurance Claim Form Reference Instruction Manual and the National Uniform Billing Committee Official UB-04 Data Specifications Manual.