Prior authorization required for radiology services for Surest plans

By September 30, 2026: Billing team must implement prior authorization requirements for all Surest plan radiology orders. (1) Update billing system and scheduling software to require prior authorization for CT, MRI/MRA, nuclear cardiology, and PET scan procedures on Surest fully insured and level funded plans. (2) Configure system to block scheduling until prior authorization number is obtained. (3) Train front desk, ordering providers, and billing staff on new process. (4) Establish workflow to verify prior authorization completion and coverage decision BEFORE rendering services. (5) Reference the 2026 UnitedHealthcare Care Provider Administrative Guide (page 105) for complete CPT code list and specific requirements for urgent requests, retrospective notification, and modified procedures. (6) Submit prior authorizations via UnitedHealthcare Provider Portal (sign in with One Healthcare ID) or by phone at 866-889-8054 (7 a.m.–7 p.m., local time, Monday–Friday). NOTE: Emergency room, urgent care, observation unit, and inpatient imaging are exempt. Failure to obtain prior authorization or verify coverage decision before rendering will result in claim denials.