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Review of an adverse benefit determination: what to do first
If your question or concern is about a benefit determination, you may informally contact UnitedHealthcare customer service before requesting a formal appeal. If the customer service representative cannot resolve the issue to your satisfaction over the phone, you may submit your question in writing. However, if you are not satisfied with a benefit determination as described in "Initial claim determinations", you may appeal it as described below, without first informally contacting customer service. If you first informally contact customer service and later wish to request a formal appeal in writing, you should contact customer service and request an appeal. If you request a formal appeal, a customer service representative will provide you with the appropriate address for UnitedHealthcare.
If you are appealing an urgent care claim adverse benefit determination, please refer to "Urgent claim appeals that require immediate action" and contact customer service immediately. The customer service telephone number is 800 387 7508. Customer service representatives are available to take your call during regular business hours, Monday through Friday.