www.uhcprovider.com Open in urlscan Pro
2620:1ec:bdf::45  Public Scan

Form analysis
3 forms found in the DOM

<form style="display: flex; position: relative;">
  <div id="searchErrorMessage" class="input-search-error error" style="visibility: hidden;"></div><label class="sr-only" for="megamenu-search-mobile">Search</label><input id="megamenu-search-mobile" class="megamenu-search" type="text"
    aria-label="search" placeholder="Search" value="" style="height: 2.25rem; border-radius: 0.25rem; border: 0.0625rem solid rgb(51, 51, 51); padding-right: 1.5rem; padding-left: 10px; width: 100%;">
  <div style="color: rgb(0, 38, 119); position: absolute; right: 0.5rem; top: 0.55rem; cursor: pointer;">
    <div class="material-icons">search</div>
  </div>
</form>

<form style="display: flex; position: relative;">
  <div id="searchErrorMessage" class="input-search-error error" style="visibility: hidden;"></div><label class="sr-only" for="megamenu-search-desktop">Search</label><input id="megamenu-search-desktop" class="megamenu-search" type="text"
    aria-label="search" placeholder="Search" value="" style="height: 2.25rem; border-radius: 0.25rem; border: 0.0625rem solid rgb(51, 51, 51); padding-right: 1.5rem; padding-left: 10px; width: 100%;">
  <div style="color: rgb(0, 38, 119); position: absolute; right: 0.5rem; top: 0.55rem; cursor: pointer;">
    <div class="material-icons">search</div>
  </div>
</form>

<form style="display: flex; position: relative;">
  <div id="searchErrorMessage" class="input-search-error error" style="visibility: hidden;"></div><label class="sr-only" for="megamenu-search-tablet">Search</label><input id="megamenu-search-tablet" class="megamenu-search" type="text"
    aria-label="search" placeholder="Search" value="" style="height: 2.25rem; border-radius: 0.25rem; border: 0.0625rem solid rgb(51, 51, 51); padding-right: 1.5rem; padding-left: 10px; width: 100%;">
  <div style="color: rgb(0, 38, 119); position: absolute; right: 0.5rem; top: 0.55rem; cursor: pointer;">
    <div class="material-icons">search</div>
  </div>
</form>

Text Content

SEARCH

close

Search
search
close Close MENU


 * SIGN IN

 * Sign in to the UnitedHealthcare Provider Portal
   
   

 * New User & User Access
   
   Need access to the UnitedHealthcare Provider Portal?

   


 * MAIN MENU

 * Eligibility and Referrals
 * Prior Authorization
 * Claims and Payments


 * OUR NETWORK

 * Join our network
 * Contact us
 * Preferred Lab Network
 * Demographics and profiles
 * Find a provider


 * RESOURCES

 * Health plans, policies, protocols and guides
 * Administrative guides and manuals
 * Drug lists and pharmacy
 * Health plans
 * Education and training
 * Reports and quality programs
 * Forms
 * News
 * Resource library
 * The UnitedHealthcare Provider Portal resources
 * * Membersopen_in_new
   * New User & User Access


Skip to main content
 * Membersopen_in_new
 * New User & User Access


Search
search
menu MENU

Search
search



 * 
 * Eligibility and Referrals
 * 
 * 
 * Prior Authorization
 * 
 * 
 * Claims and Payments
 * 
 * 
 * Our network expand_more
 * Join our network
   
   Steps to getting contracted plus plan information
   
   Contact us
   
   Phone numbers and links for connecting with us
   
   Preferred Lab Network
   
   List of contracted, high-quality independent lab providers
   
   Demographics and profiles
   
   Update, verify and attest to your practice's demographic data
   
   Find a provider
   
   Provider search for doctors, clinics and facilities, plus dental and
   behavioral health

 * 
 * Resources expand_more
 * Health plans, policies, protocols and guides
   
   Policies for most plan types, plus protocols, guidelines and credentialing
   information
   
   Administrative guides and manuals
   
   
   
   Drug lists and pharmacy
   
   Pharmacy resources, tools, and references
   
   Health plans
   
   View health plans available by state
   
   Choose a location Alabama Alaska Arizona Arkansas California Colorado
   Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho
   Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts
   Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire
   New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma
   Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas
   Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
   
   Choosing a location will immediately redirect
   
   Education and training
   
   Updates and getting started with our range of tools and programs
   
   Reports and quality programs
   
   Reports and programs for operational efficiency and member support
   
   Forms
   
   
   
   News
   
   Important news updates for you
   
   Resource library
   
   Tools, references and guides for supporting your practice
   
   The UnitedHealthcare Provider Portal resources
   
   Log in for our suite of tools to assist you in caring for your patients

 * 
 * 
 * Sign Inexpand_more
   
    * 
      
      Sign in to the UnitedHealthcare Provider Portal
   
    * Need access to the UnitedHealthcare Provider Portal?
      
      New User & User Access

search
 1. Home
 2. Prior Authorization and Notification

print Print
add_alert
May 30, 2024 at 8:00 AM CT

For information on the Change Healthcare cyber response, find updated
information on the Provider Portal. You can also learn more about the Temporary
Funding Assistance Program on the Optum websiteopen_in_new.




PRIOR AUTHORIZATION AND NOTIFICATION

Prior authorization information and forms for providers. Submit a new prior
auth, get prescription requirements, or submit case updates for specialties.

Health care professionals are sometimes required to determine if services are
covered by UnitedHealthcare. Advance notification is often an important step in
this process. Because requests vary, it is important that you verify the
specific clinical requirements of each request. 

