844-403-1027 (2024)

FAQs

How long does OptumRx prior authorization take? ›

Once your PA has been submitted and received, it usually takes 48 to 72 hours to process. If your PA request needs additional review, it may take longer. If your doctor submits a PA request electronically, they may receive approval within minutes of submitting the request.

For all other questions, call the OptumRx Prior Authorization Department at 1-800-711-4555.

If you have questions or want to speak with an Optum Rx Prior Authorization Advocate, call 1-800-711-4555.

Optum Rx has partnered with CoverMyMeds to receive prior authorization requests, saving you time and often delivering real-time determinations. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to this review?

If a provider's office submits a wrong billing code, misspells a name or makes another clerical error, this can result in a denied PA request. This is common for procedures like cosmetic surgery or treatments not approved by the FDA.

Once OptumRx receives your complete order for a new prescription, your medications should arrive within ten business days. Completed refill orders should arrive to your home in about seven business days. If we need to contact you or your doctor with questions, it may take longer to receive your order.

If an override is available, there will be a Request Override button at the bottom of the claim card • Note: The option to request an override will not appear if the claim has any additional rejections other than refill too soon. If the option is not available, contact the Pharmacy Help Desk.

(OptumRx Mail Service)

6800 W 115th St, Suite 600 Overland Park, KS 66211-9838 NCPDP: 1718634 Call 1-800-791-7658 – Provide a verbal prescription directly to an Optum Rx provider dedicated pharmacist.

Many people are receiving calls, primarily on their cell phones, from Optum RX, which they have not consented to receive. These are automated calls or robocalls, which violate the Telephone Consumer Protection Act (TCPA).

Are Optum and UnitedHealthcare the same? ›

UnitedHealth Group has two distinct business platforms: Optum and UnitedHealthcare. This cohesive partnership offers an array of health services and health benefits.

NOTE: Your benefits are still being provided by OptumRx, but now RxBenefits administers the services for a more personal and manageable approach.

For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-844-403-1027. Optum Rx has partnered with CoverMyMeds to receive prior authorization requests, saving you time and often delivering real-time determinations.

OptumRx Inc., a prescription drug benefit provider, has agreed to pay $20 million to resolve allegations that it improperly filled certain opioid prescriptions in violation of the Controlled Substances Act.

Optum Rx is an affiliate of UnitedHealthcare Insurance Company.

Taking into consideration the complexity of a prior authorization request, the prior authorization process selected by a healthcare provider, requirements set out in individual health plans, and any subsequent appeals process, a prior authorization (PA) can take anywhere from same day to over a month to process.

A preauthorization charge on a credit or debit card typically lasts for about five to seven days, but this duration can vary depending on the card issuer's policies and the type of transaction. Some banks may keep the hold for up to 14 days.

Please refer to the specific coverage information you receive after you enroll. We typically decide on requests for prior authorization for medical services within 72 hours of receiving an urgent request or within 15 days for non-urgent requests.