New online utilization management requirement
Submit prior authorization requests and inpatient notifications online for patients delegated to Optum Health Networks
Starting Oct. 1, 2024, network health care professionals will be required to submit prior authorization requests and inpatient admission/discharge notifications online for patients who are delegated to Optum Health Networks in the following states:
- Arizona
- Idaho
- Utah
You can determine if your patient is delegated to Optum Health Networks by checking their member ID card. The card will list LIFE1 as the payer ID.
By submitting your prior authorization requests and inpatient notifications online, you’ll receive a decision faster than you would with a fax submission.
What this means for you
If you have patients in the states listed above who are delegated to Optum Health Networks, you’ll need to submit prior authorization requests and inpatient admission/discharge notifications for these patients using the Medical Management platform in the Optum Pro portal. Starting Oct. 1, 2024, Optum Health Networks will no longer accept prior authorization or inpatient notifications by fax, except where required by law.
How to submit prior authorization requests and inpatient notifications online
- If you already have an Optum Pro account: Sign in to the Optum Pro portal using your One Healthcare ID and password, then select Medical Management from the navigation ribbon on the left
- If you don’t already have a One Healthcare ID, visit identity.onehealthcareid.com to get started
- If you need to create an Optum Pro account: Visit optumproportal.com, then select Register for Optum Pro
Fax numbers will be decommissioned
- In Arizona, Idaho and Utah, the following UM fax numbers will be decommissioned:
- General prior authorizations, clinical submissions for new or existing authorizations, and inpatient notifications and clinical submissions: 888-992-2809
- Reminder: You’re required to notify us of admissions within 1 business day
- Medicare Part B: 855-221-1978
- General prior authorizations, clinical submissions for new or existing authorizations, and inpatient notifications and clinical submissions: 888-992-2809
- In Idaho and Utah, 844-461-5749 will be decommissioned for clinical information, authorizations and Notices of Medicare Non-Coverage (NOMNCs)
- NOMNCs will instead be available through the Optum Pro portal
- In Arizona, the following fax numbers will be decommissioned:
- Acute inpatient notifications: 855-238-2301
- Skilled nursing facility (SNF) and post-acute admissions: 844-666-9404
Education resources
We offer eLearning modules in the Education & Training section of the Optum Pro portal. To access the eLearning modules:
- Sign in to the portal
- Select Education & Training from the navigation ribbon on the left
- eLearnings are available in the Activity section; select + to expand the collapsed Activity section
- Select the Curo Provider Authorization Portal (National) eLearning course from My Learning or Completed
Questions?
If you have questions about the portal, please contact an Optum Health Networks team member. For technical assistance, contact the support team using the Contact Us link located at the bottom of the Optum Pro portal.
PCA-1-24-02024-Clinical-NN_08062024