 


DIGITAL TOOLS

We’ve designed our digital tools to help you seamlessly submit and verify your
prior authorizations and advance notifications in real time. While you’re in the
tool, you can also easily check requirements, get status updates and more.




MEDICAL PROFESSIONAL DIGITAL TOOLS


UnitedHealthcare Provider Portal – The Prior Authorization and Notification tool
allows you to submit inquiries, process requests and get status updates. 


Sign inopen_in_new to the portal

 * Prior Authorization and Notification quick start guideopen_in_new
 * Prior Authorization and Notification interactive guideopen_in_new


Electronic Data Interchange (EDI) allows you to securely and electronically
submit and receive batch transactions for multiple cases. 




PHARMACY DIGITAL TOOLS


PreCheck MyScript® integrates directly within your EMR so you can easily run a
pharmacy trial claim and get real-time prescription coverage details.


Sign inopen_in_new to use PreCheck MyScript.






MEDICAL PROFESSIONAL RESOURCES 

Crosswalkopen_in_new
For commercial, Individual Exchange, Medicare Advantage, and Community plan
members, the crosswalk table will help you determine next steps when you need to
provide a service different from the prior authorized service. Note: An X in the
table means the crosswalk is available. An N/A in the table means Crosswalk is
not available. You can find more helpful details in the Crosswalk information
sheetopen_in_new. 

Advance notification
Take this first step to help you determine coverage based on medical necessity.
Please note, prior authorization may still be required. 

Peer-to-peer requestsopen_in_new
Peer-to-peer requests are made prior to submitting an appeal. Don’t fill out
this form if your appeal has already been initiated.

Regulatory
You can find state-required information regarding services that require
pre-service review.


PHARMACY RESOURCES

Clinical and specialty pharmacy
Certain medications require notification and review to determine coverage under
pharmacy benefits. You can view clinical pharmacy requirements here.

Drug lists
Get pharmacy coverage information including drug lists, supply limits, step
therapy and infusion care.

Community Plan prescribers
Access forms used for the manual submission of specific drug prior
authorizations.






SPECIALTY SPECIFIC RESOURCES


CARDIOLOGY



See requirements Cardiology


ONCOLOGY



See requirements Oncology


RADIOLOGY



See requirements Radiology


GENETIC AND MOLECULAR TESTING



See requirements Genetic and Molecular Testing


GASTROENTEROLOGY



See requirements Gastroenterology



PRIOR AUTHORIZATION NEWS

See all news arrow_forward

May 31, 2024


COLORADO: NO REFERRALS REQUIRED WITH HMO OPEN ACCESS



As of Jan. 1, 2024, all of our Medicare HMO H0609 plans no longer require
referrals.

Read Full Update Colorado: No referrals required with HMO Open Access

May 31, 2024


RMHP INDIVIDUAL EXCHANGE PLANS TO ALIGN WITH HOSPITAL REFERENCE LAB PROTOCOL



Effective Sept. 1, UnitedHealthcare Hospital Reference Lab Protocol will apply
to RMHP Individual Exchange plans.

Read Full Update RMHP Individual Exchange plans to align with hospital reference
lab protocol

May 31, 2024


SUREST PLANS: CHANGE TO ONCOLOGY PRIOR AUTHORIZATION PROCESS



As of July 1, 2024, prior authorization requests for Surest plans and Surest
Flex plans must be submitted using Optum CGP.

Read Full Update Surest plans: Change to oncology prior authorization process

April 30, 2024


SUREST MEDICAL INJECTABLE POLICIES TO ALIGN WITH UNITEDHEALTHCARE COMMERCIAL
PLANS POLICIES



Starting Aug. 1, we’re updating some Surest™ medical injectable policies to
align with UnitedHealthcare commercial plans policies.

Read Full Update Surest medical injectable policies to align with
UnitedHealthcare commercial plans policies

April 17, 2024


NORTH CAROLINA: GET ACCURATE RATES FOR NON-ROUTINE INFANT CARE



Learn when notification is required after rendering non-routine care to infants
and how noncompliance can affect your rate.

Read Full Update North Carolina: Get accurate rates for non-routine infant care

April 10, 2024


SUREST OUT-OF-NETWORK SERVICE AREA UPDATE



Beginning April 1, we’re updating the service area for Surest benefit plans with
out-of-network benefits.

Read Full Update Surest out-of-network service area update



Expand All add_circle_outline
HOW DO I SUBMIT A PRIOR AUTHORIZATION, ADVANCE NOTIFICATION OR ADMISSION
NOTIFICATION?

expand_more

There are several ways you can submit prior authorizations, advance
notifications and admission notifications (HIPAA 278N):

 1. Prior authorization and notification tools: These digital options, available
    in the UnitedHealthcare Provider Portalopen_in_new, allow you to seamlessly
    submit your requests in real time
 2. EDI: This digital solution allows you to automate prior authorization and
    notification tasks
 3. Provider Services: If you’re unable to use the provider portal, call
    877‐842‐3210 to submit a request
 4. Fax: You can submit requests by fax to 855‐352‐1206. Please note: This
    option is only available for the following commercial plans: Massachusetts,
    Nevada, New Mexico and Texas.




NEED HELP?

Connect with us through chat 24/7 in the UnitedHealthcare Provider
Portal.open_in_new


Did you find what you were looking for?
YesNo

 * About usopen_in_new

 * Contact us

 * Careersopen_in_new

 * Find a provider

© 2024 UnitedHealthcare | All Rights Reserved
Fraud, waste and abuseopen_in_new
Language assistanceopen_in_new
Privacyopen_in_new
Sitemap
Terms of useopen_in_new



Feedback