SubHero Banner
Text
Text

If you cannot submit requests through electronic prior authorization (ePA), or for urgent requests, please call us at 1-800-711-4555. 
Hours: 5am PST to 10pm PST, Monday through Friday

Otherwise, you can submit requests to the OptumRx® Prior Authorization Department by completing and faxing the applicable form. 

The hospice form should be used for hospice enrollees. Please complete this form along with a drug-specific form found below, when available. 

Text

A-Z drug-specific forms

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z