Forms and resources for health care professionals
Electronic remittance and appeal rights for UHC CT
Learn about contracted provider reconsiderations and more.
Washington provider manual
Our provider manual offers helpful information about Optum Care–Washington and how to work with us effectively.
Provider quick reference guide
Get important details for the Arizona market in Maricopa and Pinal County.
Provider administrative guide
This guide identifies the tools and support services available to Optum Care–Kansas City providers.
Washington non-PCP quick reference guide
This guide provides information about prior authorizations and referrals, submitting claims, customer service and more.
Curo quick start guide provider authorization module
The Curo provider module quick start guide serves as a high-level overview of the benefits and basic functionality of the platform.
Optum.com navigation
Learn how to navigate Optum.com; signing in and accessing resources.
Medicare Advantage home health prior authorization update
See updated guidelines for home health services.
Curo training guide provider authorization module
An in-depth process outline for the Optum provider authorization module.
Provider administrative manual
See our Provider Administration Manual for key information and support in providing effective care for Colorado.
Electronic remittance and appeal rights for Humana
Find information on contracted provider reconsiderations, the appeals process, the payment dispute process and health plan dispute review.
Diagnosis attestation form quick guide
This attestation form lists the diagnosis/conditions previously reported for a patient or conditions thought to be correct.
Electronic funds transfer
Learn more about enrolling in EFT and electronic remittance advice (ERA) enrollment.
Optum physician/provider change form
Please use this form to request demographic updates, remit address changes, or updates to your practice information.
Connecticut Prior Authorization Alert (APN)
Reference for obtaining Prior Authorization lists and guidelines.
Prior authorization request form
Use this form to request prior authorization of necessary services in Oregon. See the prior authorization grid for a list of this year's services.
Unbranded hemophilia and bleeding disorders referral form
Unbranded hemophilia referral/enrollment form
Eosinophilic esophagitis referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Radicava ORS® hub referral form
Announcing Radicava ORS® for ALS from Optum Specialty Pharmacy.
Prior authorization request form
Use this form to request prior authorization of necessary services in Connecticut. See the prior authorization grid for a list of this year's services.
Third party/donor referral form
Optum specialty referral form for donors and third party fertility patients.
Multiple sclerosis referral form
Optum specialty referral form for multiple sclerosis. Send us the form and we will take care of the rest.
Oncology referral form
Optum specialty referral form for oncology. Send us the form and we will take care of the rest.
Immune globulin therapy enrollment form
Optum specialty referral/enrollment form for immune globulin. Send us the form and we will take care of the rest.
Growth hormone referral form
Optum specialty referral form for growth hormone. Send us the form and we will take care of the rest.
Immunoglobulin referral form
Optum Infusion Pharmacy IVIG and SCIG referral/enrollment form. Send us the referral and we will take care of the rest.
Jynarque® enrollment form
Please complete and return the form to the requesting department.
Neuromuscular disorder referral form – migraine, cervical dystonia, overactive bladder
Optum specialty referral form. Send us the form and we will take care of the rest.
Hepatitis C referral form
Optum specialty referral form for hepatitis C patients. Send us the form and we will take care of the rest.
Unbranded IV anti-infectives referral form
Unbranded antibiotic infusion referral/enrollment form
Unbranded immunoglobulin referral form
Unbranded IVIG and SCIG infusion referral/enrollment form
Crohn's/ulcerative colitis referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Biologics infusion referral form
Optum Infusion Pharmacy referral/enrollment form chronic inflammatory disorders such as Crohn's disease, ulcerative colitis, and rheumatoid arthritis. Send us the referral and we will take care of the rest.
Enzyme replacement therapy referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Pulmonary arterial hypertension referral form
Optum specialty referral form for pulmonary arterial hypertension (PAH). Send us the form and we will take care of the rest.
Mental health refill referral form
Optum specialty office based refill form for mental health.
Ocrevus referral form
Optum Infusion Pharmacy referral/enrollment form. Send us the referral and we will take care of the rest
Osteoarthritis referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Hemophilia and bleeding disorders referral form
Optum Infusion Pharmacy referral/enrollment form for hemophilia and bleeding disorders. Send us the referral and we will take care of the rest.
Oncology REMS referral form
Optum specialty referral form for REMS oncology medications. Send us the form and we will take care of the rest.
IV anti-infectives referral form
Optum Infusion Pharmacy referral/enrollment form for antibiotics. Send us the referral and we will take care of the rest.
Ophthalmology referral form
Optum specialty referral form for ophthalmology. Send us the form and we will take care of the rest.
Neuromuscular disorder referral form
Optum specialty referral form for neuromuscular disorders. Send us the form and we will take care of the rest.
