Claims processing corrections and reprocessed claims
UnitedHealthcare (UHC) recently identified and corrected several claims processing issues affecting University of Missouri medical plans, primarily the Columbia Custom Network Plan. These errors prevented some claims from being processed correctly according to the 2026 plan designs.
The issue resulted from incorrect benefit configurations and fee schedule loading within UHC’s claims system. As a result, some claims were delayed or required reprocessing after corrections were made.
Most of these claims have been reprocessed, and plan members may now receive Explanation of Benefits (EOB), revised bills or account adjustments for services received as early as Jan. 1, 2026.
Read the message from UnitedHealthcare (PDF)
What this means for plan members
The impact will vary based on the services received and the specific claims involved. Depending on your situation, you may receive:
- An updated Explanation of Benefits (EOB)
- A revised billing statement from your health care provider
- A refund
- An adjusted account balance
Because many affected claims from earlier in the year were delayed and reprocessed together, you may receive multiple updates or adjustments within a short period of time.
January 2026 benefit changes to Columbia Custom Network Plan
Additionally, because some claims were not processed accurately or timely, employees enrolled in the Columbia Custom Network Plan may not have immediately experienced the deductible, copay and coinsurance changes that became effective Jan. 1, 2026. Your financial responsibility may differ from what you initially expected based on claim activity in previous years.
These updated coverage amounts and patient responsibilities were shared during the 2025 annual enrollment period and went into effect Jan. 1, 2026. More information can be found in the 2026 Summary of Benefits and Coverage (PDF), and a comparison chart of the changes from 2025-2027 plan years is available on this page for reference. The Columbia Custom Network Plan design will be the same from 2026-2027.
Year comparison for Columbia Custom Network Plan
For emplyoyees who live or work in Missouri counties: Audrain, Boone, Callaway, Cole, Cooper, Howard, Moniteau, Osage and Randolph. Refer to the table for coverages in 2025, 2026 and 2027.
| Category | 2025 in-network cost*3 | 2026 in-network cost*3 | 2027 in-network cost*3 |
|---|---|---|---|
| Medical deductible | $200/self; $600/family*2 | $500/self; $1,500/family*2 | $500/self; $1,500/family*2 |
| Rx deductible | Retail: $50/person; Mail-order: $0/person | Retail: $75/person; Mail order: $0/person | Retail: $75/person; Mail order: $0/person |
| Preventive care | $0 | $0 | $0 |
| Primary care | $15 copay/visit | $20 copay/visit | $20 copay/visit |
| Specialist care | $40 copay/visit | $40 copay/visit | $40 copay/visit |
| Urgent care | $50 copay/visit | $100 copay/visit | $100 copay/visit |
| Lab and x-ray | $5 copay/basic; $100 copay/advanced | 10%*1 | 10%*1 |
| Outpatient care | 10%*1 | 10%*1 | 10%*1 |
| Inpatient care (incl. maternity delivery) | 10%*1 | 10%*1 | 10%*1 |
| DME | 10%*1 | 10%*1 | 10%*1 |
| Emergency room | $250 copay/visit*1 | $250 copay/visit*1 | $250 copay/visit*1 |
| Ambulance | $200 copay/occurrence*1 | 10%*1 | 10%*1 |
Rx drug:
| Greater of copay or coinsurance*1:
| Greater of copay
| Greater of copay
|
| Medical limit | $3,750/self; $7,500/family*2 | $3,750/self; $7,500/family*2 | $3,750/self; $7,500/family*2 |
| Rx limit | $5,450/self; $10,900/family*2 | $6,850/self; $13,700/family*2 | $6,850/self; $13,700/family*2 |
*1 Coinsurance percentage or copayment after deductible is met.
*2 Considerations for “self” and “family” are different for the Healthy Savings Plan than for the Custom Network Plan and the PPO Plan.
*3 Refer to the Summary Plan Description (SPD) for additional details on allowable and eligible expenses when using an out-of-network provider.
*4 90-day fill/refill at Mizzou pharmacies at same cost as mail order.
What we're doing
Receiving updated claims information months after receiving care can be frustrating and confusing. We are working closely with UHC to ensure claims are processed according to the 2026 plan design and to ensure their claims settings are correct for 2027. UHC has corrected the underlying configuration issues and has reprocessed the majority of affected claims. We also are working with employees and providers to address questions and concerns as claims are updated. Our goal is to ensure claims are processed accurately and consistently moving forward.
Need assistance?
If you have questions about a claim, an Explanation of Benefits, or a revised bill you receive, support resources are available to help you understand any changes and determine whether any action is needed.
- Visit MyUHC to view your Explanation of Benefits (EOB).
- For questions about your coverage or claim processing, call UnitedHealthcare at 844-634-1237.
- For questions about medical bills or payment plans, contact your provider’s financial services team. For MU Health Care, contact Patient Financial Services at 573-882-2765 or toll-free at 1-833-965-2404.
- For questions about plan design changes, contact the HR Service Center at 573-882-2146 or 800-488-5288 (toll free)
We know that receiving updated claim or billing information can be confusing, especially when it relates to care you received months ago. We regret the disruption this situation has caused and are committed to keeping you informed and providing the support you need throughout this process.