Last modified: Oct. 30, 2023
Update: Contact and questions section updated to reflect new chat services
Did you know there’s another way to submit medical pre-service appeals? Network and out-of-network health care professionals (primary and ancillary) and facilities that provide services to UnitedHealthcare® Medicare Advantage, UnitedHealthcare Community Plan and Dual Special Needs Plan (D-SNP) plan members can now submit pre-service appeals electronically.
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
After submission, easily distinguish from post-service appeals and search Document Library for your pre-service appeal letters using Advanced Filter
Later in 2023, we’ll also add this feature to UnitedHealthcare commercial and UnitedHealthcare Individual Exchange plans, also referred to as UnitedHealthcare Individual & Family ACA Marketplace plans.