Benefits - Claim DenialMy plan denied my claim. What can I do?
First, check your plan's booklet or website to see if the service is covered, limited or excluded. If you feel that your claim should have been accepted, go to the disputed claims section of the booklet or website and follow the instructions to ask that your claim be reconsidered. If the plan again denies the claim, read the plan's decision letter carefully and then check your plan again. If you still disagree with the plan's decision, the disputed claims section of the booklet or website will explain you how to write to the Office of Personnel Management to ask UH Human Resources to review the claim.
UHHR can't review a denied claim unless your plan has reconsidered it first.
Typically, we will acknowledge your request within 5 days. After we complete the review, we will send you a final response. This usually happens within 60 days, unless we have to request additional information. We are sorry, but we cannot give you a case status until the review has been completed and a written copy of the final decision has been issued.
Need additional assistance? Call the HR Service Center at 713-743-3988 to discuss your situation in greater detail or to schedule an appointment with a Benefits representative.