Prior Authorization
At Health Choice Utah, we aim to work closely with you and your practice team to streamline and expedite prior authorization. Many items on our abbreviated prior authorization list ask for notification only. Our centralized prior authorization center is designed to simplify 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).
A contracted or preferred provider is recommended for all healthcare services for Health Choice members to expedite prior authorization and provide quality services to our members. Please note that all non-contracted providers must obtain authorization for any assistance.
Search Codes Requiring Prior Authorization
Search Codes Requiring Prior Authorization
- To request a prior authorization electronically, use our Prior Authorization Form.
Upcoming Changes to Codes Requiring Prior Authorization
Submitting a Prior Authorization Request
To submit a new request, obtain information about a previously submitted request, or 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
Pharmacy Prior Authorization Request
Health Choice Utah may require prior authorization for certain drugs. Prior authorization must be obtained for medications noted with a “PA” in the drug list and for all unlisted medications. Providers need to get approval from Health Choice Utah before prescriptions are filled. Please refer to the Health Choice Utah Formulary to determine if a drug requires Prior Authorization.
For your convenience, click here to obtain the Medication Prior Authorization Form.
You can also request a Retail Pharmacy Prior Authorization or exception by submitting the Retail Pharmacy Prior Authorization Request Form..
Note: Pharmacy prior authorization ONLY. Medical prior authorization requests (including J-code) may be submitted via the Provider Portal.
Guides and Forms
- Search Codes Requiring Prior Authorization
- Medical Drugs Requiring Prior Authorization
- Retail Pharmacy Prior Authorization Request Form
- Medical Services Prior Authorization Form
- Residential Treatment Prior Authorization Form
- Synagis Authorization Form
- Medical Documentation Submission Form
- Online Medical Service Prior Authorization Form
Prior Authorization for Prescription Drugs, click here.