Breadcrumb
UNI - PRV - EPA Outage - temp
Please Note: Learn how to use our new CareAdvance tool under the Request Authorization tab. Expand the appropriate service type category to locate our CareAdvance navigation guide, WebEx and tip sheet.
If you receive an email error message stating “You have no associated provider sets”, we can help you; please email your Web User name and Individual NPI to CAPAdministratorUnivera@UniveraHealthcare.com to update the system. At this time, there may be up to a two hour delay after receiving your information for the system update. Thank you for your patience as we make improvements.
If you have any questions, please contact your Provider Relations representative.
If you receive an email error message stating “You have no associated provider sets”, we can help you; please email your Web User name and Individual NPI to CAPAdministratorUnivera@UniveraHealthcare.com to update the system. At this time, there may be up to a two hour delay after receiving your information for the system update. Thank you for your patience as we make improvements.
If you have any questions, please contact your Provider Relations representative.
Page Title for page template
Authorizations
Search for Required Medical Services-Request Authorization Page Tab Content
GLO-PRV-Search Authorization Page-Row 1 Content
The medical services including provider administered drugs below require prior review by the plan to determine clinical medical necessity.
Authorization - Preauthorization - Basic Web Content
Referral & Authorization Guidelines
- Prior Authorization Guidelines Code List - April 6, 2020Open a PDF
- Prior Authorization Guidelines Code List - January 17, 2020Open a PDF
- DME Prior Authorization List - January 17, 2020Open a PDF
- DME Prior Authorization List - January 1, 2020Open a PDF
- UM Initial Determination Timeframes - Commercial ProductsOpen a PDF
- UM Initial Determination Timeframes - Medicare ProductsOpen a PDF
- UM Initial Determination Timeframes - Medicaid & Safety Net ProductsOpen a PDF
- Behavioral Health Prior Authorization Guidelines Code List Effective July 1, 2019Open a PDF
- eviCore Codes Requiring Preauthorization - Master GridOpen a PDF
- Medical Specialty Drug (For Commercial, Essential Plan, Exchange and Medicare)Open a PDF
Univera Healthcare MyHealthSM, Child Health Plus and MyHealth PlusSM
- Inpatient Prior Authorization FormOpen a PDF
- Outpatient Prior Authorization FormOpen a PDF
- Adult Behavioral Health Home and Community Based Services Prior/Continuing Authorization FormOpen a PDF
- Behavioral Health Outpatient Treatment Request FormOpen a PDF
- Inpatient and Outpatient Neuropsychological and Psychological Testing Authorization FormOpen a PDF
- Behavioral Health Prior Authorization Guidelines Code List Effective July 1, 2019Open a PDF
- Medical Specialty Drug (For Medicaid and Child Health Plus)Open a PDF
