Preauthorization means your provider must request that UMP cover a service on the UMP preauthorization list. To be covered, some services must be preauthorized before you receive services.
Because your provider has the clinical details and technical billing information needed for the preauthorization request, it is to your benefit that they submit a preauthorization request on your behalf.
To learn more about preauthorization for medical services, you can also read the "Limits on plan coverage" section in your plan's certificate of coverage.
To learn more about preauthorization for an exception to the Tier 3 drug cost-share, UMP Classic and UMP Plus members can read the "How much will I pay for prescription drugs?" section in their plan's certificate of coverage.
- Regence's UMP preauthorization page
- Regence medical policies
- Health Technology Clinical Committee (HTCC) decisions
State law requires that UMP follow these decisions, and they take precedence over any other coverage policies. Visit the Health Technology Assessment (HTA) webpage to learn more about the HTCC and Washington's HTA program.