Get OptumRx Quick-Fax 5510

Fax 1-800-491-7997 – Send a complete prescription using the Physician Fax Form.

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.

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

Fax 1-800-491-7997 – Send a complete prescription using the Physician Fax Form.

Expedited appeal requests can be made by phone at 1-888-403-3398. Who May Make a Request: Your prescriber may ask us for an appeal on your behalf. If you want another individual (such as a family member or friend) to request an appeal for you, that individual must be your representative.

Please have the doctor or a qualified member of the office staff complete the next page(s) and fax the completed form to 1-844-403-1024. If you have questions or want to speak with an Optum Rx Prior Authorization Advocate, call 1-800-711-4555.

Appeals must be submitted using the approved OptumRx spreadsheet. Any other form of appeal submission will not be accepted for review. Please submit a claim only once, duplicate claims will NOT be reviewed. MAC Appeal Detail must be filled out completely unless noted as "Optional".

Please have the doctor or a qualified member of the office staff complete the next page(s) and fax the completed form to 1-844-403-1024. If you have questions or want to speak with an Optum Rx Prior Authorization Advocate, call 1-800-711-4555.