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: 

 

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: 

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

For more information, view our newsletter.