Policies, Guidelines & Forms
What is a Prior Authorization or Pre-authorization?
Certain medical procedures and medications require approval before you will be able to receive treatment. The prior approval process is called pre-authorization, or prior authorization (PA).
Prior authorization allows for a personal review of your treatment within the context of your existing health issues, medications and treatments.
Reasons for Prior Authorization include:
- Review of treatment options and any related risks to the treatment
- Manage Costs - Prior Authorization helps ensure that you have insurance coverage for a procedure, treatment or service
- Avoid excess and waste - utilization management review for inappropriate or unnecessary medical treatments
Procedures, Products and Treatment requiring Prior Authorization
Upcoming Changes to Codes Requiring Prior Authorization
Prior Authorization (Medical Utilization Management Review) and Notifications:
In order to help you assist patients in a timely and efficient manner; please use the Prior Authorization Request Application. The Prior Authorization application replaces all previous and existing U of U Health Plans Medical Utilization forms EXCEPT for SNF, Acute Rehab and LTAC requests. For SNF, Acute Rehab and LTAC requests, please use the download form: SNF, Acute Rehab and LTAC Prior Authorization.
Updated: If you need to submit Prior Authorization requests via Fax, please use the updated number(s):
|Prior Authorization Request||Fax Number|
|Inpatient Notification, SNF & Rehab||801-213-2132|
|Behavioral Health & Substance Use Treatment||801-213-2132|
Updated: Please note the current PDF forms suitable for faxing: