At Health Choice Utah, our goal is to work closely with you and your practice team to streamline and expedite prior authorization. Many of the items on our abbreviated prior authorization list ask for notification only. Our centralized prior authorization center is designed to streamline processes resulting in timely expedited approval of prior authorization requests.
Prior Authorization Guidelines
Requests for services that require prior authorization can be submitted on the Health Choice Utah Prior Authorization form by fax or requests can be phoned into the Health Choice Prior Authorizations department. All requests must include complete diagnosis and procedure codes, and the accompanying medical documentation (as needed).
In order to expedite prior authorization and provide quality services to our members, a contracted or preferred provider is recommended for all healthcare services for Health Choice members. Please note that all non-contracted providers must obtain authorization for any service.Prior Authorization Matrix 2021
Prior Authorization Guidelines Effective 5/01/2020
Submitting a Prior Authorization Request
To submit a new request, obtain information about a previously submitted request or to make an urgent request:
- Health Choice Utah Medical PA Phone: 1-877-358-8797
- Health Choice Utah Medical PA Fax Line: 1-877-358-8793
Guides and Forms
Management of Expedited PA Request Notice
Prior Authorization Guidelines Effective 5/01/20
Prior Authorization Criteria
Medical Services Prior Authorization Form
Residential Treatment Prior Authorization Form
Synagis Authorization Form
Prior Authorization for Prescription Drugs
For more information about prior authorization for prescription drugs, click here.