West region: Prior authorization and clinical letters are going paperless
Last updated: Aug. 30, 2022
Beginning April 1, 2022, we will no longer mail prior authorization and clinical decision letters, for most* UnitedHealthcare plans in the West region. This includes letters requesting additional information, approvals and denials. Instead, you’ll be able to view them 24/7 through either the UnitedHealthcare Provider Portal or an Application Programming Interface (API).
This change affects network medical health care professionals (primary and ancillary) and facilities in the following states:
How to view prior authorization and clinical decision letters online
Document Library ‒ Immediately view letters in this secure repository of claim-related communications and reports within the UnitedHealthcare Provider Portal. An email notice will be sent to the address on file when new letters are available.**
Sign in to 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
Note: If you have access to the Prior Authorization and Notification tool (PAAN) 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.
TrackIt – Check determination status and take action on prior authorizations for your entire practice/facility (tax ID number [TIN] level) at a glance using this tool. From TrackIt, you can move directly to the Prior Authorization and Notification section 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.
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. Set-up times vary, but can be lengthy. Please plan well in advance to incorporate API into your workflow.
What’s ahead in paperless We are transitioning most 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.
*Currently excludes: UnitedHealthcare® Medicare Advantage and commercial health plans in Colorado; UnitedHealthcare Community Plans in California, Arizona and Hawaii; Behavioral Health; Medicare supplement products; Sierra Health and Life; Rocky Mountain Health Plan; UnitedHealthcare West; UMR; UnitedHealthcare Global; Student Resources; Erickson Advantage Plans; and Home- and Community-Based Services providers.
** Document Library notifications are currently limited to 1 email address per TIN. If you have multiple staff members who need to be notified when new letters are added to Document Library, your Primary Access Administrator may want to consider setting up a group mailbox. That group mailbox can be designated to receive Document Library notifications.