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Click ‘Get Form’ to open it in the editor.
Begin by filling out the Member Information section. Enter the member's name, insurance ID number, and date of birth. Ensure all fields are completed accurately.
Next, provide the Provider Information. Input the provider's name, NPI number, office phone, and address details.
In the Medication Information section, specify the medication name and strength. Indicate if this is a continuation of therapy and provide dosage form and directions for use.
Complete the Clinical Information section by selecting the requested drug and diagnosis. Answer any additional questions regarding medication history and reauthorization as applicable.
Review all entered information for accuracy before submitting. Once complete, you can easily save or print your form directly from our platform.
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The settlement resolves an investigation initiated by the Drug Enforcement Administration (DEA) into whether, between April 2013 and April 2015, OptumRx improperly filled certain opioid prescriptions in combination with other drugs such as benzodiazepines and muscle relaxants, a combination commonly referred to as the
What is going on with Optum Rx?
Call 1-800-711-4555, option 2 to request a verbal prior authorization. Hours are: Monday-Friday, 5 a.m.10 p.m. PT.
How do I submit a prior authorization to OptumRx?
Call Optum Rx at 1-844-368-8740. What do I do if my medication needs a PA? To begin the PA process, you can: Let your doctor know that a PA is needed for your medication. Call Optum Rx at 1-844-368-8740.
How long do prior authorizations take for Optum Rx?
Optum Rx is shifting to a new pharmacy reimbursement model that should result in pharmacies being paid more for brand-name drugs and less for generics. Its the latest move from a major drug middleman to reform how pharmacies are paid amid widespread criticism of the status quo.
How do I get prior authorization for Optum Rx medication?
OptumRx Prior Authorization and Exception Request Procedures Call 1-800-711-4555 to submit a verbal PA request. View and print a PA request form.
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Dec 1, 2020 The PA criteria are posted on the. Pharmacy Prior Authorization Criteria and Forms page on the OptumRx Indiana Medicaid website, accessible from
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