In response to questions, Fairview is now reprising the row in detail, saying UnitedHealthcare has the highest final denial rate among all major Medicare Advantage insurers in Minnesota for the health system’s claims seeking payment for hospital services.
For physician claims, the health system says the insurer has the highest initial denial rate and a middle-of-the-pack final denial rate, which means M Health Fairview must submit a higher volume of appeals to secure payments owed under contract.
The health system says that between high denial rates and low contracted reimbursement levels, UnitedHealthcare pays M Health Fairview the smallest percentage of Medicare rates among all major Minnesota insurers.
And M Health Fairview maintains that UnitedHealthcare’s Medicare Advantage plans have driven a 33% increase in prior authorization requests in 2025 compared with 2024, after adjusting for patient volume. These administrative hurdles add significant costs, Fairview says, while diverting clinicians from patient care.
Between October 2024 and September 2025, M Health Fairview employees made 9,596 calls and spent 1,566 hours on the phone with UnitedHealthcare to resolve claims issues, according to the health system. It takes twice as many internal follow-up actions to get paid on an average UnitedHealthcare denied claim, Fairview says, compared with its average across all health insurers.
UnitedHealthcare did not respond directly to these accusations, but defended its track record on claim denials and prior authorization.