Prior Authorization and Notification

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. We encourage you to use the following tools and resources to 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 link for more information and resources on the specific programs.

• Clinical Pharmacy Guidelines
  
• Pharmacy Drug-Specific Paper Prior Authorization Forms
• More Pharmacy Resources in the Pharmacy Section
  

UnitedHealthcare Community Plan of Ohio

• UnitedHealthcare Community Plan of Ohio Medicaid Prior Authorization Requirements - Effective Sept. 1, 2022
• UnitedHealthcare Community Plan of Ohio Medicaid Prior Authorization Requirements - Effective Jan. 1, 2022
• UnitedHealthcare Community Plan of Ohio Medicaid Prior Authorization Requirements - Effective Dec. 1, 2021
• UnitedHealthcare Community Plan of Ohio Medicaid Prior Authorization Requirements - Effective Nov. 1, 2021
• UnitedHealthcare Community Plan of Ohio Medicaid Prior Authorization Requirements - Effective Oct. 1, 2021
• UnitedHealthcare Community Plan of Ohio Medicaid Prior Authorization Requirements - Effective Sept. 1, 2021
• UnitedHealthcare Community Plan of Ohio Medicaid Prior Authorization Requirements - Effective July 1, 2021
• UnitedHealthcare Community Plan of Ohio Medicaid Prior Authorization Requirements - Effective  May 1, 2021

UnitedHealthcare Connected for MyCare Ohio

• UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid) Prior Authorization Requirements - Effective Sept. 1, 2022
• UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid) Prior Authorization Requirements - Effective March 1, 2022
• UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid) Prior Authorization Requirements - Effective Feb. 1, 2022
• UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid) Prior Authorization Requirements - Effective Jan. 1, 2022
• UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid) Prior Authorization Requirements - Effective Oct. 1, 2021
• UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid) Prior Authorization Requirements - Effective July 1, 2021
• UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid) Prior Authorization Requirements - Effective May 1, 2021

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.