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Prior Authorization Required (Pre-Certification)

Some medical services are required to be pre-authorized before the service is performed. Prior authorization assures the patient of their highest level of benefits and they the patient is not penalized for a non-covered service or for receiving care outside of the UPREHS network.

UPREHS instituted prior authorization for certain high cost or high intensity medical procedures. Our Care Coordination team can usually help maintain the highest level of care for our members.

Additionally certain medical devices also require prior authorization. UPREHS is, in many cases, able to purchase a medical device for the patient for a fraction of the cost of rentals. These measures help to assure that UPREHS is utilizing our financial resources in the best interest of all of our members.

Prior Authorization (Services Needing)

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