WELCOME TO THE CLUB NOBODY WANTED TO JOIN
UnitedHealthcare Denied You?
Yeah. We're Pissed Too.
UnitedHealthcare denies 33% of all claims—that's not a typo. One out of three. If you feel like you've been robbed by a company that literally profits from your suffering, that's because you have.
Here's the good news: We built this because we were tired of watching billion-dollar insurance companies use AI to auto-deny grandma's hip surgery. You have more power than they want you to know. Let's use it.
No credit card • No signup • Just results
Let's Talk About the Elephant in the Room
(Spoiler: The elephant is UnitedHealthcare, and it's sitting on your claim)
That's double the industry average. If UHC denied you, you're not unlucky—you're statistically inevitable.
Congratulations! You're one of
UnitedHealthcare members nationwide
"Your health is our priority."*
*After shareholder value, executive bonuses, and lobbying budgets.
Real Talk: This Isn't Your Fault
You paid your premiums. You followed the rules. You trusted the system. And then UHC hired an AI to tell you that your doctor doesn't know what they're talking about.
Here's the thing: They're counting on you to give up. They're betting you'll just pay the bill or skip the treatment. Don't.
❌ They Make It Hard
- Confusing denial letters full of jargon
- Buried appeal deadlines and requirements
- 33% denial rate—double the industry average
- AI auto-denies without human review
- Banking on 99.8% of people giving up
✅ We Make It Easy
- Upload your denial → get your appeal letter
- AI extracts key info automatically
- Proper citations and legal language included
- State Insurance Commissioner escalation ready
- We're on YOUR side, fighting for your coverage
🤝 Why Is This Free? Here's the Deal.
Nobody expects something for nothing—we get it. Here's our ask: tell us if it worked. That's it. We're building something to help millions of people fight back against UnitedHealthcare and other insurers. Your feedback helps us make the AI smarter so we can help even more people get the coverage they deserve. You're not just getting a free appeal letter—you're helping us build a movement.
First: Identify Your UHC Plan Type
Different UHC plans have different appeal rights. Select yours:
Why Does UnitedHealthcare Deny Everything?
(Short answer: Because it's profitable. Long answer: Keep reading.)
Robot Says No
UHC uses NaviHealth—an AI system—to automatically deny claims. That's right: a robot that's never examined you is overruling your actual doctor. They've been sued multiple times for this. Still doing it.
$22 Billion Reasons
In 2023, UHC made $22 billion in profit. Not revenue. Profit. Guess how they did it? Not by approving your MRI. Every denial is basically a bonus for their shareholders.
"Oops, We Got Sued Again"
UHC has been sued, fined, and investigated more times than we can count. But here's the dirty secret: the fines are cheaper than the denials are profitable. It's just a cost of doing business.
Death by Paperwork
UHC drowns you in forms, deadlines, and bureaucracy. They're betting you'll give up. Most people do. That's not an accident—it's the business model.
🎯 UHC's Greatest Hits (Their Favorite Denial Excuses)
- "Not Medically Necessary" — Translation: "We don't care what your doctor says. We disagree." (Spoiler: They're not doctors.)
- "Experimental/Investigational" — FDA-approved for 10 years? Covered by Medicare? Doesn't matter. UHC calls it experimental.
- "Out-of-Network Emergency" — You had a heart attack at the wrong hospital. How inconsiderate of you.
- "No Prior Authorization" — "You should have called us before your emergency surgery."
- "AI Says No" — NaviHealth said you don't need rehab. NaviHealth is a computer. NaviHealth has never met you.
- "Wrong Level of Care" — Needed inpatient? Should've been outpatient. Needed outpatient? Should've been home care. It's never the right level.
Sound familiar? Yeah, we've heard it all. Here's how to fight back:
🛡️ Start Your Appeal Now→ Deep dive: UHC's denial pattern analysis (it's worse than you think)
Plot Twist: You Actually Have Rights
UHC's entire business model depends on you not knowing these. They really, really don't want you reading this section:
✅ Right to Internal Appeal
By law, they have to listen to you. UHC must conduct a "full and fair review" by someone different from whoever denied you. (Novel concept: fresh eyes.) For urgent care, they have 72 hours to respond.
