Utah Labor Commission

Provider Authorization for Procedures

A provider must receive authorization for medical procedures, beyond an X-Ray, or for surgeries or hospitalization, unless it is an emergency. Per Rule R612-2-26 a provider is to request authorization in writing to an insurance carrier by fax. Commission Form 223 is to be used by the provider to appeal a denial for the procedure. The insurance carrier then has five business days to authorize the procedure or have their physician reviewer contact the treating physician to try to resolve the issue. Failure by the insurance carrier to respond to the requesting physician within five business days shall constitute an authorization for payment of the procedure. Any denials for treatment may be appealed by the claimant or the medical provider to the Labor Commission's Adjudication Division for resolution.