O4 Hubs

Forms and resources for health care professionals

Electronic remittance and appeal rights for UHC CT

Learn about contracted provider reconsiderations and more.

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.

Diagnosis attestation form quick guide

This attestation form lists the diagnosis/conditions previously reported for a patient or conditions thought to be correct.

Quick reference guide

This document provides helpful information for providers.

Electronic funds transfer

Learn more about enrolling in EFT and electronic remittance advice (ERA) enrollment.

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

Provider quick reference guide

Get important details for the Arizona market in Tucson.

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.

Hub referral card

How to refer your patients with multiple sclerosis.

Third party/donor referral form

Optum specialty referral form for donors and third party fertility patients.

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.

Immunoglobulin referral form

Optum Infusion Pharmacy IVIG and SCIG referral/enrollment form. Send us the referral and we will take care of the rest.

Synagis referral form

Optum Specialty RSV referral form for Synagis.

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

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.

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.

Unbranded biologics infusion referral form

Unbranded infusion referral/enrollment form

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.

Neuromuscular disorder referral form

Optum specialty referral form for neuromuscular disorders. Send us the form and we will take care of the rest.

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.

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

Sublocade standard referral form

Optum specialty referral form. 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.

Evidence in action

Get a closer look at how evidence is advancing life sciences.

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.

Arizona Nephrology Directory

Use this directory to find facilities in Arizona.

COVID-19 member direct mail letter #1

Letter sent to all Optum Care–Arizona members about COVID-19 important updates.

Utah COVID-19 Health Plan Provisions

The latest UnitedHealthcare COVID-19 related resources.

Arizona Chemotherapy Drug Prior Authorization

Learn more about the prior authorization process.

Provider lookup tool

Find doctors in Arizona.

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.

Provider Administrative Guide in Utah

See our provider guide for the Utah market.

Provider quick reference guide

Get important details for the New Mexico market.

COVID-19 and health plan provisions in Connecticut

Get access to the latest plan information and COVID-19 resources.

Electronic remittance and appeal rights - UHC ACO REACH

Find information on contracted provider reconsiderations.

Provider administrative manual

Get key information for the New Mexico market.

Credentialing Forms in Utah

Get more information about credentialing with Optum.

Utah Oncology Authorization Request Form

Treatment request form for medicine used for chemotherapy.

Affirmative statement

See our utilization management policy in Connecticut.

Vendor partner resources

Find more details about three of our vendor partners; Wound tech, Dispatch Health and Arizona Palliative Home Care.

Provider quick reference guides

Get important details for the Utah market.

Attestation forms and HCC codes

Find answers about attestation forms and HCC codes.

Admission notification requirements

Learn more about admitting patients in Arizona.

Urgent care directory

Find urgent care locations and contact information in Utah.

Contracted provider appeal for medical necessity

Complete this form for a medical necessity appeal.

COVID-19 management in adults

Get a brief overview of COVID-19 in adults.

Optum Care Resources For New Mexico Clinicians

Explore clinician resources.

Provider dispute resolution form - CT

Challenge, appeal or request reconsideration of a claim.

Arizona Lab Directory

Use this form to show documented evidence of a diagnosis.

Washington Provider Manual Medicaid

Our provider guide offers our network providers key information and support to provide effective care in the Washington market.

Cardiac services directory

View locations for cardiac services in Arizona.

Electronic remittance and appeal rights

Learn about contracted provider reconsiderations and more.

Home health guide

Get important details for Home Health Agencies.

Electronic remittance and appeal rights - UHC MA

Learn about Provider Appeals for WA members.

Medical management quick reference guide

Get important details for the Optum Care medical management programs.

Utah Supportive Care Referral Form

Get a referral form for patients in Utah.

Electronic remittance advice (ERA) form

Find helpful documents to complete your ERA application.

Provider quick reference guide

Get important details for the Washington market.

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).

Utah SNF Attestation Form

Use this form to show documented evidence of a diagnosis.

Provider overview

Learn about the Network of Nevada and accepted plans.

Arizona Radiology Directory

Find radiology and imaging locations in Arizona.

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.

Comprehensive formulary

Get a list of covered medications for Optum Care in Utah.

Important update on SNF and LTACH prior authorization

See the updates to prior authorization requirements.

Provider dispute resolution forms

Use these forms for the Optum Care Network–Utah.

Provider quick reference guide

Get important information for the Oregon market.

