2011 OE 100-10007 : Page 4
Emergency room services You will not be required to obtain prior approval before seeking emergency care at a network or non-network hospital. In a true medical emergency, the copayment or coinsurance you pay will be the same regardless of whether the emergency room was in-or out-of-network. This is not a change in coverage. Appeals information If you disagree with a decision about an appeal, you may be able to request an external review of your claim by an independent third party who will review the denial and issue a final decision. Additionally, you may request verbal translation services for questions related to appeal correspondence. Please contact us at the number listed on the back of your health plan ID card for information regarding external review or verbal translation services. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by UnitedHealthcare Insurance Company, United HealthCare Services, Inc. or their affiliates. Health Plan coverage provided by or through a UnitedHealthcare company. 100-10007 1/11 © 2011 United HealthCare Services, Inc.
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