Get Appeal Process With Priority Health

File a complaint (grievance) File a claim. Check the status of a claim. File an appeal. Appeals if you have a Medicare health plan. Get help filing an appeal. Your right to a fast appeal. Authorization to Disclose Personal Health Information (PDF)

Yes! You can appoint a representative to appeal a denial on your behalf. To appoint a representative, complete the Appointment of Representative form and mail it to either your MAC (if you have Original Medicare) or your Medicare Advantage Plan.

Adjudicator – The entity responsible for making the decision at any level of the Medicare claim decision making process, from initial determination to the final level of appeal, on a specific claim.

The medical provider is responsible for submitting a claim to Medicare for the medical service or procedure. If Medicare denies payment of the claim, it must be in writing and state the reason for the denial.

Explain in writing why you disagree with the decision or write it on a separate piece of paper, along with your Medicare number, and attach it to the MSN. Include your name, phone number, and Medicare Number on the MSN. Include any other information you have about your appeal with the MSN.

An appeal is the action you can take if you disagree with a coverage or payment decision by Medicare or your Medicare plan. For example, you can appeal if Medicare or your plan denies: A request for a health care service, supply, item, or drug you think Medicare should cover.

To inquire about potential appeal rights, please contact the Michigan Administrative Hearings System (MAHS) at 1-877-833-0870.

Write a letter describing your appeal or use the Redetermination Request Form (PDF) (67.62 KB). Mail or fax the letter or completed form to UnitedHealthcare.