September 01, 2022

New oral oncology prior authorization process

Update: Prior authorization process effective date changed from Oct. 3, 2022 to Dec. 1, 2022

Last modified: Nov. 17, 2022

Effective Dec. 1, 2022, you can submit chemotherapeutic prior authorization requests using the Medical Benefit Management (MBMNow) tool for your patients who have pharmacy benefits through OptumRx. This applies to members with UnitedHealthcare commercial and Individual Exchange plans.¹ You’ll no longer need to submit these prior authorization requests to OptumRx.

With this new process, you can manage your prior authorization requests for oncology medications using the same process as infused chemotherapies.

Affected plans Non-affected health plans
Individual Exchange plans (all states) Golden Rule
Commercial plans Student Resource
All Savers Sierra/Health Plan of Nevada
Neighborhood Health Plan UHC International
River Valley UHC West


New prior authorization request process

If a new prior authorization is needed on or after Dec. 1, 2022, submit a prior authorization request:

  • Online: Submit prior authorization request using MBMNow in the UnitedHealthcare Provider Portal. Sign in with your One Healthcare ID to access the Prior Authorization and Notification tool. Once you’re in the tool:
    • Select “Radiology, Cardiology & Oncology Transactions”
    • Follow the prompts to access MBMNow
  • By phone: Call 888-397-8129 for help submitting a prior authorization.

Coverage determination guidelines

Coverage determinations won’t change due to this new prior authorization request process.

For members currently receiving oral chemotherapeutic agents

If you already have prior authorization approval for a member’s treatment plan, you don’t need to submit a new request.


If you have questions, please email

¹Also referred to as Individual and Family plans
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