UnitedHealthcare appeal deadlines & timely filing (2026, verified)

Clock starts: date of service

For commercial claims, submit clean claims per the time frame listed in your Agreement or per applicable laws. We, or our capitated care provider, allow at least 90 days for participating health care providers. For commercial plans, we allow up to 180 days for nonparticipating health care providers from the date of service to submit claims.

Source: 2026 UHC Administrative Guide, p. 206 (capitation/delegation supplement)

Clock starts: date of original claim EOB or PRA

You must submit your reconsideration and appeal to us within 12 months from the date of the original claim EOB or PRA (or as required by law or your Agreement).

Source: 2026 UHC Administrative Guide, Ch. 10, p. 134

Clock starts: date of adverse payment determination

All disputes must be submitted within 365 calendar days following the date of the adverse payment determination on the claim, unless your Agreement or state law dictate otherwise.

Source: 2026 UHC Administrative Guide, p. 449 (UHC West supplement)

Clock starts: through date of service

For MA plans, we are required to allow 365 days from the through date of service for noncontracted health care providers to submit claims for processing.

Source: 2026 UHC Administrative Guide, p. 206

Clock starts: date of coverage denial notice

If you disagree with a denied claim or if we paid for a different service or level of service than what was billed, you have 60 days from the denial date to file a payment reconsideration (appeal) request.

Source: UHC MA Non-Contracted Care Provider Dispute and Appeal Rights (PCA-1-24-03448)

Clock starts: date of initial payment

You must file a dispute within 120 calendar days from the initial payment.

Source: UHC MA Non-Contracted Care Provider Dispute and Appeal Rights (PCA-1-24-03448)

Clock starts: date of service

Your Agreement requires that all information necessary to process a claim must be received by UnitedHealthcare within a specified number of days from the date of service … This number of days also applies to submission of corrected claims. For example, if the last date of service provided is May 1, and the timely filing limit in your participation agreement is 90 days, all information necessary to process the claim, including any corrections, must be received by UnitedHealthcare no later than 90 days after May 1.

Source: 2026 UHC Administrative Guide, Ch. 10, pp. 144-145

Clock starts: receipt of dispute

UnitedHealthcare acknowledges receipt of paper disputes within 15 business days and within 2 business days for electronic disputes. If additional information is required, the dispute is returned within 45 business days. A written determination is issued within 45 business days.

Source: 2026 UHC Administrative Guide, p. 450 (UHC West PDR reference table)

Clock starts: receipt of payment dispute request

UnitedHealthcare Medicare Advantage has 30 calendar days to review and respond after receiving a payment dispute request.

Source: UHC MA Non-Contracted Care Provider Dispute and Appeal Rights (PCA-1-24-03448)

Clock starts: receipt of completed payment reconsideration request

UnitedHealthcare Medicare Advantage has 60 calendar days to review and respond after receiving a completed payment reconsideration (appeal) request. If the plan upholds all or part of the initial payment determination, we must forward the case to the CMS Independent Review Entity (IRE) for a second-level review.

Source: UHC MA Non-Contracted Care Provider Dispute and Appeal Rights (PCA-1-24-03448)