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.
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 Abuse Treatment||801-213-2132|
Updated: Please note the current PDF forms suitable for faxing: