---
title: "UnitedHealthcare of Wisconsin appeal form and deadline"
url: "https://denialfacts.com/insurers/unitedhealthcare-of-wisconsin-inc--wi"
publisher: "Axion Labs — Denial Facts"
checked: "2026-11-04"
dataset_fixity: "sha256-cda2f9b89c8dde2a74989a35dbe7c0d08ff35dac5456484dc1c03c1b181a67b6"
---

# UnitedHealthcare of Wisconsin denied your claim. Here is your deadline.

Denied by UnitedHealthcare of Wisconsin? Your two appeal deadlines dated from your notice, a free letter, and its 16.3% denial rate.

## Figures

| Figure | Value |
| --- | --- |
| In-network denial rate | 16.3% |
| Claims denied | 179,349 |
| Plans in Wisconsin | 16 |
| Internal appeals filed | 470 |
| Internal overturn rate | 41.06% |
| In-network claims received | 1,102,539 |
| External reviews filed | 0 |
| External overturn rate | not reported |
| National denial rate | 15.7% |

## External-review route

**Federal process.** CMS lists Wisconsin among the states without an external review process meeting the federal standards. Insurers there must use either the HHS-administered federal process or an independent review organization under contract. This route is the one for insured plans, Marketplace, individual, and employer plans where an insurance company carries the risk. If your coverage is through a job and the employer pays the claims itself (a self-funded or self-insured plan, which is 63% of covered workers), the state process does not apply to you whatever your state operates, and your external review goes through the federal process instead. Your denial letter names your route; if it does not, ask your plan in writing whether the plan is self-funded.

## Denials by reason

| Reason | Claims | Share of this insurer's categorized denials |
| --- | --- | --- |
| Other reasons | 68,613 | 37.6% |
| Provider out of network | 37,388 | 20.5% |
| Referral required | 24,834 | 13.6% |
| Service excluded from the plan | 24,341 | 13.4% |
| Member not covered | 19,451 | 10.7% |
| Administrative reason | 7,578 | 4.2% |
| Benefit limit reached | 29 | 0% |
| Not medically necessary | 12 | 0% |

## UnitedHealthcare of Wisconsin in Wisconsin, at the top of the page

Wisconsin

Your two dates, free

Date on your denial notice

Who pays your claims?

A job, an insurance company pays the claims

A job, my employer pays the claims itself (self-funded)

A job, I do not know which

Marketplace / individual plan I bought myself

Medicare, Medicaid, TRICARE, VA or IHS

Which state?

The reason your letter gives

I'm not sure, I'll paste the sentence later

Not medically necessary
Provider out of network
Service excluded from the plan
Experimental or investigational
Referral required
Benefit limit reached
Member not covered
Administrative reason
Other reasons

Show my two dates, free

Put in the date on your UnitedHealthcare of Wisconsin, Inc. notice and get both federal deadlines as calendar dates.

Free, for a UnitedHealthcare of Wisconsin, Inc. denial in Wisconsin, and it runs entirely in your browser. The date, the plan type and the state you pick are never sent to us and never stored.

UnitedHealthcare of Wisconsin, Inc. denied 179,349 of 1,102,539 in-network claims in Wisconsin; every one of those denials had these same two dates on it. Across Wisconsin as a whole the insurers in this file denied 15.4% of in-network claims, 1,893,070 of them, and 2,216 were appealed.

Or let the [$29 Appeal Kit](/appeal-kit) date each step and write the claim-file and external-review requests.

UnitedHealthcare of Wisconsin, Inc. denied 16.3% of in-network claims in Wisconsin, 179,349 claims out of 1,102,539.

By [Axion Labs](/about) · August 19, 2026, updated November 4, 2026

Further down this page, after the free steps: the paid next step .

United keeps denying my claims. I'm up to my ears in medical debt and I make close to nothing.

We hear this most. [r/HealthInsurance, thread title](https://www.reddit.com/r/HealthInsurance/comments/1i8epgx/united_keeps_denying_my_claims_im_up_to_my_ears/) , read September 3, 2026.

The number nobody else publishes. Not one of the 179,349 denials UnitedHealthcare of Wisconsin, Inc. issued in Wisconsin reached the independent review its own staff do not decide, an explicit zero in this insurer's own filed row, not an absence. The stage was there the whole time and it binds the plan. Nationally 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) of the reviews that got there were overturned.

