How to use this page

To ensure accurate submission of your claims, answer these three questions:

  1. What plan is it? Mass General Brigham plans have instructions specific to them.
  2. What type of plan is it? Check the section on HMO Plans & PPO Plus plans for instructions specific to those plan types.
  3. What state are you located in? Your state will help determine where you should submit your claims.

 

 On this page:

 

Mass General Brigham Employee plans

Mass General Brigham employee plan members have access to the Mass General Brigham Health Plan network and the UnitedHealthcare Options PPO network outside of Massachusetts.

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  • Medical: Mass General Brigham Health Plan network and non-contracted providers in Massachusetts

    Mass General Brigham Health Plan network providers in all states and non-contracted providers in Massachusetts should submit claims directly to Mass General Brigham Health Plan. 

    Mass General Brigham Health Plan
    Provider Service: 855-444-4647
    Payer ID: 04293
    Paper Claims: PO Box #323, Glen Burnie, MD 21060

  • Medical: Non-contracted providers outside of Massachusetts

    Non-contracted providers outside of Massachusetts should submit claims to UnitedHealthcare Shared Services.

    UnitedHealthcare Shared Services
    Visit https://uhss.umr.com or 866-683-6441
    Payer ID: 39026, Group ID: 78800271
    Paper Claims: P.O. Box 30783, Salt Lake City, UT 84130-0783

  • Behavioral health

    All behavioral health providers should submit claims to Optum.

    Optum provider Service: 844-451-3520
    Payer ID: 87726
    Paper Claims: PO Box 30757, Salt Lake City, UT 84130-0757
    Visit the Optum Provider Express Portal for more information and to check member eligibility. When checking eligibility for Mass General Brigham Health Plan members, remember to search by name and date of birth

HMO Plans & PPO Plus plans 

HMO plans include access to the Mass General Brigham Health Plan network. PPO Plus Plans include access to the UnitedHealthcare Options PPO network.

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  • Medical

    HMO plans:

    Providers contracted with Mass General Brigham Health Plan and non-contracted providers in Massachusetts, New Hampshire, and Rhode Island:
    Mass General Brigham Health Plan
    Provider Service: 855-444-4647
    Payer ID: 04293
    Paper Claims: PO Box #323, Glen Burnie, MD 21060
     
    Urgent and emergency care outside of Massachusetts, New Hampshire, and Rhode Island:
    UnitedHealthcare Shared Services
    Visit https://uhss.umr.com or 866-683-6441
    Payer ID: 39026, Group ID: 78800215
    Paper Claims: P.O. Box 30783, Salt Lake City, UT 84130-0783

     

    PPO Plus plans:

    Providers in Massachusetts and New Hampshire:
    Mass General Brigham Health Plan
    ​Provider Service: 855-444-4647
    Payer ID: 04293
    Paper Claims: PO Box #323, Glen Burnie, MD 21060
     
    Providers outside of Massachusetts and New Hampshire:
    UnitedHealthcare Shared Services
    Visit https://uhss.umr.com or 866-683-6441
    Payer ID: 39026, Group ID: 78800215
    Paper Claims: P.O. Box 30783, Salt Lake City, UT 84130-0783

  • Behavioral health

    Submit behavioral health claims to Optum.

    Provider Service: 844-451-3518
    Payer ID: 87726
    Paper Claims: PO Box 30757, Salt Lake City, UT 84130-0757
    Visit the Optum Provider Express Portal for more information and to check member eligibility. When checking eligibility for Mass General Brigham Health Plan members, remember to search by name and date of birth

My Care Family plans

My Care Family offers complete care and coverage through MassHealth by Greater Lawrence Family Health Center, Lawrence General Hospital, and Mass General Brigham Health Plan.

 

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  • Medical

    Mass General Brigham Health Plan billing information:
    Mass General Brigham Health Plan Provider Service: 855-444-4647
    Payer ID: 04293
    Paper Claims: PO Box #323 Glen Burnie, MD 21060

  • Behavioral health

    Submit behavioral health claims to Optum.

    Provider Service: 844-451-3518
    Payer ID: 87726
    Paper Claims: P.O. Box 30760, Salt Lake City, UT 84130-0760

    Visit the Optum Provider Express Portal for more information and to check member eligibility.

Medicare Balance plans

Medicare Balance provides secondary coverage to Medicare — all members are required to have both Medicare Parts A and B. Medicare Balance does not have a provider network, so members may choose to see any doctor, anywhere in the nation, who accepts Medicare. Medicare Balance members don't need a referral to see a specialist.

Medicare Balance member ID

Claims information

For billing purposes, Medicare should be listed as the member's primary coverage and Medicare Balance as their secondary coverage. Also, Medicare Balance pays the entire balance on member deductibles and coinsurance costs for services charged at the Medicare-allowed amount. So, you don't have to collect any out-of-pocket fees from your patients.
 


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Additional claims resources

Here you'll find additional resources and forms related to the Mass General Brigham Health Plan claims processes.