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Imaging Denial

UnitedHealthcare Denied Your CT Scan?

Published data shows denial and appeal outcomes vary by plan, product year, denial reason, and documentation. Use this page to spot the issues to request and the evidence to gather before you decide what to submit.Sources include KFF ACA Marketplace Transparency Data, HHS OIG reports, and state insurance department filings. Aggregate rates are context, not predictions for an individual case.

Varies
Denial Data
Case-specific
Appeal Outcome
30-45 days
Typical Timeline
$1,000–$5,000
Typical Claim

Based on published government and industry research. Individual results vary based on denial type, insurer, and documentation.

Why they said no

Why UnitedHealthcare Denies CT Scan

Not medically necessary based on clinical criteria

MRI recommended instead of CT

Prior imaging not attempted first

UnitedHealthcare patterns

UnitedHealthcare's Common Denial Patterns

AI-powered automated denials that may lack individualized physician review

Prior authorization requirements for standard procedures

Narrow network restrictions denying out-of-network emergency care

What works

How to Strengthen Your CT Scan Appeal

Physician order with clinical indication

Evidence that CT is more appropriate than MRI for the condition

ACR Appropriateness Criteria supporting CT for diagnosis

Your rights

Laws That Protect You

ACA — Preventive screening requirements

State imaging parity laws

Emergency prudent layperson standard

Playbook

Tips for Appealing to UnitedHealthcare

Cite the No Surprises Act for emergency or out-of-network denials

Document that the denial lacks evidence of individualized physician review

Request the qualifications of the reviewer who denied your claim

Ready to Review Your CT Scan Denial?

Upload your denial letter and get a clear analysis in minutes. We'll identify potential weaknesses in UnitedHealthcare's reasoning and outline your appeal options.

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This information is for educational and informational purposes only. It does not constitute legal or medical advice. Statistics cited are from publicly available sources including KFF, HHS OIG, and state insurance department data. Individual results may vary. Consult a qualified professional before taking action on your specific situation.