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Prior Authorization and Notification

Health care professionals working with UnitedHealthcare can submit and verify prior authorizations and advance notifications in real time within the UnitedHealthcare Provider Portal.  Use the Prior Authorization and Notification tool to submit inquiries, process requests and get status updates. Additional information on prior authorizations is available on uhcprovider.com/priorauth.

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The cardiology prior authorization and notification programs support the consistent use of evidence-based, professional guidelines for cardiology procedures. The programs 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 help you 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 links 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.

UnitedHealthcare Community Plan of New Mexico is a product of UnitedHealthcare Insurance Company.