Provider quick reference guide

Get important details for the Indiana market.

Provider dispute resolution forms

Use these forms for the Washington market.

Quick reference guide - CT

Get important details for the Connecticut market.

Patient program referral forms

Use these forms when working with patients in Colorado.

Claims provider manual

Our provider claims guide offers our network providers key information and support in submitting claims.

Provider dispute resolution forms

Use these forms for the New Mexico market.

Direct admit to SNF form

Complete this form to initiate an admission to a skilled nursing facility (SNF).

Claims FAQ

Get important details about claims in the Utah market.

Provider administrative manual

See our provider guide for the Ohio market.

Primary care provider referral form

View the Optum Care–Utah provider referral form.

Information on utilization management

See our affirmative statement about incentives.

Prior authorization list

Get a list of codes for the Optum Care–Colorado.

Specialist referral form

Get a referral form for specialists in Arizona.

Provider dispute resolution forms

Use these forms for the Indiana market.

Medical Management Reference Guide

View the Optum Care–Arizona medical management/clinical reference guide.

Provider quick reference guide

Get important details for seeing patients in Nevada.

Claims provider quick reference guide

Get important details for provider claims.

Electronic remittance and appeal rights - UHC MA

Learn about Provider Appeals for AZ, UT, NV, CO, NM ID, KS, MO members.

Prior authorization list

Get a list of codes for the Optum Care Network–Utah.

Cozeva resource guide

If you need help with coding in Cozeva, check out this helpful guide.

Patient programs request form

Help your patients connect with support services.

Provider quick reference guide

Get important details for the Colorado market.

Provider quick reference guide

Get important details for the New York market.

Provider quick reference guide

Get important details for the Ohio market.

Provider dispute resolution forms

Use these forms for the Nevada market.

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.

Provider dispute resolution forms

Use these forms for the Ohio market.

Attestation measures guide

Use this guide as a resource to complete quality attestation forms.

Provider dispute resolution forms

Use these forms for the New York market.

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.

Care management referral form

This is a form for fax submissions.

Provider dispute resolution form

Challenge, appeal or request reconsideration of a claim.

Provider administrative manual

See our provider guide for the Indiana market.

Medical management quick reference guide

Get important details for the Optum Care medical management programs.

Provider dispute resolution request

Complete this form to request a dispute resolution.

Provider dispute resolution forms

Use these forms for the Oregon market.

Important claims submission information

Learn about the preferred method of claims submissions.

Provider administrative guide

See our provider guide for the Arizona market.

Electronic funds transfer (EFT) form

Enroll in EFT for the Connecticut market.

Cultivating community through COVID-19

Learn how we're creating a sense of community and well-being during COVID-19.

Referral policy

Learn about changes to our referral policy in Arizona.

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.

Prior authorization list

Get a list of codes for Optum Care–Arizona.

Provider manual

See our provider manual for the Nevada market.

Skilled nursing facilities

Use this directory to find preferred SNFs in Arizona.

Electronic remittance and appeal rights - UHC MA

Learn about Provider Appeals for IN, NY, OH members.

Medication Assistance Program

Download the Medication Assistance Program application for your 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 manual

Get answers to many of your questions about Optum Care–Connecticut.

Prior authorization list alert

Find prior authorization guidelines for 2022.

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.

Comprehensive formulary

Get a list of covered medications for Optum Care in Idaho.

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.

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 dispute resolution form

Use these forms for the Kansas City market.

Provider referral form for program

Use this form to request programs for your patient to be enrolled in at Optum.

Provider group plans guide

Get important details for the Utah market.

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 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.

Quick reference guide - APN

Get important details for the Connecticut market.

Submitting an electronic prior authorization (e-PA)

APN-CT Provider Manual

Get answers to many of your questions about APN-Connecticut.

Electronic remittance and appeal rights for Emblem CT

Learn about contracted provider reconsiderations and more.

Electronic remittance and appeal rights - Elevance MA (Anthem)

Learn about Provider Appeals for NV members.

Electronic remittance and appeal rights - Humana MA

Learn about Provider Appeals for WA members.

Electronic remittance and appeal rights - Humana MA

Learn about Provider Appeals for NY members.

Electronic remittance and appeal rights - Premera MA

Learn about Provider Appeals for WA members.

Electronic remittance and appeal rights - Humana MA

Learn about Provider Appeals for CO, NV, NM members.

Home Health Prior Authorization FAQ

Get important details about prior authorizations for home health services.