🎯 Your move: File within 180 days. Pro tip: Use their own medical criteria against them. They hate that.
🏛️ External Review (The Good Stuff)
Someone who doesn't work for UHC reviews your case. This is the secret weapon they don't tell you about. Independent reviewers overturn UHC denials surprisingly often—and their decision is binding.
🎯 Your move: It's free for you and costs UHC money. Win-win (mostly for you).
⚖️ ERISA Rights (Employer Plans)
Federal law with actual teeth. If you get insurance through work, ERISA says UHC must follow strict timelines. They also can't suddenly invent new denial reasons during your appeal. (They try anyway. Call them on it.)
🎯 Your move: Document every deadline. ERISA violations can lead to legal action—and lawyers love these cases.
📢 Right to Complain (Loudly)
Make some noise. Your state DOI, CMS (Medicare), and DOL (employer plans) can all investigate UHC. They've been fined before. They don't like it.
🎯 Your move: File complaints at the same time as your appeal. Creates a paper trail and makes UHC nervous.
The Timeline (Mark Your Calendar)
Ready to Exercise These Rights?
We'll help you write an appeal letter that actually uses this stuff—legal citations, medical criteria, the works.
Generate My Appeal Letter →The Playbook: What Actually Works Against UHC
After seeing thousands of UHC denials, we've noticed patterns. These strategies work. They work because they exploit UHC's specific weaknesses:
1. Challenge Their Medical Criteria
UHC uses InterQual and MCG Health guidelines to make medical necessity determinations. Your doctor's letter should:
- Cite specific InterQual criteria your case meets
- Explain why UHC's interpretation is wrong
- Reference peer-reviewed studies supporting treatment
- Document failed alternative treatments (if applicable)
Pro tip: Ask UHC for the specific medical policy they used. They must provide it.
2. Expose AI/Algorithm Errors
If denied for rehab, skilled nursing, or post-acute care, challenge the AI system:
- Request manual review by a physician (not algorithm)
- Point out NaviHealth lawsuit and known AI errors
- Get your doctor to document individualized need
- Reference similar cases where UHC reversed AI denials
3. Use State-Specific Protections
Many states have laws UHC must follow:
- California: Mental health parity laws, timely access requirements
- New York: External appeal for all denials, 4-month response time
- Texas: HMO external review rights, prompt payment laws
- Florida: Provider-initiated appeals, network adequacy standards
4. Escalate to External Review Early
Don't waste time on multiple internal appeals. UHC rarely reverses themselves. Go to external review where independent reviewers:
- Aren't paid by UHC
- Review actual medical evidence
- Overturn UHC denials 40-50% of the time
- Make binding decisions UHC must follow
5. File Parallel Complaints
While appealing, file complaints with regulators:
- State DOI: Creates investigation, potential fines
- CMS (Medicare): Can suspend UHC's Medicare contract
- DOL (employer plans): ERISA violations investigation
- Better Business Bureau: Public record, media attention
Why this works: UHC cares about regulatory scrutiny and public reputation.
6. Document Everything
UHC will claim things were never sent, deadlines weren't met, or policies were followed. Protect yourself:
- Send appeals via certified mail, return receipt
- Keep screenshots of online submissions
- Record names, dates, times of all calls (if legal in your state)
- Save every email, letter, and EOB
- Create a timeline with dates and actions
Need a UHC Appeal Letter Template?
Get our proven template that addresses UHC's specific denial tactics.
Get Template →UHC Denials by State
UnitedHealthcare's denial rates and tactics vary significantly by state. Select your state to see specific data and resources:
Texas
38%
Denial Rate
Florida
36%
Denial Rate
Georgia
35%
Denial Rate
California
31%
Denial Rate
New York
29%
Denial Rate
Illinois
32%
Denial Rate
Data based on 2023 state insurance department reports and CMS Medicare Advantage data
David vs. Goliath: Real People Who Won
Spoiler alert: David wins more than you'd think. These are real UHC denials that got overturned. The money is real. The frustration was real. The victory? Also real.
Sarah's $127,000 Cancer Treatment Win
Denied: UHC denied Sarah's immunotherapy as "experimental" despite FDA approval and NCCN guidelines.
