United Healthcare Appeal Form. Comments (please print clearly below): Apply & enroll in 2021 coverage today. 722270 or 722271, mail the form with any attachments to:
Requests not related to the submission of additional clinical information for a denied case will not be processed if submitted via the form below. Helping globally mobile populations thrive.
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Real appeal is a voluntary weight loss program that is offered to eligible participants over age 18 as part of their benefit plan. Use of this form for submission of claims to masshealth is restricted to claims with service dates exceeding one year and that comply with regulation 130cmr 450.323. 722270 or 722271, mail the form with any attachments to: M57270 5/19 ©2019 united healthcare services, inc.
