How to Write a Letter to Appeal a United Health Care Denial

UnitedHealthcare is one of the largest health insurers in the U.S., offering plans with benefits such as coverage for doctor visits, specialist consultations and emergency room and hospital stays. There are times when a health insurance bill or claim is denied and fighting the denial is best initiated by filing an appeal directly through UnitedHealthcare. The appeal process will require you to make explanations, submit documentation and follow up with additional information as requested. A proper appeal will either get a denial reversed or give you exact reasons as to why the claim was denied.

Things You'll Need

• Insurance card
• Copy of front and back of insurance card
• Statement of medical bills that were denied
• Letter of claim denial from UnitedHealthcare

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Instructions

• 1

  Read the denial letter thoroughly and highlight the reasons or codes given to explain why the claim was denied.

• 2

  Gather all medical bills relevant to the denied claim and put them in chronological order. Make copies of all the bills and highlight service dates, insurance codes and charged amounts.

• 3

  Make copies of the front and back of your UnitedHealthcare insurance card, making sure that the copies are readable and all policy and group plan numbers are clearly visible.

• 4

  Put together a packet of the information you have just gathered before contacting UnitedHealthcare. Put a paperclip on the pile of documents and ensure that you have the denial letter, copies of all medical bills and the copy of your insurance card. Have a notebook and pen ready. Write the date, time and phone number on the top of the page before you begin your phone call.

• 5

  Find the customer care contact phone number listed on the denial letter. If you cannot locate a contact number, find the phone number listed on your UnitedHealthcare insurance card.

• 6

  Call UnitedHealthcare and ask to speak to a representative about the process of filing an appeal. Discuss the denial with the representative and take notes, including the representative's name and all information given to you. Ask for and write down the address where you can send a written appeal. Ask if there is a form for appeals and if so, obtain one by having it emailed, faxed or mailed to you.

• 7

  Write a letter or fill out the appeal form and include all information regarding your denial. Write the letter using facts and figures for which you have documentation. Keep your language professional and stick to the claim issue only. Do not use the letter to vent personal frustrations or opinions. Make a copy of the letter for your files, and keep it with your original documents. Send the letter to UnitedHealthcare along with copies of the documentation you gathered before. Follow up with UnitedHealthcare by phone in four to six weeks if you have not received a response. Continue contacting UnitedHealthcare every four to six weeks until you have been given a final determination regarding your claim and appeal.