UnitedHealthcare denied skilled-nursing or rehab coverage or payment?
Start with the reason on UnitedHealthcare's notice
The written notice should explain what service was refused and why. It may say the member met therapy goals, no longer needs a skilled level of care, or can receive care in another setting. The appeal should answer the actual reason on that notice with facts supported by the clinical record.
First: which notice did you get?
The right move depends entirely on the notice UnitedHealthcare sent. A Notice of Medicare Non-Coverage (NOMNC) — telling you coverage ends on a specific date — is a fast appeal to a Quality Improvement Organization on a very short clock; our free fast-appeal helper walks you through it. A standard denial (Integrated Denial Notice) is a Level 1 reconsideration and may fit the appeal we prepare and certified-mail for $179. A denial before admission may need expedited review instead. Not sure which you have? See how to tell your notice apart, or upload it and we'll identify it for free.
The rules that may be on your side
Federal Medicare rules are clear that skilled coverage does not end simply because a patient has stopped improving — care to maintain function or slow decline can still qualify. A strong appeal ties the specific reason UnitedHealthcare gave back to the federal standards and the clinical facts in your records. Recourse builds the supported standard-appeal packet from a curated Medicare library and verifies it against your documents before mailing.
How Recourse helps
- 1. Upload your denial notice. We read it and identify which appeal applies — free.
- 2. We confirm whether it is a supported standard appeal. Urgent QIO notices receive free fast-appeal help; unsupported notices are not sold the mail service.
- 3. For a supported standard appeal, you review everything. You read the draft and confirm the plan's name and mailing address before anything is sent. You only pay — a flat $179 — if you choose to mail it.
- 4. If you choose the service, we certified-mail it. The appeal is verified against your documents, we mail it to the plan by certified mail, and you get the tracking number and a copy of exactly what was sent.
Frequently asked questions
- How long do I have to appeal a UnitedHealthcare SNF denial?
- It depends on the notice. A standard Integrated Denial Notice generally gives you 65 days to request Level 1 reconsideration. A Notice of Medicare Non-Coverage (NOMNC) has a much shorter QIO fast-appeal deadline, and a pre-service denial may qualify for expedited review. The instructions on your notice control.
- Can I appeal a UnitedHealthcare denial myself for free?
- Yes. You always have the right to file your own Medicare Advantage appeal directly, or to appoint a family member, an attorney, or a free helper such as your State Health Insurance Assistance Program (SHIP). Recourse is a paid convenience for families who do not have the time or the regulatory fluency to do it alone — you are never required to use us.
- What does the $179 include?
- Preparing your appeal letter from a curated library of Medicare regulations, pre-filling your CMS-1696 appointment form, a verification pass against your documents, and certified mailing to the plan with tracking. You see the draft and confirm the mailing address before you are charged, and you are only charged if you choose to send it.
- Is Recourse a law firm or connected to UnitedHealthcare or Medicare?
- No. Recourse is independent — not a law firm, and not affiliated with UnitedHealthcare, Medicare, or CMS. The plan whose denial you are appealing is the adverse party, not our partner. Nothing we provide is legal or medical advice.
Recourse is independent and is not affiliated with, endorsed by, or sponsored by Medicare, CMS, any government agency, or any health plan, including the plan whose denial you are appealing. Recourse is not a law firm and does not provide legal advice; we help you prepare and submit an appeal you are entitled to file under federal Medicare Advantage rules. Filing an appeal is your right and you may do it yourself for free. Appeal letters and statements are drafted with the assistance of AI and pass verification checks against your documents before anything is mailed. Drafts are provided for your review and are not legal or medical advice.