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  • Optumrx Prior Authorization Form

Get Optumrx Prior Authorization Form

Prior Authorization Request Form Fax Back To 1-800-853-3844 Phone 1-800-711-4555 5 AM 7 PM PT M-F or visit www. OptumRx. com and click Health Care Professionals for online real-time submission 24/7 Patient Information Patient s Name Insurance ID Date of Birth Height Address Apartment City State Zip Phone Number Alternate Phone Sex Male Female Provider Information Provider s Name Provider ID Number Suite Number Building Number Fax number Provider.

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Questions & Answers

Get answers to your most pressing questions about US Legal Forms API.

Contact support

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

Call 1-800-791-7658 Provide a verbal prescription directly to Optum Rx pharmacists dedicated to our health care providers.

OptumRx is an affiliate of UnitedHealthcare Insurance Company.

Who is OptumRx®? OptumRx is your CalPERS pharmacy benefit manager for Anthem, Health Net, Sharp, UnitedHealthcare, and Western Health Advantage. Our goal is to provide safe, easy and cost-effective ways for you to get the medication you need.

What is prior authorization? This means we need to review some medications before your plan will cover them. We want to know if the medication is medically necessary and appropriate for your situation. If you don't get prior authorization, a medication may cost you more, or we may not cover it.

Learn more at optum.com. How long does it take for a prior authorization to be approved or denied? Once your PA has been submitted and received, it usually takes up to 24 hours to process. If your PA request needs additional review, it may take longer.

Submitting a PA request to OptumRx via phone or fax above. For urgent requests, please call us at 1-800-711-4555. (Hours: 5am PST to 10pm PST, Monday through Friday.)

You can submit your order via phone, mail, online or through the OptumRx App. Additionally, your physician can electronically submit your prescription to OptumRx. OptumRx fills your order and mails it to you within seven days of placing the order.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232