Prior Authorization and Notification
We have online tools and resources to help you manage your practice’s notification and prior authorization requests.
To submit and manage your prior authorizations, please sign in to the UnitedHealthcare Provider Portal. Additional information on prior authorizations is available on uhcprovider.com/priorauth.
Current Prior Authorization Requirements
UnitedHealthcare Community Plan Behavioral Health Prior Authorization Requirements
UnitedHealthcare Community Plan
UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements
Community Plan Pharmacy Prior Authorization Forms
Personal Care Services
To request North Carolina Medicaid Personal Care services, please call 800-638-3302 and ask for a Personal Care services assessment and fax to # 855-541-8921. Additional forms can be found at Provider Forms, Resources and References | UHCprovider.com > Helpful resources.
The cardiology prior authorization and notification programs support the consistent use of evidence-based, professional guidelines for cardiology procedures. They were designed with the help of physician advisory groups to encourage appropriate and rational use of cardiology services. Using them helps reduce risks to patients and improves the quality, safety and appropriate use of cardiac procedures.
Using Electronic Data Interchange (EDI) for all eligible UnitedHealthcare transactions can help your organization improve efficiency, reduce costs and increase cash flow. We encourage you to use the following tools and resources to get started with electronic transactions.
The radiology prior authorization and notification programs support the consistent use of evidence-based, professional guidelines for diagnostic imaging procedures. They help reduce risks to patients and improve the quality, safety and appropriate use of imaging procedures.
UnitedHealthcare Community Plan Behavioral Health Prior Authorization Requirements
UnitedHealthcare Community Plan
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective January 1, 2025
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective July 1, 2024
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective June 1, 2024
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective May 1, 2024
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective Apr. 1, 2024
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective Mar. 1, 2024
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective Nov. 1, 2023
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective Sept. 1, 2023
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective Aug. 1, 2023
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective June 1, 2023
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective May 1, 2023
- UnitedHealthcare Community Plan Prior Authorization Requirements North Carolina - Effective Apr. 1, 2023
Prior Authorization lookup
This tool is intended to check requirements for medical or behavioral health outpatient services. Search results are based on the data you’ve selected. This tool is not a description of covered benefits for a particular member. Prior authorization is always required for services from non-contracted providers. If you are a provider, to help ensure you have the most complete and accurate information, please sign in to the UnitedHealthcare Provider Portal.
Please note: Your search is not a request for prior authorization and is not a notification to UnitedHealthcare. Coverage determinations are based on the member’s benefit plan and eligibility for benefits, in addition to other criteria. Your search does not guarantee coverage.