Arkansas Authorization Requirements and Clinical Criteria
A. Prior Authorization of Non-Urgent Healthcare Services (A.C.A. 23-99-1105) UnitedHealthcare Life Insurance Company (UHCLIC) acting on behalf of the Health Plan must make an authorization or non-authorization determination and notify the subscriber (member) and provider of the determination/decision within 2 business days of obtaining all the information needed to make the determination.
B. Prior Authorization of Urgent Healthcare Service (A.C.A. 23-99-1106) UHCLIC acting on behalf of the Health Plan must make an expedited authorization or adverse determination on an urgent request and notify the subscriber (member) and provider of the determination no later than 1 business day after receipt of all information needed to complete the review.
C. Retrospective Denial (A.C.A 23-99-1108) UHCLIC may not revoke (cancel), limit, condition, or restrict an authorization for a period of 90 days from the date the provider received the authorization.
D. Written Clinical Criteria Written clinical criteria can be found on UnitedHealthcare Medical & Drug Policy and Coverage Determination Guidelines pages. Per A.C.A. 23-99-1104 Statistics are made readily available regarding prior authorization approvals and denials.