UnitedHealthcare Denied Your Physical Therapy?
UnitedHealthcare (UHG) denies 22.2% of claims on average. But 44% of appeals succeed when patients fight back. Your physical therapy denial may have grounds for a successful appeal.
Why UnitedHealthcare Denies Physical Therapy
Visit limit exceeded per plan year
Maintenance therapy — no longer improving
Prior authorization expired or not renewed
UnitedHealthcare's Common Denial Tactics
AI-powered automated denials (90% overturned on appeal)
Prior authorization requirements for standard procedures
Narrow network restrictions denying out-of-network emergency care
How to Win Your Physical Therapy Appeal
Objective measurement of functional progress (ROM, strength, balance scores)
Treatment plan with specific, measurable goals
Documentation that cessation would cause regression
For Medicare: cite Jimmo v. Sebelius settlement requiring maintenance coverage
Laws That Protect You
ACA §2719 — Appeal rights
Jimmo v. Sebelius (Medicare) — Maintenance therapy coverage
State mandated minimums for PT visits
Tips for Appealing to UnitedHealthcare
Cite the No Surprises Act for emergency or out-of-network denials
Document that AI-generated denials have a 90% overturn rate
Request the qualifications of the reviewer who denied your claim
Ready to Fight Your Physical Therapy Denial?
Upload your denial letter and get an AI-powered analysis in minutes. We'll identify the weaknesses in UnitedHealthcare's reasoning and build your appeal strategy.
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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.