Get Professionals Optumrx

Filling out the Professionals OptumRx form is essential for submitting prior authorization requests efficiently. This guide will provide step-by-step instructions to ensure that all necessary information is accurately completed.

Follow the steps to complete the Professionals OptumRx form.

1. Click 'Get Form' button to obtain the form and open it in your preferred editor.
2. Provide member information in the designated fields, including the member's name, insurance ID number, and date of birth.
3. Enter the provider information, such as the provider's name, NPI number, office phone number, and address.
4. Fill in the medication information by stating the medication name, strength, and any specific directions for use.
5. Answer the clinical information questions truthfully, indicating continuity of therapy and any relevant medical records.
6. Complete the prescriber attestation section, confirming that the information provided is true and accurate.
7. If necessary, add any additional comments or information that may aid in the authorization review.
8. Review all the entered information to ensure accuracy and completeness. Once confirmed, save changes and print or fax the completed form as required.

Ensure you fill out your forms online accurately to streamline the authorization process.