When Do I Need to Submit a Claim?

You may need to submit a claim to UMP for payment if you receive services from a non-network provider or if you have other insurance that pays first and UMP is secondary.

How Do I Submit a Claim?

TIP: You may use the new UMP Vision Hardware Claim Form for billing UMP for contact lenses or eyeglasses. You need to submit a claim only if you get your vision hardware from a provider that doesn’t bill UMP.

To submit a claim yourself, you’ll need to obtain and mail the following documents:

1. The Uniform Medical Plan Claim Form—You can find the form here, or you may request a form by calling UMP Customer Service at 1-800-762-6004. You must fill out Sections 1, 2, 3, and 6 completely for the claim to be processed. Fill out Section 4 if the services were for a work-related illness or injury; fill out Section 5 if the patient has other insurance coverage.

2. An itemized bill from your provider that describes the services you received and the charges.

The following information must appear on the provider’s itemized bill for UMP to consider the claim for payment:

• Patient’s name and UMP ID number.
• Description of the illness or injury.
• Date and type of service.
• Provider’s name and credentials (such as MD), address, and phone number.

3. If UMP is secondary, you must include a copy of your primary plan’s Explanation of Benefits, which lists the services covered and how much the other plan paid. Do not submit a secondary claim to UMP until after the primary plan has paid.

If you have a claim form or an itemized bill from the provider, you do not have to send in proof of payment (such as a receipt). However, if the only documentation you have is a receipt, send it in along with your completed claim form. Please note that if UMP has to request additional information, this may delay the processing of your claim.

Section 6 on the UMP claim form asks you whether or not you have paid the provider. If you check “Yes,” UMP will send payment to you. If you check “No,” UMP will send payment to the provider. For hospital claims, UMP almost always sends payment directly to the hospital, whether it is in the UMP network or not.

Be sure to make copies of your documents for your records, or keep the originals and send UMP the copies.

Mail both the UMP claim form and the provider’s claim document (or bill) to: