Consumer Driven Option members need prior approval for certain services

Examples of services that require precertification include:

• Inpatient hospital admission
• Organ transplantation
• Surgery that can be considered cosmetic
• Durable medical equipment
• Genetic testing
• Other services as outlined in the current federal brochure (see Section 3: How you get care)

How to request precertification or prior approval

At least 48 hours before admission or services requiring prior authorization, you, your representative, your physician, or your hospital must call:

UnitedHealthcare

For mental health and substance misuse disorder inpatient, at least 48 hours before admission of services requiring prior authorization, your physician or your hospital must call:

UHC Behavioral Health Solutions