Get 2019 Optumrx Request

Health care providers usually initiate the prior authorization request from your insurance company for you. However, it is your responsibility to make sure that you have prior authorization before receiving certain health care procedures, services and prescriptions.

Typically within 5-10 business days of hearing from your doctor, your health insurance company will either approve or deny the prior authorization request. If it's rejected, you or your doctor can ask for a review of the decision.

Sign up to get your maintenance medication with home delivery. Find medications and lower cost alternatives covered by your plan. Set up text message notifications alerts to remind you to take your medicine. Note: Standard text and data rates may apply.

How do I get a prior authorization? Your doctor will start the prior authorization process. Usually, they will communicate with your health insurance company. Your health insurance company will review your doctor's recommendation and then either approve or deny the authorization request.

Your doctor, in turn, may need to contact Caremark to discuss whether the intended use of the drug is allowable on your plan. Please allow additional time for this process: approximately two business days for standard prior authorization and approximately one business day for an urgent prior authorization request.

If you file an urgent request, we will have a decision provided in 72 hours or less. For an urgent review of a non-covered drug, one not on your drug list, we will have a decision in 24 hours or less. A standard request may take up to 15 days for us to make a decision.

Typically within 5-10 business days of hearing from your doctor, your health insurance company will either approve or deny the prior authorization request. If it's rejected, you or your doctor can ask for a review of the decision.

Health care providers usually initiate the prior authorization request from your insurance company for you. However, it is your responsibility to make sure that you have prior authorization before receiving certain health care procedures, services and prescriptions.

How do I check the status of a prior authorization request? You can call the Member Services phone number on your member ID card from 7 a.m. to 7 p.m. Pacific time, Monday through Friday, or you can call your doctor's office.

Physicians and other healthcare providers do not usually charge for prior authorizations. Even if they wanted to, most contracts between providers and payers forbid such practices. However, there are some instances such as when a patient is out of network that it may be appropriate to charge for a prior auth.