shot of the On web page, identify how changes information. are to be made to previous requests and how providers will be notified If not auto-approved, put the case of decisions number into the EHR. Upload or fax supporting documentation. (However may still get a call from UHC reviewing nurse asking for clinicals) Steps Provide status information on Reporting Statuses are Approved, website per the BPR Pending, Denied. A letter is Check Status which is available sometimes included that indicates Identify any information that is once the Notification what additional information is ‘Radiology missing. and Authorization entry in the needed. …’ Prior Authorizations’ ‘Notifications/ drop down list is selected. Pending status does not always have a letter attached, in which case there is If pre-auth request was not auto Checking Status no information about whether action approved within two days after of Request is required of the provider and/or if submission, check status on website what documentation is required to see if a letter has been posted Allow access to status information Met Can see status of pre-authorizations about required documentation. If by the provider/organization that that were requested by outside not, call. requested the services, the providers. provider/organization that is doing the services and, as appropriate, the facility/organization where the services are to be done
shot of the information. If not auto-approved, put the case number into the EHR. Upload or fax supporting documentation. (However may still get a call from UHC reviewing nurse asking for clinicals) On web page, identify how changes are to be made to previous requests and how providers will be notified of decisions Checking Status of Request Steps Check Status which is available once the ‘Radiology Notification and Authorization …’ entry in the ‘Notifications/ Prior Authorizations’ drop down list is selected. If pre-auth request was not auto approved within two days after submission, check status on website to see if a letter has been posted about required documentation. If not, call. Provide status information on website per the BPR Identify any information that is missing. Reporting Statuses are Approved, Pending, Denied. A letter is sometimes included that indicates what additional information is needed. Pending status does not always have a letter attached, in which case there is no information about whether action is required of the provider and/or if what documentation is required Allow access to status information by the provider/organization that requested the services, the provider/organization that is doing the services and, as appropriate, the facility/organization where the services are to be done Met Can see status of pre-authorizations that were requested by outside providers.
UHC-CP%20Detail%201.docx