Submitting a PA request
Did you know…
Over 2/3 of the PAs that we receive each year are now electronic. If you are new to electronic prior authorizations (ePA), here are a few benefits to consider:
•Saves time: Providers who report using ePA submissions on average spend 2.5 fewer hours on PAs per week*
—Provides real-time submissions with typical resolutions in less than 5 minutes at no additional cost
—Eliminates wait time on the phone or using manual fax forms
—Reduces disruptions to patient care
—Allows renewals to be created from previous submissions
—Includes specific clinical questions pertinent to patient plan requirements
•Reduces paperwork: Process is eco-friendly
•Protects patient health information: Provides secure transmission using the National Council for Prescription Drug Programs (NCPDP) SCRIPT standard
Save time today and submit your PA requests to OptumRx through any of the following online portals:**
**The ePA solution supports all forms of PA and formulary exception requests. Exclusions may include cost reduction requests such as tiering exception, copay waiver, and tier cost sharing. To submit a tiering exception, copay waiver, tier cost sharing, or any other cost reductions requests (e.g., HCR), please contact the OptumRx® PA department through
telephone or fax.
OptumRx is not authorized to review requests for medications supplied by the physician’s office. For requests for buy and bill, please contact the patient’s medical benefit.
We offer other various resources to help support your understanding and use of ePA.
OptumRx Prior Authorization Guidelines and Procedures
Click here to view the OptumRx PA guidelines and Exception Request Procedures.
ePA portal support:
The American Medical Association (AMA) wants to help bring ePA awareness to physician practices. Click this link to leverage the AMA's video series to educate your staff about the advantages of ePA.
Other ways to submit a prior authorization
Having difficulties with ePA? You can submit a verbal PA request.
Call 1-800-711-4555, 5 a.m. – 10 p.m. PT, Monday-Friday and 6 a.m. – 3 p.m. PT, Saturday
If you cannot submit requests to the OptumRx® PA department through ePA or telephone, click here.