Those 179,349 denials are 9.5% of every in-network denial recorded in Wisconsin in this release, which makes UnitedHealthcare of Wisconsin, Inc. the 4th largest source of denials of the 12 insurers reporting there. Spread across its 16 plans in the state that is about 11,209 denials per plan. 470 internal appeals were filed against those 179,349 denials. Every one of those denials carried the same two dates the tool at the top of this page works out.

The clock your letter has to describe, in actual dates

Two dates matter more than anything else on this page, and they run the same in Wisconsin as everywhere else. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours . Both timeframes are federal, not your insurer's choice, [29 CFR 2560.503-1](https://www.ecfr.gov/current/title-29/section-2560.503-1) ( [PDF](https://www.govinfo.gov/content/pkg/CFR-2024-title29-vol9/pdf/CFR-2024-title29-vol9-sec2560-503-1.pdf) ) and [45 CFR 147.136](https://www.ecfr.gov/current/title-45/section-147.136) ( [PDF](https://www.govinfo.gov/content/pkg/CFR-2024-title45-vol2/pdf/CFR-2024-title45-vol2-sec147-136.pdf) ), in plain English at [HealthCare.gov](https://www.healthcare.gov/appeal-insurance-company-decision/internal-appeals/) , and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can.

Notice for UnitedHealthcare of Wisconsin, Inc. in Wisconsin, there is a deadline in this one. CMS says the HHS-Administered Federal External Review Process reopened on July 31, 2026. If your plan uses that process and you could not file between July 1, 2026 and August 3, 2026, CMS says you may be eligible for an extension and have until October 2, 2026 to request external review. If you filed before July 1, 2026 you do not need to resubmit; if you already have a final decision through the federal process, the extension does not apply to you. HealthCare.gov names one group this state-by-state page cannot show you: it says the extension may reach you if you have a state or local government plan in any state , not only in the states whose insurers use the federal process. Both pages were read at source on September 5, 2026 and this is what they said that day, [the CCIIO external appeals page](https://www.cms.gov/CCIIO/Resources/Files/external_appeals) and [HealthCare.gov on external review](https://www.healthcare.gov/appeal-insurance-company-decision/external-review/) . Read them again before you rely on this: it is a live deadline and it has moved once already. Wisconsin is one of the states CMS lists as using the federal process, so this applies to an insured plan bought there. If your plan uses a contracted independent review organization instead, none of this affects you.

Data verified November 4, 2026 · CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain

You are not alone, and here is the measured version of that sentence: 179,349 in-network claims were denied by UnitedHealthcare of Wisconsin, Inc. in Wisconsin in a single plan year. A denial rate is a fact about an insurer's book of business. It is not a judgment about you, and it is not the last word on your claim.

- Of the 12 insurers reporting a denial rate in Wisconsin, UnitedHealthcare of Wisconsin, Inc. is the fifth highest at 16.3%. The highest in the state is 24.5% and the lowest is 6.5%.

- That is 0.6 percentage points above the 15.7% national average across this dataset, and 0.9 points above the Wisconsin average of 15.4%.

- Behind the percentage: 1,102,539 in-network claims were processed under 16 plans in Wisconsin, and 179,349 of them came back denied.

- For every 10,000 claims UnitedHealthcare of Wisconsin, Inc. denied, about 26 came back as an internal appeal. The other 9,974 stopped at the letter.

- Of the internal appeals it did receive, UnitedHealthcare of Wisconsin, Inc. overturned 41.06% , 193 claims that started life as a no.

- Not one of those denials reached independent external review, the stage whose decision the plan is required by law to accept, and where nationally 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) are overturned.

- Its most-recorded denial reason is other reasons at 37.6% of its categorized denials, against 32.4% nationally, a heavier share than the country as a whole. That is the denial mix, not an outcome rate.

- UnitedHealthcare of Wisconsin, Inc. accounts for 9.5% of every in-network claim denied in Wisconsin in this file.

- By raw volume it is the 72th largest source of denials among the 135 insurer-state records in the file that report one.

- After that, its second-most-recorded reason is [provider out of network](/denial-reasons/out-of-network) , 37,388 claims, 20.5% of its categorized denials.

