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.
- We can be reached directly by phone at 303-493-7507, by fax at 303-493-7501 or by email at medmanagement@cumedicine.us.
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.
Exception: We also require authorization for DEXA scans-- CPT codes 77080, 77081, 7708.
Please contact Anthem directly to request authorization for these services:
- Behavioral Health: 800-424-4014 or 866-621-0554
- All others: 800-832-7850
- Durable Medical Equipment
- Hospice
- Home Health Care
- Transplant Care
- Out of Area Emergency Department Admissions
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
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