Neuromuscular refill request form
Optum specialty office-based refill shipment request form
Home parenteral nutrition referral form
Optum Infusion Pharmacy referral/enrollment form for parenteral nutrition. Send us the referral and we will take care of the rest.
Dermatology referral form
Optum specialty referral form for Dermatology. Send us the form and we will take care of the rest.
Hematopoietic referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Fertility general referral form
Optum specialty fertility referral form. Send us the form and we will take care of the rest.
Unbranded parenteral nutrition referral form
Unbranded parenteral nutrition infusion referral/enrollment form
General referral form
General Optum specialty referral form. Send us the form and we will take care of the rest.
Injectable psychotropic medication referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Sublocade standard referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Osteoporosis referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Transplant referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Cystic fibrosis referral form
Optum specialty referral form. Send us the form and we will take care of the rest.
Rheumatology referral form
Optum specialty referral form for Rheumatology. Send us the form and we will take care of the rest.
Neuromuscular disorder referral form– achalasia, chronic anal fissure, fetrusor overactivity, spasticity, bleopharospasm
Optum specialty referral form. Send us the form and we will take care of the rest.
HIV referral form
Optum specialty referral form for HIV. Send us the form and we will take care of the rest.
Forum for evidence-based medicine: COVID-19 issues
Sign up for educational information about COVID-19.
Optum Care Case Management
Our case management programs help reduce health care spend and keep our most vulnerable members safe.
COVID-19 member direct mail letter #1
Letter sent to all Optum Care–Arizona members about COVID-19 important updates.
Humana Electronic Remittance and Appeal Rights in New York
Learn about contracted provider reconsiderations and more.
Utah COVID-19 Health Plan Provisions
The latest UnitedHealthcare COVID-19 related resources.
Premera Electronic Remittance and Appeal Rights
Find information on contracted provider reconsiderations, the appeals process, the payment dispute process and health plan dispute review.
Arizona Chemotherapy Drug Prior Authorization
Learn more about the prior authorization process.
Healthcare effectiveness data and information
Use this reference guide to learn how we measure performance.
Step therapy prior authorization requirements
Get prior authorization requirements and instructions.
COVID-19 and health plan provisions in Connecticut
Get access to the latest plan information and COVID-19 resources.
CareMount DCE electronic remittance and appeal rights
Learn about contracted provider reconsiderations and more.
Humana Electronic Remittance and Appeal Rights
Find information on contracted provider reconsiderations, the appeals process, the payment dispute process and health plan dispute review.
Utah Oncology Authorization Request Form
Treatment request form for medicine used for chemotherapy.
COVID-19 provider email communication #1
Use this guide as a resource to complete quality attestation forms.
Vendor partner resources
Find more details about three of our vendor partners; Wound tech, Dispatch Health and Arizona Palliative Home Care.
COVID-19 Provider Email Communication No2
Find details about telehealth, copay, co-insurance and deductible changes.
Contracted provider appeal for medical necessity
Complete this form for a medical necessity appeal.
Provider dispute resolution form - CT
Challenge, appeal or request reconsideration of a claim.
Washington Provider Manual Medicaid
Our provider guide offers our network providers key information and support to provide effective care in the Washington market.
Arizona HEDIS quick reference guide
Use the Optum Care–Arizona HEDIS reference guide to learn more about how we measure performance.
Electronic remittance and appeal rights
Learn about contracted provider reconsiderations and more.
Electronic Remittance & Appeal Rights
Find information on contracted provider reconsiderations, the appeals process, the payment dispute process and health plan dispute review.
Medical management quick reference guide
Get important details for the Optum Care medical management programs.
Electronic remittance advice (ERA) form
Find helpful documents to complete your ERA application.
Medical management program referral guide and form
Refer a patient for one of our medical management programs.
Laboratory Protocol in Arizona
Use this referral policy for services in Optum Care–Arizona.
Skilled nursing facilities manual
Get important details for skilled nursing facilitates (SNFs).
Arizona Urgent Care Directory
Find Arizona urgent care locations and contact information.
Nevada COVID-19 Health Plan Provisions
Information and resources on the changing federal and state regulatory health plan requirements related to COVID-19 in Nevada.
Important update on SNF and LTACH prior authorization
See the updates to prior authorization requirements.
Claims provider manual
Our provider claims guide offers our network providers key information and support in submitting claims.
Direct admit to SNF form
Complete this form to initiate an admission to a skilled nursing facility (SNF).
Medical Management Reference Guide
View the Optum Care–Arizona medical management/clinical reference guide.
Electronic remittance and appeal rights
Use this form to review provider appeal rights for the Nevada market.
Electronic remittance and appeal rights
Learn about contracted provider reconsiderations and more.
