Utah Admin. Code R414-1-32 - Prior Authorization from Primary Payers First
(1) Health care providers are encouraged to
seek prior authorization , when necessary, from a health insurance entity that
is the primary payer before seeking third-party liability through
Medicaid.
(2) A health insurance
entity may not deny a claim submitted by the Office of Recovery Services, the
Office of Inspector General of Medicaid Services, Medicaid, or an authorized
contractor for an item or service based solely on a lack of prior
authorization .
Notes
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