- Third on its own list is [referral required](/denial-reasons/referral-required) , 24,834 claims, 13.6% of what UnitedHealthcare of Wisconsin, Inc. categorized in Wisconsin. Between them the top three account for 71.8% of its categorized denials.

- Where UnitedHealthcare of Wisconsin, Inc. differs most from the national mix is [provider out of network](/denial-reasons/out-of-network) : 20.5% of its categorized denials in Wisconsin against 9% across the file.

- Read the other way round: 923,190 of those 1,102,539 in-network claims were paid, 83.7% of everything UnitedHealthcare of Wisconsin, Inc. processed in Wisconsin.

- Spread across the 16 plans it reports in Wisconsin, that is about 11,209 denied claims per plan, on about 68,909 claims processed per plan.

- Its reason columns add up to 182,246 categorized rows against 179,349 denials, 101.6% of them, and every reason share on this page is a share of that first figure rather than of the second.

- Its smallest recorded category in Wisconsin is [not medically necessary](/denial-reasons/not-medically-necessary) , 12 claims, 0% of what UnitedHealthcare of Wisconsin, Inc. categorized there.

- Against the file as a whole, this one record is 0.2% of the 83,907,852 in-network claim denials reported by every issuer in it.

What to do tonight

- Find the reason code on your denial letter. The reason UnitedHealthcare of Wisconsin, Inc. records most often in Wisconsin is other reasons , but yours may be one of the other 8, copy the exact wording and code off your own letter tonight, because that sentence is what your appeal has to answer.

- Ask UnitedHealthcare of Wisconsin, Inc. in Wisconsin for the clinical criteria they judged you against. Under [29 CFR 2560.503-1](https://www.ecfr.gov/current/title-29/section-2560.503-1) they have to hand you the claim file and the policy they applied, free, on request, and you cannot argue with a checklist you have never read.

- Put both deadlines on your calendar before you go to bed. 180 days from the date on the letter for the internal appeal, 4 months from the final internal denial for external review. The free calculator on this page turns your date into the two calendar dates in about ten seconds. UnitedHealthcare of Wisconsin, Inc. overturned 41.06% of the internal appeals it did receive, 193 claims, so the stage you are about to start is not decorative.

None of those three steps costs anything. Anyone charging you to do them is selling you something you can do yourself in twenty minutes.

16.3%

In-network denial rate

179,349

Claims denied

16

Plans in Wisconsin

470

Internal appeals filed

41.06%

Internal overturn rate

## How that compares

| Denial rate | Rate | Difference |
| --- | --- | --- |
| UnitedHealthcare of Wisconsin, Inc. | 16.3% | , |
| Wisconsin average | 15.4% | +0.9 pts |
| National average (this dataset) | 15.7% | +0.6 pts |

UnitedHealthcare of Wisconsin, Inc. denies 0.6 percentage points more of its in-network claims than the national average across this dataset. A denial rate is a property of the insurer's book of business, coding practice, plan design, the population it covers, not evidence about the merits of any one claim, including yours.

## What happened to appeals

| Stage | Filed | Overturned |
| --- | --- | --- |
| Internal appeal (to UnitedHealthcare of Wisconsin, Inc.) | 470 | 41.06% |
| External review (independent) | 0 | not reported |

Read that again: UnitedHealthcare of Wisconsin, Inc. denied 179,349 claims in Wisconsin, and not one went to independent external review. External review is free to you and the insurer must follow the decision.

## The gap nobody escalated

179,349 claims denied. 470 internal appeals filed. None reached independent external review. Nationally 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) of external reviews are overturned and the decision binds the plan.

That is arithmetic from the reported figures, not a prediction: nobody can say what those specific denials would have done at review, because they never got there. What the numbers do establish is that the binding stage was almost entirely unused here.

