New, online functionality for small group eligibility verification audits

Creating simpler experiences and advancing innovation are just a couple of areas we are continually exploring to help enhance service to producers and our clients. One of our latest developments is new functionality on uhceservices.com and employereservices.com intended to streamline the client risk management audit process. 

• Home page message shown, post-login, informing of an audit
• Ability to respond to the audit entirely online, including uploading documents; producers responding to an audit on behalf of a client can complete a Group Attestation form as part of the online process and proceed without delay
• Ability to track the status of their audit/their group’s audit online (e.g., Not Submitted, Incomplete, Approved, Denied)
• Convenience of starting, pausing and returning to the audit response online at a later time without losing saved entries

The new, entirely online risk management audit process will be in place effective May 2023 for small group clients. Active audits for clients beginning with June 2023 renewal dates are the first to be implemented with the all-digital experience.  These clients and their producers will see the audit notification when they sign in to uhceservices.com or employereservices.com and can track the process online through completion. We anticipate releasing the audit notification to direct clients to utilize this experience with August 2023 renewal dates via mail per standard USPS process.

Our small group risk management audit protocols remain unchanged. We will also continue the practice of mailing a letter to clients identified for an eligibility verification audit and the client’s broker of record, in addition to the new online notification on uhceservices.com and employereservices.com.

1. Respond online to our audit notification as soon as possible; sign in to uhceservices.com or employereservices.com.
2. A message appears at the top of the screen indicating an Eligibility Verification Audit is required.
3. Click the link to begin the Eligibility Verification Audit response process; producers with multiple clients undergoing an audit can click View Groups for a list of their affected clients and the status of each client’s audit.
4. Review the guide, How to Complete an Eligibility Verification Audit, that is accessible within the eligibility verification website: uhc.com/rm.
5. Complete all forms in their entirety.
6. Gather all requested tax documentation. Be sure to include the required information listed in the instructions for each employee directly on the tax form(s) you submit.
7. Upload the documents in the Manage Documents section; producers completing the audit response on behalf of a client must also download the Group Attestation form from this section, fill in the required information and upload the completed form.
8. Confirm all requested information has been provided and uploaded as specified in the Eligibility Verification Audit guide.
9. After completing the required audit response forms online and uploading requested documentation, clients or producers acting on their behalf will be prompted finally to complete the Eligibility Verification Attestation form. Once this form is submitted online, a confirmation message will display on the page.

Please keep in mind that it can take at least up to 5 business days for us to process the information your client provides us, or you provide on your client’s behalf. If we do not receive the information timely, we will not be able to renew the client’s group coverage. It will be canceled as of the renewal date.

Review the guide, How to Complete an Eligibility Verification Audit, that is accessible within the eligibility verification website: uhc.com/rm, which provides details, including annotated screen images to help producers and clients become familiar with the new, online audit response features.

If you or your client experiences technical issues with uhceservices.com, including access or login issues, please call us, toll-free, at 1-866-908-5940 to be connected to a service associate who can assist you. All technical issues for Employer eServices call 1-800-651-5465, TTY 711.

For eligibility verification audit specific questions, including questions about the new, online capabilities, please call us, toll-free, at 1-877-504-1179, TTY 711 and a Risk Management team member will assist you. You can also reach the team by email at risk.management@uhc.com. Please include your name, the group policy number and a phone number with any messages.

We hope you and your clients find these online enhancements helpful. Additional enhancements are planned for the online Eligibility Verification Audit process this year and we look forward to providing you with the details as these developments become available.