12/2019: Enhancements Help Streamline Prior Authorization

In October 2019, we began a journey to enhance functionality in our online Prior Authorization and Notification tool on Link. The new functionality is designed to streamline your overall online prior authorization submission process and improve our process times. We launched this new functionality for certain prior authorization categories throughout October and November:

  • Therapy Evaluations and Re-evaluations for UnitedHealthcare Community Plan members in Ohio, Nebraska and New York
  • Sleep Studies, Sleep Apnea Procedures and Surgeries for all lines of business (Excludes UnitedHealthcare Mid-Atlantic Health Plan, Neighborhood Health Partnership, River Valley, All Savers, Oxford and UnitedHealthcare West)
  • Site of Service for Office-based program and Outpatient Hospital for UnitedHealthcare commercial plans and UnitedHealthcare Community Plan. (Excludes UnitedHealthcare Mid-Atlantic Health Plan, Neighborhood Health Partnership, River Valley, All Savers, Oxford and UnitedHealthcare West)   
  •  Site of Service Reviews for Certain Surgical Procedures for UnitedHealthcare commercial plans and UnitedHealthcare Community Plan.
    • See previous issues of the Network Bulletin for UnitedHealthcare Community Plan state-specific implementation dates at UHCprovider.com/news
      (Excludes UnitedHealthcare Mid-Atlantic Health Plan, Neighborhood Health Partnership, River Valley, All Savers, Oxford and UnitedHealthcare West)
  • Electrical and Ultrasound Bone Growth Stimulators(Electromagnetic) and Hip Resurfacing and Replacement Surgery (Arthroplasty) for UnitedHealthcare Community Plan members
  • Hysterectomy for Benign Conditions and Implanted Electrical Stimulator for Spinal Cord for UnitedHealthcare commercial plans. (Excludes UnitedHealthcare Mid Atlantic Health Plan, Neighborhood Health Partnership, River Valley, All Savers, Oxford, and UnitedHealthcare)

We’ll continue to add additional prior authorization service categories. For the latest service category launch dates, system functionality and training, access the Interactive Guide for Prior Authorization and Notification Tool at UHCprovider.com/paan. It includes:

  •  Affected service categories
  • Clinical information necessary for submission
  • What’s the same or different
  • Frequently Asked Questions

Getting Started with Our Prior Authorization and Notification Tool

If you haven’t used our Prior Authorization and Notification tool before, you can learn more at UHCprovider.com/paan.

To access the tool, you’ll need an Optum ID. Go to UHCprovider.com/newuser to get started. If you need help, call the UnitedHealthcare Connectivity Help Desk at 866-842-3278, option1, from 7 a.m. to 9 p.m. Central Time, Monday through Friday.

In the coming months, we’ll also unveil a new look and feel of the prior authorization user interface tool to help simplify your use and enhance your overall prior authorization online experience. This new design re-organizes and streamlines the initial authorization submission entry point.