What that record means for your own UnitedHealthcare of Wisconsin, Inc. letter, and by when. UnitedHealthcare of Wisconsin, Inc. overturned 41.06% of the 470 internal appeals its Wisconsin members filed against 179,349 denials, and not one of those Wisconsin denials went on to the independent stage whose decision binds the plan, UnitedHealthcare of Wisconsin, Inc.'s own rows in the plan-year 2027 release of the CMS Transparency in Coverage file, read November 4, 2026 ( [data.healthcare.gov](https://data.healthcare.gov/) ). Whichever way that lands, nobody files the appeal for you, and the filing runs on a clock set by which plan you hold: an employer or Marketplace plan gives you at least 180 days from the denial notice to file the internal appeal ( [29 CFR 2560.503-1(h)(3)(i)](https://www.govinfo.gov/content/pkg/CFR-2024-title29-vol9/pdf/CFR-2024-title29-vol9-sec2560-503-1.pdf) , carried onto individual-market coverage by [45 CFR 147.136(b)(3)(i)](https://www.govinfo.gov/content/pkg/CFR-2024-title45-vol2/pdf/CFR-2024-title45-vol2-sec147-136.pdf) ), while Medicare Advantage gives you 65 calendar days from the date of its notice ( [CMS](https://www.cms.gov/medicare/appeals-grievances/managed-care/reconsideration-advantage-health-plan-part-c) , [42 CFR 422.582(b)](https://www.ecfr.gov/current/title-42/section-422.582) ) and Medicaid managed care 60 calendar days from the date on the notice ( [42 CFR 438.402(c)(2)(ii)](https://www.ecfr.gov/current/title-42/section-438.402) ), both stages free, and the three steps above are the whole of what to do tonight, so take the date printed on your UnitedHealthcare of Wisconsin, Inc. notice and file well inside whichever of those windows is yours. The free steps are above; the [$29 kit](/appeal-kit) is the same clock with the letters pre-filled for UnitedHealthcare of Wisconsin, Inc. in Wisconsin. One payment. No subscription. No cut of your claim.

## UnitedHealthcare of Wisconsin, Inc. inside Wisconsin

Your denial did not happen in a national average. It happened in a state market, alongside 11 other insurers reporting into the same federal file, and these are that market's own figures.

- Across the whole of Wisconsin, the 12 insurers reporting in this file processed 12,326,174 in-network claims and denied 1,893,070 of them, a state denial rate of 15.4%. UnitedHealthcare of Wisconsin, Inc. is one of those 12.

- That puts Wisconsin 18th of 29 states by denial rate, 0.3 points below the 15.7% national average, before you get to what UnitedHealthcare of Wisconsin, Inc. did inside it.

- Wisconsin recorded 2,216 internal appeals against those denials: one appeal for every 854 claims the state's insurers refused. UnitedHealthcare of Wisconsin, Inc.'s own ratio is one for every 382.

- Independent external review was reached 12 times in the whole of Wisconsin, once for every 157,756 denials, against one in 17,061 nationally. None of them came from UnitedHealthcare of Wisconsin, Inc.'s denials.

- Of the Wisconsin external reviews that were filed, 0 were overturned, 0%. That percentage is measured on 12 reviews, which is why the count beside it matters more than the rate does when you are deciding whether to file against UnitedHealthcare of Wisconsin, Inc..

- The reason Wisconsin's insurers record most often is [other reasons](/denial-reasons/other) , 687,434 claims, 34.3% of the state's categorized denials. UnitedHealthcare of Wisconsin, Inc. records the same one most often, so your letter is likely to say it too.

- The other insurers a Wisconsin reader could have bought from run from 24.5% ( [Common Ground Healthcare Cooperative](/insurers/common-ground-healthcare-cooperative--wi) ) to 6.5% ( [HealthPartners Insurance Company](/insurers/healthpartners-insurance-company--wi) ). UnitedHealthcare of Wisconsin, Inc. at 16.3% sits between the two.

- Put the two together and UnitedHealthcare of Wisconsin, Inc. is responsible for 9.5% of every in-network claim denied in Wisconsin in this release, from 8.9% of the claims the state's insurers processed.

- Every Wisconsin figure in this section is that state's own row in the same federal file UnitedHealthcare of Wisconsin, Inc.'s numbers above come from, [CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain](https://data.healthcare.gov/) , and the full Wisconsin page is free at [/states/wisconsin](/states/wisconsin) .

