Directory information, not recipient confirmation. Fax numbers can change and differ by department, location, form, or plan. Confirm this destination directly with UnitedHealthCare Services, Inc. (UnitedHealthcare / UHC) before sending sensitive documents. FaxFlow is not affiliated with this organization.

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UnitedHealthCare Services, Inc. (UnitedHealthcare / UHC) fax number

(800) 696-8151

Network Gap Exception / Prior Authorization

Used for: Network Gap Exception Request submission (provider submits request with supporting documentation)

Fax destination details

Department
Network Gap Exception / Prior Authorization
Purpose
Network Gap Exception Request submission (provider submits request with supporting documentation)
Form
PCA-1-24-02318-UHN-FM_07312024 — Connecticut Network Gap Exception Request Form

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Complete the form and attach clinical documentation; fax to 1-800-696-8151. For assistance, contact Member Services via the toll-free number on the member's ID card.

Official form instructions are published as a downloadable file on the organization's website.

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