The claims mailing address is:
UMWA Funds
PO Box 211551
Eagan, MN 55121-2751
The Funds has a long-standing relationship with the Medicare program as a Health Care Prepayment Plan (HCPP) and is the Medicare payer for non- facility Part B services, such as physician, laboratory, and ambulance services and medical equipment and supplies. You must bill the Funds for Medicare Part B services. Medicare carriers will not pay for Part B services provided to Funds’ beneficiaries. The Funds payment to the provider will include the Medicare amount plus the Medicare coinsurance and deductible amount, making it unnecessary for the provider to submit claims to two payers.
Health care providers should bill charges for Medicare Part A services and other services normally paid by the Medicare fiscal intermediary directly to the intermediary as they would for patients without Funds’ benefits. After payment by the fiscal intermediary the provider may bill the Funds for Medicare coinsurance and deductibles.
The telephone number for pre-authorization is 1-800-292-2288, option #3.
No referral is required for The Funds’ Plans.
Yes, the prescription benefits are administered by CVS Caremark at 1-800-294-4741.
Yes, the Funds follows CMS’s guidelines related to Nurse Practitioners and Physician Assistants.
The timely filing is 12 months from the date of service for claims (21 months prior to 1/1/2011). An appeal of a denied claim must be filed within 180 days of the date of denial.
Appeals and Disputes can be submitted to the address below.
UMWA Health & Retirement Funds
P.O. Box 211225
Eagan, MN 55121-2625
Electronic Claims can be submitted from any clearing house* for payment by utilizing the Funds Electronic Payor ID Number.
*Excludes Change Healthcare Clearing House*
The electronic payer ID number is 52180.
The Funds utilizes ECHO for all payments on claims submitted. Below you will find the contact information for ECHO. Please note the Customer Service number below is a dedicated line for Funds providers.
