Advance Notification and Prior Authorization requirements

Health care professionals can view the following advance notification and prior authorization information or sign in to the UnitedHealthcare Provider Portal to help determine a member’s coverage.

Manage prior authorizations online

You can use the UnitedHealthcare Provider Portal to verify if a prior authorization is required. Check by member first to get the most accurate response, get a Decision ID and easily submit electronically if a prior authorization is required.

Summary of changes to advance notification and prior authorization requirements

Specialty resources

Current requirements by plan type

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Advance Notification and Prior Authorization requirements

Manage prior authorizations online

Summary of changes to advance notification and prior authorization requirements

Specialty resources

Current requirements by plan type

Commercial

Surest

Mid-Atlantic Health Plans

Oxford Health Plans

UnitedHealthcare Complete

UnitedHealthcare West

Neighborhood Health Partnership (NHP)

UnitedHealthcare of the River Valley

UnitedHealthcare Medicare Advantage/Peoples Health Plans prior authorization requirements

Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida

UnitedHealthcare Community Plan (Medicaid and long-term care)

Individual Exchange

Individual Exchange behavioral health

Commercial

Surest

Mid-Atlantic Health Plans

Oxford Health Plans

UnitedHealthcare Complete

UnitedHealthcare West

Neighborhood Health Partnership (NHP)

UnitedHealthcare of the River Valley

UnitedHealthcare Medicare Advantage/Peoples Health Plans prior authorization requirements

Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida

UnitedHealthcare Community Plan (Medicaid and long-term care)

Individual Exchange

Individual Exchange behavioral health

Previous requirements by plan type

Commercial

Mid-Atlantic Health Plans

UnitedHealthcare West

UnitedHealthcare of the River Valley

Surest

Oxford Health Plans

Neighborhood Health Partnership (NHP)

UnitedHealthcare Complete

UnitedHealthcare Medicare Advantage/ Peoples Health and Rocky Mountain Health Plans

Preferred Care Network

Behavioral Health Rocky Mountain Health Plans CareAdvantage Value, CareAdvantage Enhanced

UnitedHealthcare Community Plan (Medicaid and long-term care)

Individual Exchange

Individual Exchange behavioral health

Additional resources

Medicare Advantage Prior Authorization Outpatient Therapy Resources