Prior Authorization - Utilization Review

Prior Authorization (Medical Utilization Management Review) and Notification:

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.

Request a Prior Authorization Request

Prior Authorization (Medical Utilization Management) Guidelines

Please Note: U of U Health Plans is planning on discontinuing Fax and 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) 281-6121.

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.

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University of Utah Contracting Criteria

Provider information in this directory is collected from information that we receive from our provider network and updated 5 days per week, excluding weekends, holidays, or interruptions due to upgrades, system maintenance, or unplanned outages. This information is subject to change at any time.