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Prior Authorization and Notification

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, RadiologyClinical 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.

We’re continuously looking for ways to provide greater administrative simplicity for care providers and reduce the costs of doing business with us.

As part of this effort, we’re retiring certain fax numbers for medical prior authorization requests and asking you to use the Prior Authorization and Notification tool on Link — the same website you already use to check eligibility and benefits, manage claims and update your demographic information. 

Learn more about retiring fax numbers.