Skip to main content
Starting June 15, 2026, UnitedHealthcare (Optum Behavioral Health) requires prior authorization (PA) before Intensive Outpatient Program (IOP) services are rendered to adult Arizona Medicaid (AHCCCS) members. Encore lets admissions staff submit and track those authorizations directly from the lead record — pre-filling the Optum AZ Standard PA form from data already captured during intake. Covered codes: Mental Health IOP (S9480) and Substance Use Disorder IOP (H0015).

​
Prior authorizations on the lead

The Prior Authorizations panel on a lead’s detail page lists every submission with its billing code, status (Pending / Approved / Denied), submitted date, and Optum confirmation number. Staff with ce.prior_auth.submit see New Authorization to start a request.
CE-69 prior authorizations panel

​
The prior authorization wizard

New Authorization opens a four-step wizard (Submission & Patient, Provider, Services & Clinical, Review & Submit) pre-filled from the lead’s contact, insurance, and the org’s IOP defaults. Staff review and edit every field before submitting.
CE-69 prior authorization wizard
When the wizard submits, a server-side job attempts the Optum portal submission and captures the confirmation number. If automation is unavailable (portal outage, login failure, or bot-detection), the request falls back to guided manual mode: the authorization is saved as Manual Pending and staff can download a pre-filled summary and open the portal directly — so an authorization is never missed because of a portal issue.

​
Settings

Org admins configure the integration under Settings → Integrations → UHC/Optum Prior Authorization: enable the feature, set IOP defaults, and store the One Healthcare ID credentials (encrypted; never displayed again after saving). The feature is Arizona/AHCCCS scoped and off by default.
CE-69 prior authorization settings

​
Admission handoff

When a lead with an approved (or submitted) authorization is converted to a Practice Management patient, the prior-authorization number, authorized dates, and billing code flow to the patient record so billing can include them on claims without re-keying.