Strategy: Sarah's oncologist wrote a detailed letter citing clinical trials, FDA approval date, and NCCN Category 1 recommendation. External review overturned in 38 days.
Result: Full coverage approved. Sarah is now in remission.
✓ $127,000 covered
James' Emergency Surgery Reversal
Denied: UHC denied $43,000 emergency appendectomy at out-of-network hospital, claiming it wasn't an emergency.
Strategy: James filed internal appeal with ER records showing life-threatening condition. Cited federal law requiring emergency coverage regardless of network. State DOI complaint filed simultaneously.
Result: UHC reversed within 14 days of DOI complaint.
✓ $43,000 covered
Maria's Mental Health Parity Victory
Denied: UHC approved only 10 days of residential mental health treatment despite doctor recommending 30 days.
Strategy: Maria's therapist documented treatment plan showing medical necessity. Appeal cited Mental Health Parity Act violations. External review requested.
Result: Full 30 days approved before external review completed.
✓ $31,000 additional coverage
Robert's Medicare Advantage Rehab Win
Denied: UHC's NaviHealth AI denied skilled nursing after hip replacement, claiming Robert could do therapy at home.
Strategy: Robert requested physician review (not AI). Doctor documented why home therapy was unsafe given Robert's living situation. Cited NaviHealth lawsuit and requested manual clinical review.
Result: 21 days skilled nursing approved after escalation.
✓ $28,000 covered
UnitedHealthcare Appeal FAQ
Why does UnitedHealthcare deny so many claims?
UHC denies 33% of claims due to a combination of profit-driven policies, aggressive AI-based reviews (especially NaviHealth), and reliance on members not appealing. Their business model depends on denial rates significantly higher than competitors.
What's the best way to appeal a UHC denial?
Start with internal appeal within 180 days, but don't stop there. Request external review immediately after internal denial—this is where you have the best chance (40-50% success rate). File parallel complaints with your state Department of Insurance.
How long does UHC have to respond to my appeal?
Urgent/expedited: 72 hours. Standard: 30 days. External review: 45-60 days. If UHC misses these deadlines, they may be required to automatically approve your claim.
Can I appeal even if I already paid the bill?
Yes. You have 180 days from the denial date to appeal, even if you've paid. If successful, UHC must reimburse you. Keep all receipts and payment records.
What if UHC denies my appeal?
Request external review immediately. This is an independent third-party review that's binding on UHC. It's free for you and overturns UHC denials 40-50% of the time. Also file complaints with your state DOI and CMS (for Medicare).
Do I need a lawyer to appeal UHC?
Not for internal appeals and external review. Most successful appeals are done by members with doctor support. However, for very large claims ($100K+) or if UHC violates ERISA, consider consulting a patient advocate or attorney.
What's NaviHealth and why did it deny my rehab?
NaviHealth is an AI system UHC uses to evaluate post-acute care (rehab, skilled nursing). It's been sued multiple times for systematic over-denials. Request a physician review and challenge the AI decision with individualized medical evidence.
Can UHC deny emergency care because the hospital was out-of-network?
No. Federal law requires coverage of emergency care regardless of network status. If UHC denied emergency care, appeal immediately citing the Prudent Layperson Standard and federal emergency coverage requirements.
My employer plan is through UHC. Do I have ERISA rights?
Yes. Employer-sponsored plans are governed by ERISA, which gives you specific appeal rights and timelines UHC must follow. They cannot use new reasons during appeal that weren't in the original denial. See our ERISA guide.
Where do I file a complaint about UHC?
State DOI: Your state's Department of Insurance. CMS: For Medicare Advantage (1-800-MEDICARE). DOL: For employer plans (dol.gov/agencies/ebsa). File with all applicable agencies.
UnitedHealthcare Appeal Resources
Detailed Guides
External Resources
- → CMS Medicare Appeals
- → Department of Labor ERISA Help
- → NAIC Consumer Resources
- → Find your state Department of Insurance
They Made It Hard. We Made It Easy.
UHC designed their denial system hoping you'd give up. 99.8% of people do. You don't have to be one of them.
🤝 The Deal:
We're investing in you. We want to help millions fight back against unfair denials—and your feedback makes our AI smarter. All we ask: tell us if it worked.
No credit card • No signup • State Insurance Commissioner escalation included