Understanding UHA's Claims Process

Now that your group has coverage with us, whose responsibility is it to file your claims, and what is the process for filing those claims?

Members must show their UHA Member ID card at the time of service to verify eligibility. In the event a member has dual coverage, other carrier's membership card(s) should be presented as well.

A non-participating provider may either file a claim on the member's behalf, or give the member the claim to file with UHA. The member is responsible for submitting a completed claim form to UHA with attached copies of the bill and payment receipt for services1. You may contact Customer Services for assistance with filing your claim.

All claims submitted from a foreign country for reimbursement must be translated into English. If the bill was paid with foreign currency, the rate of exchange applicable on the date of service must also be supplied to UHA1.

Explanation of Benefits

After claims have been processed, we will send an Explanation of Benefits (EOB) to the subscribing member. The EOB should be kept for filing with another carrier when applicable and also for tax purposes2. Members should review the EOB to verify that the services listed were actually provided. Please notify UHA immediately if you did not receive the services indicated on the EOB.

Typically, claims received by UHA are processed within 30 days of receipt.

For comprehensive information on claims submission, coordination of benefits, and third-party liability please refer to the Medical Benefits Guide.

For existing members, to view your current Benefit plan, claims and other information, please login to your account at Online Member Services.

UHA will only accept completed CMS (HCFA) 1500 and UB-92/UB-04 medical claim forms, which are the national standard forms.

  1. Claims, receipts and/or invoices are to be mailed to: 
    Attn: Customer Services 
    700 Bishop Street, 3rd Floor
    Honolulu, HI 96813
  2. UHA is not responsible for the loss of any receipts. Always keep a copy of everything submitted with your claims.
  3. Request for duplicate copies of Explanation of Benefits is taken, generated, and mailed by the Customer Services Department.