Central/Southeast/Northeast regions: Prior authorization and clinical decision letters are going paperless
Last updated: Aug. 30, 2022
Please note, the launch date has changed from May 20 to June 17.
Beginning June 17, 2022, we will no longer mail prior authorization and clinical decision letters for most1 UnitedHealthcare plans in the Central, Southeast and Northeast regions. Instead, you’ll be able to view them 24/7 through either the UnitedHealthcare Provider Portal or an Application Programming Interface (API) system-to-system data feed.
Who this change affects This change affects network medical health care professionals (primary and ancillary) and facilities in the following states:
Which letter types are going paperless
Pre-service/prior authorization decision letters
Inpatient review letters, including concurrent, retrospective, length of stay and level of care
Extension for lack of clinical information letters
Complex care management and OrthoNet letters available in Document Library
How to view prior authorization and clinical decision letters online
Document Library ‒ Immediately view letters in this secure repository of claim-related communication and reports within the UnitedHealthcare Provider Portal. You can check Document Library for new letters at any time. We encourage you to set up a daily task to check it for updates.
Sign into the portal – Go to UHCprovider.com and select Sign In in the upper-right corner, then sign in with your One Healthcare ID and password
In the menu, select Documents & Reporting
Then, click Document Library and select the Prior Auth Letters folder
Need to notify multiple staff members? When new letters are available in Document Library, an email notification will be sent to the address on file, which is typically the Primary Access Administrator. Document Library notifications are limited to 1 email address per tax ID number (TIN). If multiple staff members require notification, the Primary Access Administration can consider using a group email address. See our Paperless Delivery Options for Primary Access Administrators for more information.
Note: If you have access to the Prior Authorization and Notification tool in the portal, you also have direct access to the Prior Auth Letters folder in Document Library. If you don’t have access to the tool and need to view letters in Document Library, please request access from your Primary Access Administrator.
Application Programming Interface (API)– Consider API if you prefer an automated data feed that can pull information from UnitedHealthcare on a schedule you set. The automated feed replaces having to look for specific items in Document Library. Data can be pulled into your practice management system, portal or any application you prefer. API requires technical programming between your organization and UnitedHealthcare.
TrackIt – Check determination status and take action on prior authorizations for your entire practice/facility TIN level) at a glance using this tool. From TrackIt, you can move directly to the Prior Authorization and Notification area of the portal where you can explore a case further, add required information or link to Document Library.
Note: You cannot start or submit prior authorizations using TrackIt.
What’s ahead in paperless We are transitioning most3 contracted health care professionals (primary and ancillary) and facilities from paper to digital communication over the next several years. Look for announcements in UHCprovider.com/news 90 days before mailings end. (The announcement will include any applicable exclusions.) We encourage you to share this information and start using our digital solutions ahead of each change. If you work with an outside vendor for your mail processing, please talk with them about this change.
Network professionals please note: Health care professionals and facilities in the UnitedHealthcare network are required to do business with us electronically. We must have a valid email address on file to send you required notifications and important information. Please update your preferences regularly. The Provider Communications chapter in the administrative guide (UHCprovider.com/guides) provides more details.
Not contracted with UnitedHealthcare? You can still set up e-delivery and turn off mailings any time. Visit UHCprovider.com/paperlessfor more information.
1Currently excludes: UnitedHealthcare Commercial Plan of New Jersey; UnitedHealthcare Community Plan of Indiana; UnitedHealthcare Community Plan of Kansas; UnitedHealthcare Community Plan of Kentucky; UnitedHealthcare Community Plan of Louisiana; UnitedHealthcare Community Plan of Michigan; UnitedHealthcare Commercial, Medicare and Community Plans of Minnesota; UnitedHealthcare Community Plan of Missouri; UnitedHealthcare Community Plan of Nebraska; UnitedHealthcare Community Plan of Washington, D.C.; Behavioral Health; Medicare supplement products; UnitedHealthcare West; UMR; UnitedHealthcare Global; Student Resources; Erickson Advantage Plans; and Home- and Community-Based Services providers.