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 app, is available on Link, the gateway to UnitedHealthcare’s self-service tools. Learn more
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To see more information on any of these areas, click on the plus sign (+) next to their title.
Medical Records Requirement for Pre-Service - To decrease the need for repeated requests, improve turnaround time for medical records reviews and help improve the claims process, please prepare suggested materials in advance.
Check current prescription coverage and price, including out-of-pocket prescription costs for UnitedHealthcare members at their selected pharmacy with the PreCheck MyScript App 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.
If you do not yet have access to the PreCheck MyScript app, 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.
Looking for Pharmacy information? More forms can be found in the Clinical Pharmacy and Specialty Drugs Prior Authorization Programs section.
- Commercial Standard Prior Authorization Request Form
- 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
- 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
Other Helpful Resources
- Inpatient Admission Notification and Case Management Process for Skilled Nursing Facilities
- Medical Records Required for Post-Service Medical Necessity Facility Reviews
- Medical Records Requirement for Pre-Service
- Medicare Advantage Prior Authorization Reduction Frequently Asked Questions
- Medicare Part D Prior Authorization Guidelines