MINNEAPOLIS (Sept. 17, 2007) – Physicians nationwide who work with UnitedHealthcare now have access to a new online claim-estimating tool that makes confirming eligibility and anticipating costs associated with medical care easier and faster for both physicians and consumers.

With UnitedHealthcare’s Claim Estimator, physicians can determine in advance of a patient’s office visit whether the individual is covered for a procedure and the estimated cost of the service.  The cost estimate includes how much the patient will owe and how much the physician is likely to be reimbursed.  The Claim Estimator provides this estimate in less than 10 seconds without requiring physicians or their staff to submit paperwork or make phone calls to verify patient eligibility and reimbursement rates. 

The Claim Estimator is available to doctors now at UnitedHealthcare’s dedicated physician Web site, www.unitedhealthcareonline.com.  

“The Claim Estimator is a significant step forward in simplifying the health care experience and making cost information more transparent for both consumers and physicians,” said Sam Ho, M.D., UnitedHealthcare’s executive vice president and chief medical officer.  “The Claim Estimator reduces administrative work for doctors’ offices and provides needed coverage, cost and payment information in seconds.”

The Claim Estimator (known to physician offices as a ‘pre-determination of benefits’) provides consumers with clearer information on out-of-pocket costs.  For instance, physicians’ staff can give patients peace of mind while scheduling an appointment by confirming that the anticipated service is covered and how much the individual will have to pay for the procedure.  Also, physicians who recommend a follow-up procedure can determine eligibility and cost for additional treatment before the patient leaves the office or sets up additional appointments.

To use the Claim Estimator, a doctor or staff person goes online and enters the relevant patient information, diagnosis and procedure codes.  Within 10 seconds, UnitedHealthcare confirms whether the patient is eligible and provides an estimate of the amount the physician will be reimbursed by UnitedHealthcare and how much the patient will owe, based on his or her benefits coverage.

Doctors’ offices can also use a unique feature of the Claim Estimator to better manage compliance with rules and regulations surrounding claim submission.  The technology enables “what if” scenarios that test in advance whether the claims the office is planning to submit will meet coding guidelines or require additional information.  This helps reduce the likelihood of claim adjustments, removing what can be time-intensive work.

The Claim Estimator is the latest step in an ongoing effort by UnitedHealthcare to simplify physicians’ office billing and administrative processes so they have more time to focus on patient care.  Earlier this year the company announced real time adjudication, which enables physicians to receive a fully adjudicated claim in less than 10 seconds.  Coupled with the Claim Estimator, the two tools now allow doctors to estimate a full claim experience before seeing a patient, and then have the official claim fully processed before the patient leaves the office.

About UnitedHealthcare
UnitedHealthcare (www.uhc.com) provides a full spectrum of consumer-oriented health benefit plans and services.  The company organizes access to quality, affordable health care services on behalf of more than 26 million individual consumers, contracting directly with more than 535,000 physicians and care professionals and 4,700 hospitals nationwide to offer consumers broad, convenient access to services nationwide.  UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company.