## What UnitedHealthcare of Wisconsin, Inc. denies most

The most common denial reason recorded for UnitedHealthcare of Wisconsin, Inc. plans in Wisconsin is other reasons . [How that denial is beaten →](/denial-reasons/other)

| Denial reason | Claims | Share | National share |
| --- | --- | --- | --- |
| Other reasons | 68,613 | 37.6% | 32.4% |
| Provider out of network | 37,388 | 20.5% | 9% |
| Referral required | 24,834 | 13.6% | 9.6% |
| Service excluded from the plan | 24,341 | 13.4% | 13.4% |
| Member not covered | 19,451 | 10.7% | 7.9% |
| Administrative reason | 7,578 | 4.2% | 17.2% |
| Benefit limit reached | 29 | 0% | 4.9% |
| Not medically necessary | 12 | 0% | 5.5% |

The last column is each reason's share of all categorized denials nationally, so you can see where UnitedHealthcare of Wisconsin, Inc.'s mix in Wisconsin differs from everyone else's. This is denial mix , not overturn rate by reason , the federal file does not report appeal outcomes broken down by denial reason, and we do not imply otherwise.

Work out your two deadlines

Put the date from your notice in and get the two calendar dates, with the days remaining.

Date on your denial notice

Which denial is this?

First denial (I have not appealed yet)

Final internal denial (my appeal was refused)

Show my deadlines

Runs entirely in your browser, the date you type is never sent to us and never stored. [Open the full calculator →](/appeal-deadline-calculator)

Or let the [$29 Appeal Kit](/appeal-kit) date each step and write the claim-file and external-review requests.

The three steps at the top of this page are the whole of what you have to do tonight. The longer
version, what the internal appeal has to contain, how the independent stage works, and how to ask
for expedited handling when waiting would seriously jeopardize your health, is
[published free here](/how-to-appeal) . For what it is worth on this page specifically: UnitedHealthcare of Wisconsin, Inc. overturned 41.06% of the internal appeals it received.

## Who appeals what at UnitedHealthcare

UnitedHealthcare runs a mandatory TWO-STEP provider process, a claim reconsideration first, an appeal only after, and is strict about who counts as the member's representative. The first row is the member's route; the others are the provider's. From UnitedHealthcare's published pages, written for health care providers and members; each is listed below with its date. It is brand-level and applies to UnitedHealthcare of Wisconsin, Inc. in Wisconsin the same as to every other UnitedHealthcare entity in the file.

| Dispute | Route |
| --- | --- |
| A plan denial you want changed (member) | Member, authorized representative or contracted provider. The member form says a timely request; federal rules generally give at least 180 days |
| Post-service claim dispute (provider) | Reconsideration first, then appeal, both steps inside 12 months |
| Pre-service denial | Appeal 'made prior to a planned health care service'; expedited available if delay could seriously jeopardize the member |
| Provider appealing on the member's behalf | Requires authorization/patient consent, an assignment of benefits is NOT enough |

##### Operational facts from the same policy

- Combined window for both steps: 12 months , One clock covers both steps — a slow reconsideration eats the appeal window.

- Two-step structure is mandatory: reconsideration, then appeal

- Assignment of benefits is not representation: separate patient consent needed , For patients: your provider billing UnitedHealthcare for you does NOT automatically let them appeal AS you — a separate authorization is needed, or you appeal yourself.

- Submission is portal/API: UnitedHealthcare Provider Portal or API , No mailing address or fax is published on this page.

- Expedited appeal is pre-service only: not available after the service

- Peer-to-peer review windows: 3 business days inpatient / 21 calendar days outpatient

- Member grievance window (California section of the form): 180 calendar days , Member-side second source. This wording sits under the form's California grievance instructions, so it is not a national appeal deadline. UnitedHealthcare's provider page publishes no member window.

- Who may appeal (member side): member, authorized representative, or contracted provider

- Member review clocks: acknowledge 5 days, decide 30 days standard / 3 days urgent , Stated on a form page that also carries California-specific sections (DMHC 1-888-466-2219, Independent Medical Review) — plan-state specifics can vary.

Sources: [UnitedHealthcare, "Pre- and post-service appeals and reconsiderations"](https://www.uhcprovider.com/en/claims-payments-billing/appeals.html) , quoted, not paraphrased; audience: health care providers; checked 2026-11-05. [UnitedHealthcare, "Member service request form (memberforms.uhc.com — carries state-specific sections incl. California IMR; undated)"](https://memberforms.uhc.com/Memberappealsandgrievances.html) , quoted, not paraphrased; audience: members; checked 2026-11-05. Brand-level policy, applied here because UnitedHealthcare of Wisconsin, Inc. is a UnitedHealthcare entity. Your own denial letter and plan documents govern your specific case.

