Get Optumrx Prior Auth

The Optumrx Prior Auth form is a crucial document for obtaining approval for specific medications. This guide provides step-by-step instructions to help users fill out the form accurately and efficiently.

Follow the steps to complete the Optumrx Prior Auth form online.

1. Press the ‘Get Form’ button to access the form, enabling you to fill it out digitally.
2. Enter the required member information in the designated fields, including the member's name, date of birth, and insurance ID number.
3. Fill in the provider information by providing the provider's name, NPI number, office phone, fax number, and office address.
4. Complete the medication information section, specifying the medication name, strength, and whether you are requesting the brand or continuation of therapy.
5. In the clinical information section, select the relevant diagnosis and provide additional details, such as the patient's surgical history or previous treatments.
6. If necessary, indicate the quantity of medication requested per day and explain any reasons for exceeding plan limitations.
7. Add any additional comments or pertinent medical information that may support the request.
8. Review all entered information for accuracy, then choose to save changes, download, print, or share the completed form.

Complete your Optumrx Prior Auth form online today for a smoother submission process.