Notice of Health Plan Accreditation Survey

How to Submit a Claim

elderly man writing

In most cases, when you go to a network provider, you will not need to submit a claim for your care — their office will do it for you using the information on your member ID card. However, there are a few occasions when submitting a claim on your own may be required for you or the provider to receive reimbursement:

  • Overseas Claims: For covered services received outside the United States and Puerto Rico, you must submit a completed overseas claim form.
  • Out-of-Network Claims: Out-of-network providers may not submit a claim on your behalf, and you may have to submit this claim on your own.
  • Multiple Claims Payers: If another health plan is your primary payer and does not automatically submit claims to your secondary payer, you will need to submit a claim. If you have Medicare primary coverage, Medicare generally sends the processed claim for secondary coverage consideration.

Ways to File a Claim

Find out how you can submit a claim if you are enrolled in our Standard or High Option Plans. Stateside medical claims, overseas medical claims, and overseas pharmacy claims, are processed by our claims administrator, UMR. Stateside pharmacy claims are processed by our pharmacy benefits manager, Optum Rx.

Compass Rose Medicare Advantage members should visit retiree.uhc.com/CompassRose to find out how to submit a claim for their plan.

You can submit a claim online to UMR for:

  • Stateside medical claims
  • Overseas medical claims
  • Overseas pharmacy claims

To submit a claim online through your myCompass account:

  1. Sign in to myCompass
  2. Click Go to UMR in the Quick Links menu
  3. In the I need to... menu, click Find a form
  4. From the list, select Online Claim Submission

You can submit a claim by mail to UMR for:

  • Stateside medical claims
  • Overseas medical claims
  • Overseas pharmacy claims

To file a claim with UMR by mail, send your completed claim form (linked below), itemized bills and proof of payment to:

UMR P.O. Box 8095
Wausau, WI 54402

You can also fax your claim form to (855) 405-2189.

To submit a claim online to Optum Rx, visit the Optum Rx website.

To file a claim with Optum Rx by mail, return the completed form (linked below) and acceptable receipts to:

Optum Rx Claims Department
P.O. Box 650629
Dallas, TX 75265-0629

It is important to send all documents for your claim as soon as possible. You must submit the claim by December 31 of the year after you received the service. If you were unable to file on time because of Government administrative operations or legal incapacity, you must submit your claim as soon as reasonably possible.

How to View Your Claims & EOBs Online

Get step-by-step instructions on how to access your Claims and EOBs through your myCompass account.

View Instructions