What should I do if my claim is denied?

If a claim is denied by UMR, it is important to first carefully review the denial letter. This letter typically provides specific reasons for the denial, which can assist in understanding the situation. Next, gather all relevant documentation related to the claim, including medical records, billing statements, and any communication with healthcare providers. Once you have collected the necessary information, consider contacting UMR for clarification on the denial. It may be helpful to ask for more details regarding the specific policy provisions that were cited in the denial. Following this, if you believe the denial was unjustified, you can initiate the appeals process. UMR outlines the steps for appealing a claim denial in their policy documents, so it is advisable to refer to them for guidance. Make sure to submit your appeal within the timeframe specified in the denial letter. Document all communications and maintain copies of the appeal and any supporting documents. This can facilitate a more effective review of the denied claim. For additional information on the process, visiting UMR's current web page may provide further insights and resources.