UMR (UnitedHealthcare Solutions, Inc.) fax number

Fax destination details

Department

Medical Claims / Claims Submission

Purpose

Medical claim submission

Form

Claim submission form — Member Medical Claim Submission Form

Address

PO Box 30541, Salt Lake City, UT 84130-0541

Voice phone

877-293-4913 (fax)

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

Submit your itemized bill or receipt with this claim form. Include patient name, date of service, description of service, diagnosis, and charge for each service, plus provider name, address and 9-digit provider tax ID. For valid claims, include the provider's tax ID (9 digits) and complete all required fields. Attach itemized statements to the back of the form; use a separate form for each provider and each family member. This fax number also supports international faxing.

Official form instructions are published as a downloadable file on the organization's website.