Prior Authorization Search Tools

Search Medical Services That Require PA

*Disclaimers:
1. Outpatient services rendered in an inpatient setting require prior authorization.
2. For members living in Hawaii, ALL out-of-state requests require prior authorization.
3. For members on the mainland, ALL ASC or hospital-based elective procedures require prior authorization.
4. UHA reserves the right to perform retrospective review for services that do not require prior authorization to validate if services rendered met payment determination criteria.
5. Durable medical equipment requires prior authorization if rental is greater than $100/month or purchase is greater than $500.
6. Prophylactic mastectomy requires prior authorization, but non-prophylactic mastectomies do not.