UMR
Operated by UnitedHealth Group.
UMR denials follow a predictable pattern — and most of them are appealable. We track the specific reasons UMR most commonly cites, what's worked to overturn them, and which federal and state protections apply. If you're appealing a UMR denial, this is your starting line.
Appeal process
Internal appeal to UMR must be filed within 180 days of the denial notice. UMR has 30 days to decide standard appeals, 72 hours for urgent. After internal exhaustion, external review by an Independent Review Organization is available for non-grandfathered plans under ACA §2719.
Frequently asked questions
How do I appeal a UMR denial?
File an internal appeal in writing within 180 days of the denial. UMR has 30 days to decide standard appeals (72 hours for urgent). After internal exhaustion, request external review by an Independent Review Organization (IRO) — federal law requires this for non-grandfathered plans (ACA §2719).
Which federal regulations apply to UMR appeals?
Depends on plan type: ERISA §503 + ACA §2719 for commercial/employer plans, 42 CFR Part 422 Subpart M for Medicare Advantage, 42 CFR Part 438 Subpart F for Medicaid managed care.
Other Third-party administrator
Appeal a UMR denial
Upload your denial — DenialHelp drafts a physician-ready appeal letter in five minutes with the right clinical guideline and federal regulation cited.
Get started →Contact: hello@denialhelp.com