## Questions

##### Is UnitedHealthcare of Wisconsin, Inc.'s denial rate in Wisconsin high?

16.3% against a national average of 15.7% across the plans in this dataset. It is above average. A denial rate describes the insurer, not the merits of your claim.

##### How many people appealed a UnitedHealthcare of Wisconsin, Inc. denial in Wisconsin, and how many won?

470 internal appeals were filed against 179,349 denials, and 41.06% of them were overturned (193 claims). Not one went on to independent external review, the stage whose decision is binding on the plan.

##### How does UnitedHealthcare of Wisconsin, Inc. compare with other insurers in Wisconsin?

Of the 12 insurers in Wisconsin with a reported denial rate, UnitedHealthcare of Wisconsin, Inc. ranks 5 highest at 16.3%. The highest in Wisconsin is Common Ground Healthcare Cooperative at 24.5%; the lowest is HealthPartners Insurance Company at 6.5%.

##### What does UnitedHealthcare of Wisconsin, Inc. deny most often in Wisconsin?

Other reasons, 68,613 claims, 37.6% of this issuer's categorized denials, against 32.4% nationally. This is the denial-reason mix; the federal file does not report overturn rates by reason.

##### How long do I have to appeal a UnitedHealthcare of Wisconsin, Inc. denial in Wisconsin?

Generally 180 days from the date on the denial notice to file the internal appeal, then generally four months from the final internal denial to request independent external review. Expedited review, decided in about 72 hours, is available where delay would seriously jeopardize your health. Those timeframes are federal, so they are identical for every insurer reporting in Wisconsin, UnitedHealthcare of Wisconsin, Inc. included, what varies by state is who runs the independent review at the end. Your own denial letter states the deadlines that govern your plan; that letter is the authority.

##### Does appealing a UnitedHealthcare of Wisconsin, Inc. denial in Wisconsin cost anything?

The internal appeal to UnitedHealthcare of Wisconsin, Inc. is free. External review is free under the HHS-administered federal process; where an issuer uses a contracted independent review organization or a state process, any fee is capped at $25 per review. Nobody in Wisconsin can be charged more than that to file one.

##### Can UnitedHealthcare of Wisconsin, Inc. ignore an external review decision in Wisconsin?

No, and that is the whole point of the stage. External review decisions are binding on the plan by law, which is what makes the zero external reviews recorded against 179,349 UnitedHealthcare of Wisconsin, Inc. denials in Wisconsin the striking number on this page.

The line on this page we would read twice is the one that says not one of UnitedHealthcare of Wisconsin, Inc.'s 179,349 denials in Wisconsin reached independent review. We are not going to tell you that you will win. This page prints the insurer's own reported numbers whichever way they fall. If what it says does not match the letter in your hand, write to us and we will correct the page.

Axion Labs · hello@getaxionlabs.com

[Get my Appeal Kit, $29](/appeal-kit)
Everything you need for your UnitedHealthcare of Wisconsin, Inc. appeal in Wisconsin: your two deadlines, the argument that fits your denial reason, the letters, a brief for your doctor on what the reviewer checks, and the external review request. One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com.

Where these numbers come from The UnitedHealthcare of Wisconsin, Inc. figures on this page, the 16.3% denial rate, the 179,349 denials and the 0 external reviews, are this issuer’s own reported rows in that file.

Counts: [CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain](https://data.healthcare.gov/) . Rights and timeframes: [29 CFR 2560.503-1](https://www.ecfr.gov/current/title-29/section-2560.503-1) (180 days, and your free right to the claim file) and [45 CFR 147.136](https://www.ecfr.gov/current/title-45/section-147.136) (4 months, and what qualifies), explained at [HealthCare.gov](https://www.healthcare.gov/appeal-insurance-company-decision/external-review/) . Expedited review is decided in about 72 hours under both sections.

Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at [govinfo.gov (29 CFR 2560.503-1)](https://www.govinfo.gov/content/pkg/CFR-2024-title29-vol9/pdf/CFR-2024-title29-vol9-sec2560-503-1.pdf) and [govinfo.gov (45 CFR 147.136)](https://www.govinfo.gov/content/pkg/CFR-2024-title45-vol2/pdf/CFR-2024-title45-vol2-sec147-136.pdf) .

