Tools To Make The Most Of Your Health Plan
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Determine Your Financial Responsibility

To determine what your financial responsibility may be in advance of receiving services, you should:

  1. Call the provider's office and request the CPT*, DRG** or APC*** codes that will be used to bill for services and the charge for each code - behind Unity's secure portal, you can access the Determination of Benefits Worksheet to help you gather this information.
  2. Submit the Determination of Benefits Worksheet by calling Unity Customer Service at 800-362-3310 between 7am and 5pm or by faxing it to 608-643-2564.  If you call Unity Customer Service, you must have the Worksheet information available to provide to the customer service representative.

Within 5 working days of a completed request, an estimate of your responsibility for the specific services will be mailed to you.

*CPT/HCPCS Codes - CPT is an acronym for Current Procedural Terminology.  These codes are used for professional services such as those services rendered by physicians who treat you in an office setting, during an inpatient hospitalization, or for outpatient hospital services.  HCPCS stands for Healthcare Common Procedure Coding System.  These codes are used for billing supplies, materials, injections and durable medical equipment services.

**DRG Codes - DRG is an acronym for Diagnostic Related Groups.  A DRG is the billing code associated with an inpatient hospital stay.

*** APC Codes - APC is an acronym for Ambulatory Payment Classification.  These codes are associated wth services provided at an outpatient facility.