Cozeva resource guide
If you need help with coding in Cozeva, check out this helpful guide.
Primary care provider referral forms
View primary care provider referral forms for Colorado.
Washington Provider Manual Medicare
Our provider guide offers our network providers key information and support to provide effective care in the Washington market.
Attestation measures guide
Use this guide as a resource to complete quality attestation forms.
Provider dispute resolution forms
Use these forms when working with patients in Colorado.
Clinical Diabetes Management program referral
Learn more about the Optum Clinical Diabetes Management program in Arizona.
Provider dispute resolution form
Challenge, appeal or request reconsideration of a claim.
Medical management quick reference guide
Get important details for the Optum Care medical management programs.
Important claims submission information
Learn about the preferred method of claims submissions.
Cultivating community through COVID-19
Learn how we're creating a sense of community and well-being during COVID-19.
Prior authorization online submission – tips and tricks
This is a reference for an online submission.
Optum Prepayment Review System quick reference guide
Learn more about the Optum Prepayment Review System.
Electronic remittance and appeal rights
Learn about contracted provider reconsiderations and more.
Medication Assistance Program
Download the Medication Assistance Program application for your Optum Care patients
Northern Nevada provider quick reference guide
Get important details for working with Optum Care patients.
Compliance prior authorization and claims
Learn more about the correct coding for claims submissions.
UnitedHealthcare MA plan coverage summaries
See coverage summaries and get the latest provider news.
Patient program referral form
Get important details for the Optum Care patient referral programs.
Provider administrative manual
This manual provides detailed provider information for New York.
Optum Care ACE Smart Edits
Learn more about the Advanced Communication Engine and the edits currently in place.
Case Management Form and Guide
Use our form and guide for the Optum Care patient referral programs.
Case Management Provider Follow-up Form
This form provides updates on program progress and request collaboration.
Provider referral form for program
Use this form to request programs for your patient to be enrolled in at Optum.
Skilled Nursing Notice – Medicare Non-Coverage
Notify patients of the effective date coverage of their current Skilled Nursing Services will end.
Home Health Notice – Medicare Non-Coverage
Notify patients of the effective date coverage of their current Home Health Services will end.
Home Health Prior Authorization FAQ
Get important details about prior authorizations for home health services.
OCKC Admission Notification Requirements
Learn more about admitting patients in Kansas and Missouri.
In-network skilled nursing facilities
This list provides an overview of the current in network Skilled Nursing Facilities and Home Health Agencies in Optum Care Network–Idaho.
Appendix to Provider Administrative Manual
Use this appendix in Optum Care Network – Colorado
Home Health Notice – Medicare Non-Coverage
Notify patients of the effective date coverage of their current Home Health Services will end.
Skilled Nursing Notice – Medicare Non-Coverage
Notify patients of the effective date coverage of their current Skilled Nursing Services will end.
Optum Care Kansas City Case Management Overview
Use this guide to learn more about Kansas City Case Management.
Medical coverage decision criteria
See criteria by plan to help determine coverage eligibility.
Alpha-1 referral form
Optum Infusion Pharmacy referral/enrollment form for alpha-1 proteinase inhibitor therapy
Optum Clinical Claims Review (CCR) Pre-Pay Review Quick Reference Guide
Learn about the CCR pre-pay review process
Unbranded alpha-1 referral form
Unbranded referral/enrollment form for alpha-1 proteinase inhibitor therapy
Medicare Advantage home health prior authorization update (APN)
See updated guidelines for home health services
Provider referral form for program
Use this form to request programs for your patient to be enrolled in at Optum.
Medicare Advantage home health prior authorization update (OCN)
See updated guidelines for home health services
Clinical programs quick reference guide
Get details about the clinical programs available in Optum Care Network–Idaho.
Provider quick reference guide
This guide provides a glance at the most important details you'll need when working with Optum Care Network—Idaho patients.
Clinical programs quick reference guide
Get details about the clinical programs available in Optum Care Network-Utah
Optum Care ACE quick reference guide
Get important details about the Advanced Communication System.
Prior authorization grid
View a list of CPT codes requiring a prior authorization for Indiana, Ohio and New York.
Prior authorization form
Get an Optum prior authorization form for use in Arizona, Colorado, Idaho, Kansas City, Nevada and Utah.
Prior authorization request form
Use this form to request prior authorization of necessary services in Washington. See the prior authorization grid for a list of this year's services.
Prior authorization request form
Use this form to request prior authorization of necessary services in New Mexico. See the prior authorization grid for a list of this year's services.
Prior authorization request form
View the prior authorization request form for the Indiana, New York and Ohio markets.
Provider dispute resolution form - APN
Challenge, appeal or request reconsideration of a claim.
Submitting an electronic prior authorization (e-PA)
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