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