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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:**

 

Electronic prior authorization (ePA)

Submit an ePA using CoverMyMeds

Electronic prior authorization (ePA)

Submit an ePA using Surescripts

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**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.

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.

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Supporting resources

We offer other various resources to help support your understanding and use of ePA.

    ePA Overview

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   OptumRx Prior Authorization Guidelines and Procedures
   
Click here to view the OptumRx PA guidelines and Exception Request Procedures.

   ePA portal support:

       CoverMyMeds

       Surescripts

       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.