Prior Authorization - Utilization Review
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 Coding Changes
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: