Benefits of utilization management attestations: a guide for care providers

We have expanded our utilization management (UM) attestation process — a streamlined approach to simplify clinical request approvals. We encourage you to utilize UM attestations. This initiative aims to enhance efficiency and reduce the administrative burden on healthcare providers, ensuring that you can focus more on patient care and less on paperwork.

What are UM attestations?

UM attestations are a series of yes or no questions we use to gather essential clinical information. This process enables us to evaluate and approve your requests quickly and efficiently without submitting extensive clinical records, expediting patient care and reducing wait times.

Accessing UM attestations through Availity Essentials

The UM attestation process is available through Availity Essentials. This user‑friendly platform enables seamless integration into your existing workflows. To offer even more flexibility, we will expand the ability to submit attestations via phone later this year.

What to do if your request is not approved

If a request cannot be approved solely through attestation, you will be notified to submit clinical records.

Step‑by‑step instructions for submitting attestations

• From the prior authorization attestations screen, select the appropriate attestation from the To‑Do List on the left side of the screen and select Complete Forms.
• Answer the questions based on the information reflected in the clinical records and submit.
• You will receive notification that your submission was successful. Complete this process for all applicable attestations.
• On the Authorization Response page, you will see the outcome of the attestation. If the status is pended, submit clinical records for your request to be reviewed. If the status is approved, your request is approved.

The attestations are designed to be completed based on information documented in the clinical records. As with any new process, it may take some time for staff to become fully comfortable and efficient in completing them, but we are confident that with continued practice and support, this will improve quickly.

An FAQ will be released in October 2025 that will help answer questions and further guide submitters through the process.

Future expansions

Throughout the year, we will broaden the types of clinical requests that can utilize UM attestations. This expansion is part of our ongoing efforts to improve accuracy, efficiency, and satisfaction in the approval process.