Physicians, health care professionals and ancillary health care providers are responsible for:
Facilities are responsible for:
If you perform multiple procedures for a member in 1 day, and at least 1 service requires prior authorization, you must obtain prior authorization for any of the services to be paid.
If you do not follow these requirements, we may deny claims. In that case, you cannot bill the member. Advance notification or prior authorization is valid only for the date of service or date range listed on it. If services have not been rendered and the specified date of service or date range has passed, you must contact us to update the date of service or date range. When you contact us, we will advise if submission of a new request is required.
See Coverage and utilization management decisions section for additional details.
Save time- No need to call, fax or mail information so you can spend time on other things.
Reduce costs- Online solutions are the most efficient and cost-effective way to manage these transactions.
Get information- Check if prior authorization or notification is required by member or procedure code.
Intuitive and accurate- Required information is highlighted and fields automatically adjust as data is entered. Error messages alert corrections needed before submitting.
Superior documentation- Obtain a Decision ID for inquiries and a reference number for submissions. Save PDF confirmation files or print records as you wish.
Find and check status- Many search options are available to check the status of your submissions, regardless of the submission method you used.
New user & user access
Interactive Guide for Prior Authorization and Notification in the UnitedHealthcare Provider Portal
UnitedHealthcare Web Support
1-866-842-3278, Option 1, Monday - Friday 7 a.m. - 9 p.m CT
Your request must have the following information:
If the member’s benefit plan requires a clinical coverage review, we may request additional information, as described in more detail in the Clinical coverage review section.