- Prescription Assistance
- Free Rx Assistance Drug Cards Low/No Cost Health Care Programs
- Medicare Drug Coverage
- Medicaid and Childrens Health Insurance Programs (CHIP)
- Alzheimer's
- Blood Pressure
- Generic Medicine
- Healthy Pregnancy
- Heart Health
- Immunization
- Kidney Health
- Lung & Respiratory
- Men's Health
- Mental Health
- Multiple Sclerosis
- Women's Health
More Information
- Health Information Directory
- Drug Information Search
- Healthy Recipes
News Topics
- Drug Recalls
- Medical Association
- Prescription Drugs
- Pharmacy News
- Continuing Education
- Pharmacy Benefits Management
RxResource Home > Pharmacy Resources > Pharmacy Benefit Management
2441 Warrenville Road, Suite 610 Lisle, IL 60532-3642
Susan Fleming, Vice President, Marketing
Phone: (630) 577-4880
http://www.catamaranrx.com/
Catamaran offers a true alternative to the status quo in pharmacy benefit management. You don't have to choose between the scale and purchasing power of the largest providers and the flexibility and agility of smaller ones. We offer the best of both.
At Catamaran, we put your individual needs - and those of your members - at the center of our services. We connect pharmacists, doctors and caregivers with prescription data to improve health outcomes, offering the clinical intelligence, technology and scale to lower payer costs while improving member health.
- Pharmacy Resources
- What is a PBM?
- What Does a Benefits Manager Do?
- What To Do When You Can't Afford Your Medication
PBM Info from the FDA
- Pharmacy Benefit Management Companies (PBMs)
- The Influence of PBMs and HMOs on Prescription Drug Prices
- PBM Glossary
PBM News Articles
- Rankings - Best Pharmacy Coupons April 8, 2016
- Rankings - PBM Drug Rebates March 22, 2016
- PBM Rankings - Best Discount Drug Card June 9, 2012
- Top 10 PBM Companies - Rankings: Best Funded PBM June 8, 2012
- Wish List: 10 Things You Want From Your PBM November 29, 2011
- Important Links
- Prescription Assistance Programs
- Health Resources
- Healthy Living
- Terms of Use
- Privacy Policy
Website Administered by RxResource.org © 2024 RxResource
Optum Rx Form Downloads
Optum® home delivery mail-order form – english (pdf), optum® home delivery mail-order form – spanish (pdf), claim form – commercial (pdf), claim form – medicare part d (pdf), step therapy exemption form (pdf), prior authorization request form including fax number (pdf).
OptumRX Prior Prescription (Rx) Authorization Form
The OptumRX Prior Authorization Request Form is a simple form to be filled out by the prescriber that requests that a certain treatment or medication be covered for a patient. A list of tried and failed medication must be provided as a justification for the request alongside the diagnosis. This info will allow those at OptumRX to determine whether or not partial or full coverage is feasible. This form must be completed in full and double checked for accuracy before being faxed to the insurance company for review.
How to Write
Step 1 – Begin by downloading the form in Adobe PDF and opening it up in the PDF reader of your choice.
OptumRX Prior Prescription Authorization Form
Step 2 – The first required information is that of the member. Enter their name, insurance ID number, DOB, full address, and phone number.
Step 3 – Next, to the right of the member info, supply the healthcare provider info. This will require the following:
- Office phone
- Office address
Step 4 – The medication’s name, strength and dosage form must be enter next. If requesting a brand, select the appropriate box. If the physician is supply the medication, check that this is the case. In the two bottom windows, enter in the directions for use and whether or not it is a continuation of a current therapy. If yes, answer the two accompanying questions.
Step 5 – The clinical information window is required. Supply the diagnosis followed by a list of medications that have been tried and failed and the date on which each drug was prescribed.
Step 6 – Check the “yes” box to indicate that all the information provided is both true and accurate. Enter in the date and, once the document has been printed off, sign the signature field. Before doing so however, enter in any other comments, diagnoses, symptoms etc. that will help the reviewing process.
Fax the form, once 100% complete, to 1 (800) 711-4555 if this is an expedited request, or to 1 (800) 527-0531 if the need for the medication could be classified as non-urgent.
IMAGES
VIDEO
COMMENTS
Optum Rx has partnered with CoverMyMeds to receive prior authorization requests, saving you time and often delivering real-time determinations.
