Get Optum Network Participation Request Form 2021-2025

(OptumRx Mail Service) 6800 W 115th St, Suite 600 Overland Park, KS 66211-9838 NCPDP: 1718634 Call 1-800-791-7658 – Provide a verbal prescription directly to an Optum Rx provider dedicated pharmacist. Fax 1-800-491-7997 – Send a complete prescription using the Physician Fax Form.

Assuming you're using a medical provider who participates in your health plan's network, the medical provider's office will make the prior authorization request and work with your insurer to get approval, including handling a possible need to appeal a denial.

If you have questions or want to speak with an Optum Rx Prior Authorization Advocate, call 1-800-711-4555.

Optum Rx Prior Authorization Guidelines The ePA solution supports all forms of PA and formulary exception requests. Exclusions may include cost reduction requests such as tiering exception, copay waiver, and tier cost sharing. To submit these requests, please contact our PA department at 1-800-711-4555.

How do I register on OptumRx.com? Enter the number on your health plan ID card. A. Don't have your ID card? Use your Social Security number and ZIP code. B. ... Choose a username and password. Enter an email address. Enter a phone number or choose security questions.

Check the status of your PA by signing into optumrx.com > Benefits and claims > Prior authorization or exception request. You will see the status of any active PAs in process. If your medication is approved, the PA is entered and coverage will be provided under your benefit.

Fax this form to: 1-866-434-5523 Phone: 1-866-434-5524 OptumRx will provide a response within 24 hours upon receipt.

Optum Rx Prior Authorization Guidelines The ePA solution supports all forms of PA and formulary exception requests. Exclusions may include cost reduction requests such as tiering exception, copay waiver, and tier cost sharing. To submit these requests, please contact our PA department at 1-800-711-4555.