Dec. 1: Digital pre-service appeal submissions required
Affects network commercial, Medicare Advantage and Dual Special Needs Plans (D-SNP)
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
- New users who don’t have a One Healthcare ID: Visit UHCprovider.com/access to get started
- 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
Chat with a live advocate 7 a.m.–7 p.m. CT from the UnitedHealthcare Provider Portal
Contact Us page.
For help accessing the portal, technical issues and changing notification preferences, please contact UnitedHealthcare Web Support at firstname.lastname@example.org or 866-842-3278, option 1, 7 a.m.–9 p.m. CT, Monday–Friday.
You can also contact UnitedHealthcare Provider Services at 877-842-3210, TTY/RTT 711, 7 a.m.–5 p.m. CT, Monday–Friday.