New ORP claim denials for UnitedHealthcare Community Plan of Ohio
Claims without an NPI number will be denied
Starting May 1, 2025, the state of Ohio requires that claims include a valid National Provider (NPI) number for the ordering, referring and prescribing (ORP) health care professional. UnitedHealthcare Community Plan of Ohio will deny claims that do not contain a valid NPI.
If you are an ORP health care professional, you must include a National Provider Identifier (NPI) number on your claim. Claims submitted without an NPI number will be returned with a Y42 denial and the following message(s):
- OH Ordering NPI Not Submitted on Claim (behavioral health)
- OH Ordering or Referring NPI Not Submitted on Claim
What to do if you receive a Y42 denial
If you receive a Y42 denial, please submit a corrected claim based on your UnitedHealthcare Provider Agreement timely filing deadline. If you do not submit a corrected claim on time, we will deny the claim for timely filing.
Resources
- Learn how to send a corrected claim
- Find additional information about which procedures require an NPI number for ORP health care professionals
Questions?
For chat options and contact information, visit Contact us.
PCA-1-25-00133-POE-NN_04162025
