Prior Authorization and Notification

Plan Announcement

Effective December 31, 2022, Community Plan is exiting the Medi-Cal Program. Members will be transferred to a new Managed Care Plan effective January 1, 2023. The Plan remains available to assist with Continuity of Care, appeals and grievances. Please check eligibility before submitting requests. Call Provider Services for questions (866) 270-5785.

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 to learn about our Prior Authorization and Notification tool.

Current Prior Authorization Plan Requirements

UnitedHealthcare Community Plan of California

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

Expand All add_circle_outline

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. 

Previous Prior Authorization Requirements

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.