How do I request from the Settlement Claims Administrator the report that lists the covered out-of-network services or supplies I provided?
You can request a copy of this report from the Settlement Claims Administrator by completing and signing the authorization form contained in page 15 of the claim form. You can also visit www.ama-assn.org/go/ucrsettlement to download a copy of the authorization form. Then, return the form to the Settlement Claims Administrator by mail, fax or e-mail: • Mail: United HealthCare Class Action Litigation c/o Berdon Claims Administration LLC P.O.
