Here you will find the tools and resources you need to help manage your practice’s notification and prior authorization needs. Your primary UnitedHealthcare prior authorization resource, the Prior Authorization and Notification tool, is available on Link, the gateway to UnitedHealthcare’s self-service tools.
Need to submit or check the status of a prior authorization request? Learn more at UHCprovider.com/priorauth.
Current Prior Authorization Requirements
UnitedHealthcare Community Plan of Iowa
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.
The oncology prior authorization and notification programs aim to increase quality and patient safety by increasing compliance with evidence-based standards of care.
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.
Utilization Guidelines, such as Milliman Utilization Care Guidelines, may be used as part of the prior authorization process. You may request a copy of a specific guideline by calling 1-888-650-3462.