Updated process for prior authorization requests
Individual Exchange plans: Non-oncology injectable medications
Effective Jan. 1, 2023, Optum will manage prior authorization requests for non-oncology injectable medications for Individual Exchange plans, also referred to as Individual and Family plans. You’ll need to follow a new step when requesting these prior authorizations.
Please note that the prior authorization request process for oncology medications won’t change.
The new process
As of Jan. 1, you’ll submit these prior authorizations to Optum by following a new step 3:
- Sign in to the UnitedHealthcare Provider Portal by visiting UHCprovider.com and selecting Sign In
- Select the Prior Authorization tool
- New step: Select Specialty Pharmacy Transactions
- Enter the required information
Existing prior authorizations
Prior authorizations that are active before Jan. 1 will remain in effect.
You won’t need to submit a new request until the existing authorization expires or you change the medication therapy, such as:
- Dosage
- Frequency of administration
- Place of therapy
Questions?
If you have any questions, please contact your provider advocate or call us at 888-397-8129, 8 a.m.–5 p.m. local time, Monday–Friday.