This page presents federal statistics and a general description of appeal rights created by federal law. It is not legal, medical, or insurance advice, and no outcome is guaranteed. Your denial letter and plan documents govern your specific case. Free help is available from your state's Consumer Assistance Program and from the federal Marketplace at HealthCare.gov.

Problem solved: You have both dates for your UnitedHealthcare of Wisconsin, Inc. notice, you know that an insured plan in Wisconsin goes to the federal process, and you have the letter, free, on this screen, tonight.

## The pages that answer the next question

- [Every insurer reporting in Wisconsin](/states/wisconsin) , the state's own row, the 12 companies filing there, and the Wisconsin insurance department's consumer number, read at source.

- [United Healthcare denial rate](/company/unitedhealthcare) , UnitedHealthcare of Wisconsin, Inc. is the Wisconsin one; the brand's national rate is 20.4% across 38,271,926 claims in 19 states, and it is not the same in any two of them.

- [If United Healthcare denied your claim](/united-healthcare-denying-claims) , UnitedHealthcare's own appeal steps, quoted and labeled member or provider, and the two federal dates for your notice. This record is the Wisconsin one.

- [UnitedHealthcare Plan of the River Valley, Inc. in Iowa](/insurers/unitedhealthcare-plan-of-the-river-valley-inc--ia) , 16% of in-network claims denied, 3,163 of them, the neighboring record in this file.

- [University of Utah Health Insurance Plans in Utah](/insurers/university-of-utah-health-insurance-plans--ut) , 18.9% of in-network claims denied, 171,878 of them, the neighboring record in this file.

- [USAble HMO, Inc. in Arkansas](/insurers/usable-hmo-inc--ar) , 15.9% of in-network claims denied, 283,918 of them, the neighboring record in this file.

- [If your employer pays the claims itself](/self-funded-denial) , then UnitedHealthcare of Wisconsin, Inc. is only administering the plan, your state's external review has no power over the denial, and the route is federal. It is the first question our own calculator asks. 12 insurers report in Wisconsin; whether your plan is one of theirs at all is what that page settles.

- [If it was refused before the treatment](/prior-authorization-denied) , a prior-authorization refusal from UnitedHealthcare of Wisconsin, Inc. runs on the same two federal clocks as a denied claim, and it can be appealed while the treatment is still ahead of you. 1,893,070 in-network claims were denied in Wisconsin in this release; a refusal before the treatment is not counted among them and is appealed the same way.

- [Before you pay a lawyer](/before-you-call-a-lawyer) , two free appeals run before anyone bills you by the hour, and UnitedHealthcare of Wisconsin, Inc. has to hand you the claim file for nothing under 29 CFR 2560.503-1. Free help in Wisconsin starts with the state consumer line printed on that state's page.

- [All 152 insurer-state records](/insurers) , the whole table, ranked, with UnitedHealthcare of Wisconsin, Inc. in it and the 12 that file in Wisconsin beside it.

Your dates are ready. [Write the letter, free](/appeal-letter)

## The two federal clocks

The clock your letter has to describe, in actual dates Whatever else is on the page, these two dates are the page. You have 180 days from the date on your denial notice to file the internal appeal, and then 4 months from the final internal denial to ask for an independent external review. If waiting would seriously jeopardize your health you can ask for both to be expedited, decided in about 72 hours . Both timeframes are federal, not your insurer's choice, 29 CFR 2560.503-1 ( PDF ) and 45 CFR 147.136 ( PDF ), in plain English at HealthCare.gov , and your own denial letter states the ones that govern your plan. The PDFs are the same sections on govinfo.gov, which serves them without a challenge page, so an automated reader can check these two dates as easily as you can.

## How rare the second appeal is

You are not alone, measured rather than said: 83,907,852 in-network claims were denied in a single plan year, and only 4,918 of them, one in 17,061, ever reached the independent review stage. Of the ones that did, 22.2% (1,092 of 4,918; interval 22.2-23.8% for counts CMS withheld; 32.6% without SelectHealth) were overturned.

