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.
State of California prior authorization form
UHC West of California delegated medical group auto-authorization form
State of Colorado prior authorization form
State of Louisiana prior authorization form
State of Massachusetts general prior authorization form
State of Massachusetts - Hepatitis C prior authorization form
State of Massachusetts - Synagis prior authorization form
State of Michigan prior authorization form
State of Minnesota prior authorization form
State of New Hampshire prior authorization form
State of New Mexico prior authorization form