Provider Resources

Already part of the Southwestern Health Resources (SWHR) network?

Find reference material and tools to help you and your office staff deliver safe, reliable, consistent, timely and well-coordinated care.

 

Membership payment process

Learn more about how to pay membership dues.

Go to membership payment process ›

 

Provider portal

Access resources on the provider portal.

Go to provider portal ›

 

Systems access

Request access to SWHR systems and applications.

SWHR System Access Request Form for PCP Offices ›

SWHR System Access Request Form for Specialty Offices ›

 

Prior authorization code lookup

Look up specialty drugs, codes and services that require prior authorization.

Medicare guidelines state that expedited processing may be requested when the enrollee or their physician believes that waiting for a decision under the standard time frame could place the enrollee’s life, health or ability to regain maximum function in serious jeopardy.

  • Decision — 72 hours from request received date
  • Provider notification — 72 hours from request received date
  • Member notification — 72 hours from request received date
  • Pharmacy expedited — 24 hours
  • Pharmacy standard — 72 hours
  • Retro — 14 calendar days

Criteria for services that require a prior authorization is available on request. Requested criteria will be faxed or emailed to the you.

Some criteria is available on the Medicare Coverage Database (MCD). Some services require a medical necessity review that may not be part of the NCD or LCD available on this website.  

The member's health plan, a list of service codes, and for procedure requests, inpatient or outpatient status, will be required to provide accurate criteria. 

Call 817-632-8602 to obtain a copy of the criteria.

Doctor with stethoscope in a hospital, back view
For Providers
Our clinically integrated network offers independent providers the benefits of a trusted alliance with UT Southwestern Medical Center and Texas Health Resources along with tools, services and expertise for success.
Has the authorization been submitted?
Submitter's Full Name
Health plan
Requestor's Full Name

Do not include patient Protected Health Information (PHI).

Call SWHR Help Desk at 817-632-3033

Check claim status & eligibility using Availity or call 844-806-8216 (M-F 7:30 am — 5:00 pm)

Please call 800-448-6262

Contact Provider Services at 877-842-3210 or online at https://www.uhcprovider.com