Forms and resources for health care professionals
Online prior authorization submissions
View important benefits of submitting prior authorizations online using the prior authorization module (Curo)
Optum Care ACE quick reference guide
Get important details about the Advanced Communication System.
Optum-WA physician/provider change form
Please use this form to request demographic updates, remit address changes, or updates to your practice information.
Optum Care management intake form
To refer to Optum Care management, submit a completed intake form.
Optum-OR physician/provider change form
Please use this form to request demographic updates, remit address changes, or updates to your practice information.
Optum Provider Change Form
lease use this form to request demographic updates, remit address changes, or updates to your practice information.
Claims provider manual
Our provider claims guide offers our network providers key information and support in submitting claims.
Prior Authorization Grid Wisconsin
View a list of CPT codes requiring a prior authorization for Wisconsin.
Prior authorization grid
View a list of CPT codes requiring a prior authorization for Indiana, Ohio and New York.
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 Kansas City.
Prior authorization grid South Carolina
View a list of CPT codes requiring a prior authorization for South Carolina.
Prior authorization grid
View a list of CPT codes requiring a prior authorization for New Jersey.
Prior authorization grid
View a list of CPT codes requiring a prior authorization for Tennessee.
Prior authorization grid
View a list of CPT codes requiring a prior authorization for Georgia.
Prior authorization grid
View a list of CPT codes requiring a prior authorization for Oregon.
Prior authorization list (BCBS)
Get a list of codes for Optum Care-Arizona (BCBS Members).
Prior authorization grid
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 requirements for Optum APN-Connecticut
View the prior authorization process for Connecticut.
Prior authorization grid
View a list of CPT codes requiring prior authorization for Idaho
Provider Claim Reconsideration Request Form
Use this form to challenge, appeal or request reconsideration of a claim.
Provider Claim Reconsideration Request Form
Challenge, appeal or request reconsideration of a claim.
Prior authorization supporting documentation cover sheet
View the supporting documents (medical records) cover page for Washington
Provider claim reconsideration request form
Use these forms for the South Carolina market.
Provider claim reconsideration request forms
Use these forms for the Optum Care Network–Utah.
Provider claim reconsideration request form - APN
Challenge, appeal or request reconsideration of a claim.
Provider claim reconsideration request form - CT
Challenge, appeal or request reconsideration of a claim.
Provider claim reconsideration request forms
Use this form to challenge, appeal or request reconsideration of a claim.
Provider claim reconsideration request form
Use this form to challenge, appeal or request reconsideration of a claim.
Provider claim reconsideration request form
Use this form to challenge, appeal or request reconsideration of a claim.
Provider claim reconsideration request form
Use this form to challenge, appeal or request reconsideration of a claim.
Provider claim reconsideration request form
Use this form to challenge, appeal or request reconsideration of a claim.
SNF list
Providers directing community SNF admissions should reference the Arizona contracted SNF list.
Fertility Solutions Provider Prior Authorization Form
UHC providers may use this form to submit for infertility/fertility prior authorization.
Washington Provider Manual
Our provider guide offers our network providers key information and support to provide effective care in the Washington market.
Formulary Updates for Providers
Optum helps minimize patient disruption by providing guidance during formulary cycle updates, allowing for greater medication adherence.
Managed Infertility Program Prior Authorization Form
Oxford providers may use this form to submit for infertility/fertility prior authorization.
Optum Care ACE Smart Edits
Learn more about the Advanced Communication Engine and the edits currently in place.