Effective July 1, 2021, the North Carolina Department for Medicaid Services requires UnitedHealthcare Community Plan to follow the North Carolina Fee-For-Service PDL and Clinical Criteria. Additional pharmacy benefit and medication information can be found below in this section to assist our providers.
For submission of a prior authorization for a UnitedHealthcare Community Plan of North Carolina:
Prior Authorization Requests - Prescribers may submit prior authorizations for Community Plan Members:
By calling 855-258-1593 or by fax at 866-940-7328
Online at uhcprovider.com > Sign In (top right) > sign in with your One Healthcare ID > Prior Authorization & Notification application
Streamline Your Prior Authorization Process with CoverMyMeds
CoverMyMeds streamlines the medication prior authorization process, electronically connecting providers, pharmacists and plan/PBMs to improve time to therapy and decrease prescription abandonment with electronic prior authorization.
Get Real-Time Prescription Costs and Coverage Detail
The PreCheck MyScript Solution on Link helps make it easy to run a pharmacy trial claim and get real-time prescription coverage detail for your patients who are UnitedHealthcare benefit plan members.