University Health Alliance (HSA) Prior Authorization Lookup
- University Health Alliance (HSA) coverage criteria
- All University Health Alliance (HSA) policy updates
Latest University Health Alliance (HSA) prior authorization updates25
- Prior AuthReimbursement/Payment PolicyEff. 2026-04-01Out-of-State (Mainland) Medical Service Reimbursement and CoordinationPolicy governing prior authorization, reimbursement, and coordination for medically necessary services provided on the U.S. mainland for University Health Alliance members when those services are not available in Hawaii; applies to members of UHA and referring providers managing mainland referrals.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2024-06-26Master Payment Policy — medical necessity and payment determinationsGovernance of UHA's approach to medical necessity determinations, payment criteria, and use of external authoritative sources to guide coverage and prior authorization decisions for University Health Alliance members and providers.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2023-01-01Anesthesia for Dental ServicesThis UHA reimbursement policy governs when anesthesia (general anesthesia or monitored anesthesia care) for dental and oral/maxillofacial procedures is considered medically necessary and reimbursable, and outlines related limitations, prior authorization, and billing guidance for providers.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-12-01Psychological and Neuropsychological Testing reimbursementThis policy governs prior authorization, medical necessity criteria, limitations, billing and payment rules for outpatient psychological and neuropsychological testing for University Health Alliance members and providers.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-08-01Cardiac Ablation Procedures — Reimbursement and Prior AuthorizationDefines UHA reimbursement, prior authorization, and medical necessity criteria for surgical and catheter cardiac ablation procedures for various arrhythmias; applies to University Health Alliance members and providers seeking payment.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-08-01Durable Medical Equipment (DME) reimbursementThis policy governs reimbursement and coverage criteria for durable medical equipment, prosthetics, and orthotics for University Health Alliance members, including medical necessity, limitations, prior authorization, rental/purchase rules, and documentation requirements.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-08-01Growth hormone (somatropin) therapy reimbursementDefines UHA reimbursement criteria, prior authorization requirements, limitations, monitoring, and continuation rules for growth hormone (somatropin) therapy for pediatric and adult indications.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-08-01Home Infusion Pain ManagementThis document governs reimbursement and medical necessity criteria for home infusion therapy for pain management provided to University Health Alliance members, including covered indications, limitations, prior authorization and administrative requirements.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-08-01Home Total Parenteral Nutrition (TPN) for AdultsDefines medical necessity, coverage criteria, limitations, and prior authorization/administrative requirements for reimbursement of home TPN (including IDPN) for adult members of University Health Alliance.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-08-01Kyphoplasty and Vertebroplasty Reimbursement PolicyDefines UHA reimbursement policy, medical necessity criteria, limitations, contraindications, and administrative prior authorization and documentation requirements for kyphoplasty and vertebroplasty for enrolled members and participating providers.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-08-01Stereotactic Radiosurgery (SRS) and Stereotactic Body Radiotherapy (SBRT) ReimbursementThis payment policy governs University Health Alliance (UHA) reimbursement for SRS and SBRT when medically necessary and meeting specified clinical criteria, and describes limitations, exclusions, and administrative requirements (including prior authorization) for providers and members.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-08-01Treatment of hepatic neoplasms (non-systemic chemotherapy)Defines medical necessity, prior authorization, covered and experimental treatments, and coding guidance for procedures treating primary or metastatic liver tumors outside of systemic chemotherapy for University Health Alliance members.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-07-01Treatment of Prostate CancerDefines UHA reimbursement, medical necessity, evaluation, prior authorization, and documentation requirements for treatment of operable prostate cancer for University Health Alliance members.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2022-03-01In Vitro Fertilization (IVF) Reimbursement PolicyThis policy governs University Health Alliance (UHA/HSA) coverage, limitations, and administrative requirements for in vitro fertilization services for members, including eligibility criteria, exclusions, and prior authorization requirements.