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Provider Information
Providers may submit medical claims to the Funds on paper or electronically.
- Medical Claims Submission
- Please submit paper claims for Funds' beneficiaries directly to the Funds at:
Claims Submissions
UMWA Health and Retirement Funds
P.O. BOX 619099
Dallas, TX 75261-9741
- Electronic Medical Claims Submission
- If you would like to submit claims electronically to the Funds, please contact Envoy at 1-800-215-4730 for information and assistance.
Provider Assistance Services
The Funds has four different provider assistance programs for medical services:
In addition to the above programs, the Funds' Field Service Offices provide general assistance to all providers.
- Medical Claims Assistance
Provider Customer Service
Medical claims assistance is provided by the Provider Customer Service unit. The Funds offers telephone support services to providers for inquiries about medical claims status, eligibility, medical benefits, coverage, remittance advice, and electronic claims submission information.
For assistance, please call the Provider Customer Service unit at 1-888-865-5290. You may chose to speak directly to a customer service representative or you may select the automated voice response system.
Provider Customer Service is available from 8:30 a.m. to 5:30 p.m., Eastern Standard Time, Monday through Friday.
- Provider Information Change Assistance
Provider Maintenance Unit
Provider information changes, such as changes in tax identification numbers, practice or billing address, name, and status may be mailed to the Provider Maintenance Unit. Providers wishing to submit claims and be included in the Funds' provider database file may mail basic practice information, including a W-9 form, Medicare number, specialty, a copy of your license, billing address, and practitioners' full names, UPINs and/or Social Security numbers to the Unit at:
Provider Maintenance Unit
UMWA Health & Retirement Funds
PO Box 619111
Dallas, TX 75261-9111
- Pre-Certification Assistance
Funds' Medical Management Assistance Line
Providers may call the Funds' Medical Management line at 1-800-292-2288 for information about eligibility, benefit determination, and pre-certification.
The Medical Management line is available from 8 a.m. to 6 p.m., Eastern Standard Time, Monday through Friday for pre-certifications. The Medical Management line is available from 8 a.m. to 4:30 p.m. EST Monday through Friday for pharmacy and medical appeals.
- Pharmacy Assistance
Funds' Pharmacy Services Inquiry Line
For assistance, providers and pharmacists may call the Funds' Pharmacy Services Inquiry Line at 1-800-294-4741. The Funds provides assistance for prescription claim status and eligibility inquiries, criteria-based prior authorizations and a technical help desk for pharmacists.
Pharmacy Services is available 24 hours a day, seven days a week.
- General Information Inquiries
Funds' Field Service Offices
For basic assistance on issues other than claims, providers may call the Call Center or the Funds' Field Service Office listed on your patient's Funds' membership card:
| Field Service Office |
Telephone Number |
| The Call Center |
1-800-291-1425 |
| Washington, PA |
1-724-229-5401 |
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