When I call UnitedHealthcare with a concern on how my claim was processed and they send my claim back to be reviewed, is that the same as an appeal?
No. Your claim/inquiry will be forwarded to the appropriate department for review to determine if the calculation is correct or if it needs to be submitted for reprocessing. A determination will be mailed from UnitedHealthcare within ten business days. If the determination results in a different benefit calculation, you will receive a corrected Explanation of Benefits (EOB) and additional benefit, if applicable.
