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Insurer · UnitedHealthcare

How we file an UnitedHealthcare appeal.

The procedure we follow on an UnitedHealthcare bill — where the errors usually hide, and the codes and laws we cite.

UnitedHealthcare appeal procedure

UHC accepts appeals through MyUHC, mobile app, fax, or mail. They are aggressive on what they consider 'experimental' but receptive to procedure-coding appeals.

Most common findings on UnitedHealthcare bills
  • Optum-network steering (referrals coded out-of-network when in-network alternatives existed)
  • Modifier-25 over-application on E/M visits same-day as procedures
  • Telehealth visits billed at in-person rates
What we cite in UnitedHealthcare appeals
  • UHC Reimbursement Policy Bulletins
  • AMA CPT Manual
  • Federal No Surprises Act
  • State telehealth parity statutes

Got an UnitedHealthcare bill that looks wrong?

Start with the EOB and the provider’s itemized bill. The public site routes you to a free human audit instead of claiming an instant result.

Try the audit
Other insurers: Aetna · Blue Cross Blue Shield