INSURER FILING GUIDE

UMR

Use this public information to prepare your packet, then confirm the route on the insurer's own page.

AT A GLANCE

Claim facts

Member form	Member Claim Submission Form Number: UMF0022 Revision: 0425 UA Open the insurer form
Portal upload	YES
Portal path	Member account: Claims > Submit a claim > Submit an online claim; UMR app also accepts claim submission
Mail address	UMR, P.O. Box 30541, Salt Lake City, UT 84130-0541
Fax	855-444-2896
Attachments	Patient name; date of service; service description; diagnosis or type of illness or injury; charge for each service; provider name; provider address; provider tax ID; member number on attachments
Deadline	Not published by the insurer
Outcome and status	UMR member account Claims and EOBs; UMR app can view claims
Processing time	Not published by the insurer
Caveats	Coverage, filing limit, external review, and any behavioral carve-out depend on the employer plan; HMO or EPO, Medicare Advantage, and Medicaid routes are outside this generic form

STEP BY STEP

Filing steps

Source: https://www.umr.com/print/UMF0022.pdf

Read date: 10-09-2026

Research steps

Sign in to the UMR member account. Open Claims, select Submit a claim, then select Submit an online claim. The UMR app is also a published submission route. https://www.umr.com/print/UMF0022.pdf
Complete the online claim. The public PDF lists Behavioral health as a service type in this same route. https://www.umr.com/print/UMF0022.pdf
Add the receipt or itemized statement. It must carry patient name, service date, service description, diagnosis, charge for each service, and provider name, address, and tax ID. Put the member number on every attachment. https://www.umr.com/print/UMF0022.pdf
Select member payment rather than provider payment when the payment choice appears. https://www.umr.com/print/UMF0022.pdf
NOT PUBLISHED: whether the portal accepts the completed UMF0022 PDF as an attachment or replaces it entirely with on-screen fields. Also NOT PUBLISHED: accepted file types, size limit, file count, one-PDF versus separate-file rule, and submission reference. The signed-in tool is UNREADABLE without an account.
Check the claim and EOB under the UMR member account. The UMR app also shows claims. https://member.umr.com/home
NOT PUBLISHED: a universal timely-filing deadline or plan-specific behavioral carve-out. The employer plan controls.

Filing facts

Portal upload: YES
Portal: UMR member account and UMR app
Portal path: Member account: Claims > Submit a claim > Submit an online claim; UMR app also accepts claim submission
Mail address: UMR, P.O. Box 30541, Salt Lake City, UT 84130-0541
Fax: 855-444-2896
Attach: patient name; date of service; service description; diagnosis or type of illness or injury; charge for each service; provider name; provider address; provider tax ID; member number on attachments
File types: NOT PUBLISHED
File size limit: NOT PUBLISHED
Maximum files: NOT PUBLISHED
One file or separate files: NOT PUBLISHED
Confirmation: NOT PUBLISHED
Status check: UMR member account Claims and EOBs; UMR app can view claims
Processing time: NOT PUBLISHED
Member deadline: NOT PUBLISHED
Deadline basis: YES: UMR administers employer plans and the controlling plan document sets timely filing
Mental health route: UMF0022 includes Behavioral health and Substance use in the same member route; a plan-specific behavioral administrator remains NOT PUBLISHED

Confirm the address, fax number or portal path on the insurer's own claims page before you send; read on 10-09-2026.

Read on 10-09-2026 from https://www.umr.com/print/UMF0022.pdf. Confirm the address, fax number or portal path on the insurer's own claims page before you send.

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