Policies, Guidelines & Forms
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.
Prior Authorization (Medical Utilization Management) Guidelines
Please Note: U of U Health Plans is planning on discontinuing Fax and Box.com Upload support in the near future. Please plan accordingly and communicate if you have questions or concerns. If you need to submit Prior Authorization requests via Fax, please use (801) 213-1358.
If you need to upload a request via the box interface, the upload form is located here.
PDF forms suitable for faxing are located here.