CU Health Plan Medical Management

Information and Resources Regarding our Services for

CU Anthem Exclusive Members

Important Information

• Do not submit requests via Availty or to Carelon.  
  
• CU Medical Management is the approving authority for medical procedures, infusions, and labs requiring authorization.
• We do not have a web portal and do not authorize care over the phone. See below to learn how to submit a request.
• Use this link to find in-network providers for our plan. Our network is separate from Anthem HMO. 
• All authorizations expire June 30 of each year. 
• Infertility treatment is authorized by Winfertility, 800-430-6068. 
• All inpatient stays require prior authorization. Exceptions exist for OB. Call for details.

Prior Authorization

We review requests for care on the medical benefit only. Below are links for criteria and plan policies: 

• CU Exclusive plan document
• Anthem medical policies/criteria
• Anthem clinical criteria for facility administered medications
• Carelon guidelines

We utilize the Anthem Colorado Precertification list. View it at this link.

Forms

Faxed or emailed requests must be on our form. Include clinical information in support, and submit forms as follows: 

• Email to MedManagement@CUmedicine.us
• Fax to 303-493-7501

Requestors may also use UCHealth Epic if an arrangement currently exists (e.g. Radiology).

• General Request Form — Word Document
• General Request Form — PDF
• Facility Administered Medication Request Form — Word Document
• Facility Administered Medication Request Form — PDF

For more information, view our newsletter.