In order to initiate a prior authorization request, the following essential information (EI) is required:
If a prior authorization request does not contain each of the essential information data points, the request will not be created and will be returned to the provider with guidance on which information is missing.
NOTE: Please ensure all required clinical documentation is included to avoid delays in service for our shared members.
For information about what other documentation might be required, go to Medical Record Requirements for Pre-Service Reviews.
UnitedHealthcare Community Plan - Children's Health Insurance Program (CHIP)
UnitedHealthcare Community Plan - Connected Texas (Medicare-Medicaid Plan)
UnitedHealthcare Community Plan - STAR
UnitedHealthcare Community Plan - STAR Kids
UnitedHealthcare Community Plan - STAR+PLUS
UnitedHealthcare Medicare Solutions & UnitedHealthcare Community Plan (Dual Special Needs Plan) Prior Authorization Requirements
UnitedHealthcare Community Plan - Children's Health Insurance Program (CHIP)
UnitedHealthcare Community Plan - Connected Texas (Medicare-Medicaid Plan)
UnitedHealthcare Community Plan - STAR
UnitedHealthcare Community Plan - STAR Kids
UnitedHealthcare Community Plan - STAR+PLUS