How to avoid medical records request from United Healthcare
United Healthcare requests medical records for most of the claims. After our deep analysis we found that if the total claim charge amount is more than $1,300 UHC is requesting medical records. We tried two claims for different patients with the same procedure but one with a total charge amount above $1,300 and other less than $1,300. United Healthcare requested a medical record for the claim with above $1,300 and paid the claim below $1,300 according to the contract. Rather than doing further analysis if the UHC medical records requests are reasonable we managed to split the claims for the same DOS so that the total charged amount is less than $1,300. Hundred percent of claims are paid in first submission without medical record request.