Two-step claims reconsiderations and appeals process reminder

As a reminder, we follow a 2-step claims reconsideration and appeals process for UnitedHealthcare commercial and Medicare members, as outlined in Chapter 10 of the 2024 UnitedHealthcare Care Provider Administrative Guide for Commercial, Exchange, and Medicare Advantage (uhcprovider.com).

Under this policy, you’re allowed 1 reconsideration. If we deny that reconsideration, you can then file an appeal. Claims reconsideration does not apply in some states, based on applicable state law.

Take action

Familiarize yourself with the 2-step reconsideration and appeals process by viewing our Claims Interactive Guide titled: Claims - How To Submit Electronic Reconsideration Requests and Appeal/Disputes. When submitting a reconsideration, be sure to include all pertinent documentation. Your reconsideration request may be denied if the necessary documentation is not included, and you will not be allowed to file another reconsideration request.

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