Fax this form to 1-866-434-5523 Phone: 1-866-434-5524 OptumRx will provide a response within 24 hours upon receipt. health information (PHI). The Provider named above is required to safe ard PHI by applicable law. The information in this document is r the sole use of OptumRx. Proper consent to disclose PHI between thes
Find forms for claim reimbursement, Medicare and Medicaid, prior authorization requests and privacy and confidentiality.
OptumRx offers online prescription refill and management services with fast and free delivery to your home or office.
OptumRx offers online prescription management, home delivery, and specialty pharmacy services.
Welcome to the one-stop source for those who write and fill prescriptions. Prescribers can access prior authorization systems and complete compliance requirements. Pharmacies can access patient info, claim details and get forms. Select one of these options.
Step 4 - In the Doctor Information section, please submit the information below before printing the form and providing the signature. Doctor's Name Date NPI # Phone Number Action Required (Urgent or To Review) Fax Pharmacy Fax Fax Completed Form at: 1 (888) 852-1832 Optum Rx (formerly Catamaran Rx) is a pharmacy benefit manager for MPSERS retirees.
How to access the OptumRx PA guidelines: Reference the OptumRx electronic prior authorization ( ePA ) and (fax ) forms. which contain clinical information used to evaluate the PA request as part of. the determination process. Call 1-800-711-4555 to request OptumRx standard drug-specific guideline to be faxed.
Optum Rx has partnered with CoverMyMeds to receive prior authorization requests,
Find prior authorization information, access our pharmacy portal, get Optum Rx contact information and more.
Certain states require Optum Rx to communicate prior authorization changes before the effective date. Flyers are sent to members to outline the drugs affected by prior authorization, quantity limits, and step therapy based on benefit plan designs. Please review each document for more details.
This document provides information on electronic claims processing, specific to NCPDP defined fields and requirements, for OptumRx (formerly Catamaran) non-Medicare Part D business.
This request may be denied unless all required information is received within established timelines. This request may be denied unless all required information is received. For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-800-527-0531.
OptumRx and Catamaran combine to strengthen pharmacy benefit services OptumRx® and Catamaran® have joined forces to deliver enhanced pharmacy benefit services and a better health care experience for members. Your prescription claims will continue to be processed quickly and accurately, and your pharmacy benefits will not change.
What is a prior authorization? Prior authorization (PA) requires your doctor to tell us why you are being prescribed a medication to determine if it will be covered under your pharmacy benefit. Some medications must be reviewed because they may: • Only be approved or effective for safely treating specific conditions.
At Catamaran, we put your individual needs - and those of your members - at the center of our services. We connect pharmacists, doctors and caregivers with prescription data to improve health outcomes, offering the clinical intelligence, technology and scale to lower payer costs while improving member health.
Optum Rx has partnered with CoverMyMeds to receive prior authorization requests, saving you time and often delivering real-time determinations.
OptumRx's Preferred Method for Prior Authorization Requests Our electronic prior authorization (ePA) solution provides a safety net to ensure the right information needed for a determination gets to patients' health plans as fast as possible.
Optum® Home Delivery mail-order form - English (pdf) Optum® Home Delivery mail-order form - Spanish (pdf) Claim form - Commercial (pdf) Claim form - Medicare Part D (pdf) Step Therapy Exemption Form (pdf) Prior Authorization Request Form including Fax Number (pdf) Tools. Pricing and coverage tool.
Submitting prior authorizations via ePA (electronic prior authorization) is the fastest and most convenient method for submitting prior authorizations. ePA can save time for you and your staff, leaving more time to focus on patient care. See the ePA Video Overview below to learn more. Start a Prior Authorization with CoverMyMeds >.
Step 1 - Begin by downloading the form in Adobe PDF and opening it up in the PDF reader of your choice. OptumRX Prior Prescription Authorization Form. Step 2 - The first required information is that of the member. Enter their name, insurance ID number, DOB, full address, and phone number. Step 3 - Next, to the right of the member info ...
Prior authorization (PA) requires your doctor to tell us why you are taking a medication to determine if it will be covered under your pharmacy benefit. Some medications must be reviewed because they may: Only be approved or effective for safely treating specific conditions. Cost more than other medications used to treat the same or similar ...
Complete General/Non-Preferred Drug Prior Authorization Form - Catamaran online with US Legal Forms. Easily fill out PDF blank, edit, and sign them. Save or instantly send your ready documents.