2023 HEDIS Measure CPT Category II Codes

Utilizing CPT Category II codes provides more complete information to the plan and much more.

2023 Star Measures

Listing of Star measures and HEDIS requirements.

Quality Measures At-A-Glance

Measures, descriptions, documenting tips and coding for quality measures.

Oncology referral form

Optum specialty referral form for oncology. Send us the form and we will take care of the rest.

Home Health Care prior authorization intake request form

View the prior authorization request form for the Connecticut, Indiana, and Ohio market.

Nevada Home Health Prior Authorization FAQ

Get important details about prior authorizations for home health services

Kansas City Home Health Prior Authorization FAQ

Get important details about prior authorizations for home health services

Optum-WA physician/provider change form

Please use this form to request demographic updates, remit address changes, or updates to your practice information.

Prior authorization grid

View a list of CPT codes requiring prior authorization for Idaho

Prior authorization grid

View a list of CPT codes requiring prior authorization for Utah

Prior authorization grid

View a list of CPT codes requiring prior authorization for Kansas City

Prior authorization grid

View a list of CPT codes requiring prior authorization for New Mexico

EDI Companion Guide

HIPAA Companion Guides describe Optum Rx specific technical details for EDI transactions.

Multiple sclerosis referral form

Optum specialty referral form for multiple sclerosis. Send us the form and we will take care of the rest.

Medicare Part D Prior Authorization for Hospice Form

Use this form for hospice enrollees.

Optum Provider Change Form

Please use this form to request demographic updates, remit address changes, or updates to your practice information.

Benzodiazpines Prior Authorization Form

This is a Medicare form for benzodiazepines prior authorization requests.

Opioids & Medication Limits Prior Authorization Request Form

Please use this form for all opioid requests including MME exceeded, concurrent uses, quantity limits.

Prior Authorization Request Form

Use this form for Emergient North Dakota plan only.

Opioids & Medication Limits Prior Authorization Request Form-UnitedHealthcare Medicare only

Please use this form for all opioid requests including MME exceeded, concurrent uses, quantity limits.

Prior Authorization Request Form

Use this form for Emergient Vermont Plan only.

Healthcare Reform Copay Waiver Request Form

This is for OptumRx (non-Medicare).

Member Pays Difference Exceptions PA Form

This form is for CalPERS Plan only.

Prior Authorization Request Form

This is a Medicare form for general PA requests.

Prescription Drug Reference Pricing Program

This form is for UFCW Plans only.

Healthcare Reform Copay Waiver Request Form

This for is for UnitedHealthcare (non-Medicare).

Delaware Prior Authorization Form

The form is for UnitedHealthcare (non-Medicare).

UHC West of California delegated medical group auto-authorization form

This form for UnitedHealthcare (non-Medicare).

Rhode Island Prior Authorization Form

This form is for UnitedHealthcare (non-Medicare).

Partial Copay Waiver (PCW) Exception Prior Authorization Request Form

This is for CalPERS Plan only.

Prior Authorization Form UHC

This form is for UnitedHealthcare (non-Medicare).

Massachusetts Chemotherapy and Supportive Care PA Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Massachusetts Hepatitis-C Medications Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Louisiana Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Colorado Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Illinois Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

State of Arizona prior authorization form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Florida Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Massachusetts Prior General Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

State of California prior authorization form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

New Hampshire Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

New Mexico Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Minnesota Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Michigan Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Oregon Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Massachusetts Synagis Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Texas Prior Authorization Form

This form for Optum Rx (non-Medicare) and UnitedHealthcare (non-Medicare).

Prior authorization supporting documentation cover sheet

View the supporting documents (medical records) cover page for New Mexico

Prior authorization supporting documentation cover sheet

View the supporting documents (medical records) cover page for Connecticut

Prior authorization supporting documentation cover sheet

View the supporting documents (medical records) cover page for Indiana, Ohio, and New York

Prior authorization supporting documentation cover sheet

View the supporting documents (medical records) cover page for Washington

Prior authorization supporting documentation cover sheet

View the supporting documents (medical records) cover page for Oregon

Prior authorization supporting documentation cover sheet

View the supporting documents (medical records) cover page for Arizona, Colorado, Idaho, Kansas City, Nevada, and Utah

Osteoarthritis referral form

Optum specialty referral form. 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.

General referral form

General Optum specialty referral form. Send us the form and we will take care of the rest.

Gastroenterology 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.