Prior Authorization and Notification

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 oncology prior authorization and notification programs aim to increase quality and patient safety by increasing compliance with evidence-based standards of care. View the following link for more information and resources on the specific programs.

UnitedHealthcare Community Plan Pennsylvania CHIP

• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Mar. 1, 2025open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Feb. 1, 2025open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Jan. 1, 2025open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Dec. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Oct. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Sep. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Aug. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Jul. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Jun. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Apr. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Mar. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Jan. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Oct. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Sept. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Aug. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Jul. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective Jun. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania CHIP - Effective May 1, 2023open_in_new

UnitedHealthcare Community Plan Prior Authorization Pennsylvania Medicaid

• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Mar. 1, 2025open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Feb. 1, 2025open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Jan. 1, 2025open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Dec. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Oct. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Sep. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Aug. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Jul. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Jun. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Apr. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Mar. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Jan. 1, 2024open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Oct. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Sept. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Aug. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Jul. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective Jun. 1, 2023open_in_new
• UnitedHealthcare Community Plan Prior Authorization Requirements Pennsylvania Medicaid - Effective May 1, 2023open_in_new

• Pharmacy Drug-Specific Paper Prior Authorization Forms 

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.