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Prior Authorization and Notification

We have online tools and resources to help you manage your practice’s notification and prior authorization requests.

Need to submit or check the status of a prior authorization request?  Go to UHCprovider.com/priorauth to learn about our Prior Authorization and Notification tool on Link.

Prior Authorization and Notification logo Prior Authorization and Notification logo

Effective Dec. 1, 2018: United Healthcare’s Long Term Care Plan Exited Region 9

Member enrollment in Region 9 ended on Nov. 30, 2018.  However, member authorizations remain active throughout the 60 day continuity of care period. Please refer to member’s plan of care for details. If you have questions or need further assistance please contact Provider Services at 800-791-9233.

Current Prior Authorization Plan Requirements

UnitedHealthcare Community Plan of Florida

UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements

 

The cardiology prior authorization and notification programs support the consistent use of evidence-based, professional guidelines for cardiology procedures. They were designed with the help of physician advisory groups to encourage appropriate and rational use of cardiology services. Using them helps reduce risks to patients and improves the quality, safety and appropriate use of cardiac procedures.

Using Electronic Data Interchange (EDI) for all eligible UnitedHealthcare transactions can help your organization improve efficiency, reduce costs and increase cash flow. We encourage you to use the following tools and resources to get started with electronic transactions.

The oncology prior authorization and notification programs aim to increase quality and patient safety by increasing compliance with evidence-based standards of care. View the following link for more information and resources on the specific programs.

The radiology prior authorization and notification programs support the consistent use of evidence-based, professional guidelines for diagnostic imaging procedures. They help reduce risks to patients and improve the quality, safety and appropriate use of imaging procedures.

Helpful Resources