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September 01, 2023

Dec. 1: Digital pre-service appeal submissions required

Affects network commercial, Medicare Advantage and Dual Special Needs Plans (D-SNP)

Last modified: Oct. 30, 2023
Update: Contact and questions section updated to reflect new chat services

Beginning Dec. 1, 2023, you’ll be required to submit medical pre-service appeals electronically. No more wasting time tracking down lost or delayed mail. See your pre-service appeal status 24/7 in the UnitedHealthcare Provider Portal.

This change affects network health care professionals (primary and ancillary) and facilities that provide services to commercial, UnitedHealthcare® Medicare Advantage, and D-SNP plan members. Although not required, we also encourage UnitedHealthcare Community Plan (Medicaid) and out-of-network health care professionals to submit pre-service appeals electronically.

How to submit a pre-service appeal

You’ll use the Prior Authorization and Notification tool through the UnitedHealthcare Provider Portal:

  • From any page on UHCprovider.com, select Sign In at the top-right corner
  • Enter your One Healthcare ID and password
  • In the menu, select Prior Authorizations
  • Scroll down to “View Status of existing submissions, drafts and make updates” and click “Search Existing Submissions & Drafts”
  • Find your service reference number (SRN) and expand to see the details
    • If the details show the coverage status as “Not Covered/Not Approved,” you’ll see the “File a Pre-Service Appeal or a Grievance” link
    • You can also click on the SRN to see the originally entered case details, as well as the “File a Pre-Service Appeal or a Grievance” link under the coverage status section
  • Once you click the link, a new tab will open that takes you to the instructions page of the submission form
  • You will be guided to complete the form, upload any supporting documents, review your information and submit
  • Use Advanced Filter to search Document Library for your pre-service appeal letters

Questions? We’re here to help.

Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.

PCA-1-23-02618-POE-News_08142023

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