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2021-08-10Blepharoplasty and Repair of Blepharoptosis ReimbursementThis policy governs UHA reimbursement for blepharoplasty, repair of blepharoptosis, and related brow ptosis repair when medically necessary and meeting specified medical criteria, and describes prior authorization and documentation requirements for providers seeking payment.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2021-08-10Continuous Glucose Monitoring System (CGMS) reimbursementDefines University Health Alliance coverage, prior authorization requirements, limitations, and payment codes for continuous and intermittent continuous glucose monitoring systems for members with diabetes.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2021-08-10Prophylactic (Risk‑Reducing) Mastectomy — Reimbursement/Payment PolicyDefines University Health Alliance reimbursement policy, coverage criteria, limitations, and administrative requirements (including prior authorization and applicable codes) for prophylactic (risk‑reducing) mastectomy for members and providers.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2021-06-15Cosmetic and Reconstructive Surgery ReimbursementGoverns reimbursement and coverage criteria for reconstructive and cosmetic surgery and related services for University Health Alliance members, including prior authorization requirements and exclusions.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2021-06-02Colorectal Cancer Screening ReimbursementDefines University Health Alliance (UHA) reimbursement coverage, limitations, and administrative requirements for colorectal cancer (CRC) screening for members, including covered screening modalities and prior authorization rules.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2021-06-02External Insulin Pump (E0784) Reimbursement PolicyDefines medical necessity, coverage criteria, limitations, and prior authorization requirements for reimbursement of external insulin pumps (E0784, A9274, S1034) for University Health Alliance members.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2021-06-02Varicose Veins Treatment Reimbursement and Prior-Authorization PolicyDefines UHA reimbursement and prior-authorization requirements for surgical and procedural treatment of primary venous insufficiency manifested by varicose veins, including coverage criteria, limitations, coding guidance, and administrative documentation requirements for providers and members.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2020-12-14Negative Pressure Wound Therapy (NPWT) Reimbursement and Prior AuthorizationThis document governs University Health Alliance (UHA) reimbursement and prior authorization requirements for negative pressure wound therapy (wound vac) when medically necessary, including coverage criteria, limitations, exclusions, and administrative rules for providers requesting payment.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2020-12-12Physical Therapy Reimbursement and Prior Authorization PolicyDefines medical necessity, coverage criteria, limitations, coding and prior authorization requirements for physical therapy services under University Health Alliance (UHA). Affects providers submitting PT/OT claims and requesting authorizations for UHA members.All University Health Alliance (HSA) updates
- Prior AuthReimbursement/Payment PolicyEff. 2019-10-18Virtual (CT) Colonoscopy ReimbursementThis policy governs University Health Alliance reimbursement for CT colonography (virtual colonoscopy), including medical necessity criteria, prior authorization requirements, and coding guidance for providers submitting claims.All University Health Alliance (HSA) updates
- Prior AuthClinical/Medical PolicyEff. 2012-03-01Procedures That Are Considered CosmeticDefines procedures, services, and codes that University Health Alliance (UHA) considers cosmetic and not covered, with limited exceptions for asterisked codes that may be medically necessary with prior authorization. Applies to UHA members and providers submitting claims to UHA.All University Health Alliance (HSA) updates
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Tool Description
Search University Health Alliance (HSA)prior authorization policies by drug name, procedure, or policy title. Results include any policy that mentions prior authorization requirements (drug coverage criteria, imaging guidelines, site-of-service rules) not just documents titled “prior authorization.” Every result links to a full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
Filter by payer, specialty, policy type, or effective year; or search directly for a drug (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee arthroplasty”), or a policy number.
Coverage spans 110+ payers. Jump straight to the busiest prior-auth publishers: UnitedHealthcare, Cigna, Aetna, Anthem, and Centene. You can also browse the full policy updates feed.
Pair a prior-auth search with the billing code lookup to confirm the CPT or J-code on the claim, the payer lookup for plan footprint, and payer profiles for contacts and coverage context.
FAQ
Type a drug name (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee”), or a policy title into the search bar. Filter results by payer, specialty, policy type, or effective year. Open any result for the full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
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