SelectHealth (UT/ID) Letter of Medical Necessity Guide
How to write an LMN and overturn a prior authorization denial with SelectHealth (UT/ID). Includes denial reasons, turnaround times, appeals address, and clinician tips.
Quick Facts
- Avg Turnaround: 30 days standard, 72h expedited
- Appeals Address: SelectHealth Member Appeals, PO Box 30192, Salt Lake City, UT 84130
- Provider Portal: https://selecthealth.org/provider
Why SelectHealth Denies Prior Authorizations
- 1. Medical policy criteria not met
- 2. Step therapy
- 3. Non-formulary without exception
- 4. Quantity limit exceeded
Clinician Tips for SelectHealth
- ✓ SelectHealth is the health plan subsidiary of Intermountain Health (IHC Group)
- ✓ Reference SelectHealth Medical Policy number in LMNs
- ✓ Express Scripts is the PBM; pharmacy PA via CoverMyMeds or the SelectHealth provider portal
- ✓ SelectHealth Medicare Advantage follows CMS timelines and coverage rules
Provider-sponsored plan tied to Intermountain Health system. Covers Utah, Idaho, and Nevada. Express Scripts PBM. Medical Policies are publicly searchable at selecthealth.org.
SelectHealth Prior Authorization FAQ
Why does SelectHealth deny prior authorizations?
The most common SelectHealth denial reasons are: Medical policy criteria not met; Step therapy; Non-formulary without exception; Quantity limit exceeded.
How long does SelectHealth take to review a prior authorization?
SelectHealth typically responds in 30 days standard, 72h expedited.
What should a Letter of Medical Necessity for SelectHealth include?
An LMN for SelectHealth (UT/ID) should reference the specific medical policy or coverage bulletin, document failed first-line therapies with dates, include current labs and ICD-10 codes, and cite supporting clinical guidelines. Provider-sponsored plan tied to Intermountain Health system. Covers Utah, Idaho, and Nevada. Express Scripts PBM. Medical Policies are publicly searchable at selecthealth.org.