## What is free here, and what the one paid thing costs

Denied a claim? Insurers upheld 165,863 of the 262,982 internal appeals counted in 2024, 63.1% ( KFF ). The win is at independent external review, and the only way to arrive there is to run the internal stage on time, in the right order, with the record intact. That sequence is what the Appeal Kit is. Get my Appeal Kit, $29 One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com. Get my Appeal Kit, $29 Everything you need for your appeal: your two deadlines, the argument that fits your denial reason, the letters, a brief for your doctor on what the reviewer checks, and the external review request. One payment. No subscription. No cut of your claim. Opens on screen the moment you pay. 14-day refund, no questions, one email to hello@getaxionlabs.com.

## What we will not pretend

What we will not pretend. We cannot overturn your denial. Only your plan, or an independent reviewer, can do that. We cannot make your plan cover a service it genuinely excludes. We cannot guarantee external review applies to your denial. It covers medical judgment, experimental or investigational determinations, and rescission, a purely administrative denial may not qualify, and we say so on those pages rather than selling you past it. We have no customer testimonials and publish none. Our evidence is the federal dataset and the regulation cites, both of which you can check.

## Every page on this site

Home Start here Insurers By company States Denial reasons Use cases How to appeal Ranked by denial rate The external-review gap Write the letter, free Deadline calculator Self-funded plan? Prior authorization denied Medicare WISeR denial Denial code CO-50 Before you call a lawyer Attorney for a denied claim Your denial letter United Healthcare denying claims Time limits on a claim Appeal a Medicare denial About Editorial policy How we compare Privacy Terms For machines: llms.txt openapi.json changes.json the composed answer this page as markdown

## Which release these figures are

Which release these figures are Every number on this page is the plan-year 2027 Transparency in Coverage file, issued October 22, 2026, covering plan-year 2025 claims. This is the newest plan year CMS has published: there is no Transparency in Coverage file for a plan year after 2027. The dataset list is at data.healthcare.gov . A test in this site’s build fetches that list on every run and fails if CMS publishes a plan year we have not acknowledged here. Every earlier release, plan-year 2024, plan-year 2025, plan-year 2026, is kept alongside it so the record is visible rather than a single year’s snapshot; /about says what changed between them. From the plan-year 2024 release to the plan-year 2026 release, external reviews filed went from 2,336 to 5,881. Overturned reviews went from 32.8% in the plan-year 2026 release to 22.2% in plan-year 2027, or from 32.6% to 32.6% without SelectHealth. We do not compare filed or overturned counts across plan-years 2026 and 2027. Some issuers may have counted pre-service appeals in their 2026 cells.

## Where these numbers come from

Where these numbers come from Counts: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain . Rights and timeframes: 29 CFR 2560.503-1 (180 days, and your free right to the claim file) and 45 CFR 147.136 (4 months, and what qualifies), explained at HealthCare.gov . Expedited review is decided in about 72 hours under both sections. Reading either regulation from a script rather than a browser: eCFR answers automated fetches with a challenge page, so the same two sections are mirrored as government PDFs at govinfo.gov (29 CFR 2560.503-1) and govinfo.gov (45 CFR 147.136) .

## Who publishes this

Denial Facts publishes federal data about health insurance claim denials. We are independent: not affiliated with, endorsed by, or acting for any insurer, government agency, or review organization. We are not a law firm, a medical provider, or an insurance producer, and nothing here is legal, medical, or insurance advice. Data: CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain. Figures cover individual-market Qualified Health Plans on the federal Exchange and come from the plan-year 2027 release, issued October 22, 2026, covering plan-year 2025 claims. This is the newest plan year CMS has published: there is no Transparency in Coverage file for a plan year after 2027. See where the data comes from .

## Sources

- CMS Transparency in Coverage Public Use File (PY2027 release, PY2025 claims), data.healthcare.gov — US Government public domain: https://data.healthcare.gov/
- CCIIO state external review table (read August 3, 2026): https://www.cms.gov/CCIIO/Resources/Files/external_appeals
- 29 CFR 2560.503-1 (180 days, and your free right to the claim file): https://www.ecfr.gov/current/title-29/section-2560.503-1
- 45 CFR 147.136 (4 months, and what qualifies): https://www.ecfr.gov/current/title-45/section-147.136
- HealthCare.gov on external review: https://www.healthcare.gov/appeal-insurance-company-decision/external-review/

Cite: Axion Labs — Denial Facts, "UnitedHealthcare of Wisconsin appeal form and deadline", https://denialfacts.com/insurers/unitedhealthcare-of-wisconsin-inc--wi (checked 2026-11-04). free to quote with the URL.