Contact UnitedHealthcare directly. Their member services number is readily available on their website.
Gather your documentation. This includes your prescription, claim denial letter, and any supporting medical evidence from your doctor explaining medical necessity.
- Clearly understand the reason for denial. The denial letter usually specifies why your claim was rejected. This is crucial for your appeal. If the denial is based on prior authorization requirements, ensure you’ve followed all procedures. If the denial cites a lack of medical necessity, obtain additional documentation from your doctor emphasizing the medical justification for Viagra’s prescription.
Follow the appeal process outlined in your denial letter. This usually involves submitting a written appeal with all supporting documentation within a specific timeframe.
Carefully complete the appeal form provided by UnitedHealthcare. Clearly state your disagreement with the denial and reiterate your need for the medication. Include all relevant documentation, including your doctor’s supporting statement. Send your appeal via certified mail with return receipt requested for proof of delivery.
If your initial appeal is unsuccessful, explore your next steps. UnitedHealthcare’s denial letter will explain their internal review process and potential avenues for further appeal. You may want to consult with your doctor or a healthcare advocate for assistance.
Track your appeal. Expect a response within a reasonable timeframe; however, the precise timeline depends on UnitedHealthcare’s processes. Contact them to check on the status of your appeal if you haven’t received a response within the expected timeframe.
