In this section you will find the tools and resources you need to help manage your practice’s prior authorization and notification requirements, with program specific information available for Cardiology, Oncology, Radiology, Clinical Pharmacy and Specialty Drugs.
Your primary UnitedHealthcare prior authorization resource, the Prior Authorization and Notification tool, is available on Link, UnitedHealthcare’s self-service tools. Learn more.
What Would You Like to Do?
To see more information on any of these areas, click on the plus sign (+) next to their title.
Helpful Resources
Medical Records Requirement for Pre-Service: Prepare suggested materials in advance to decrease the need for repeated requests, improve turnaround time for medical records reviews and help improve the claims process.
For information on specific prior authorization and notification clinical programs by specialty, choose from below:
Check current prescription coverage and price, including out-of-pocket prescription costs for UnitedHealthcare members at their selected pharmacy with the PreCheck MyScript Tool on Link.
- Get information on lower-cost prescription alternatives, if available, to help save members money.
- See which prescriptions currently require prior authorization, or are non-covered or non-preferred.
- Request prior authorization and receive status and results.
Learn more about PreCheck MyScript Solution.
If you do not yet have access to the PreCheck MyScript tool, you may request it from the Link Marketplace.
Note: This application is available to physicians and facilities, not to pharmacies.
Starting Nov. 1, 2017, notification is required for certain genetic and molecular lab tests for certain UnitedHealthcare Commercial benefit plans.
Ordering care providers will complete the notification/prior authorization process online or over the phone.
Labs must register their tests to participate as part of the Genetic and Molecular Lab Testing Notification/Prior Authorization process.
Learn more about the Genetic & Molecular Lab Testing Notification / Prior Authorization Process.
Forms
Looking for Pharmacy information? More forms can be found in the Clinical Pharmacy and Specialty Drugs Prior Authorization Programs section.
- Fertility Solutions Prior Authorization Request Form
- Mid-Atlantic Health Plans Universal Request for Prior Authorization
- Pre-Determination Fax Form for Services that Do Not Require Prior Authorization - Commercial Members Only
State-Specific Forms
- Indiana Standard Prior Authorization Request Form for Health Care Services
- Massachusetts Commercial Prior Authorization Form - Cardiac Imaging Prior Authorization Form
- Massachusetts Commercial Prior Authorization Form - CT/CTA/MRI/MRA Prior Authorization Form
- Massachusetts Commercial Prior Authorization Form - Hepatitis C Medication Requests
- Massachusetts Commercial Prior Authorization Form - Non-OB Ultrasound Requests
- Massachusetts Commercial Prior Authorization Form - PET CT Imaging Authorization Form
- Massachusetts Commercial Prior Authorization Form - SYNAGIS® Requests
- Texas Standard Prior Authorization Request Form for Health Care Services
Additional Resources
- Inpatient Admission Notification and Case Management Process for Skilled Nursing Facilities
- Medicare Advantage Prior Authorization Reduction Frequently Asked Questions
- Medical Records Required for Post-Service Medical Necessity Facility Reviews
- Medical Records Requirement for Pre-Service
- Medicare Part D Prior Authorization Guidelines