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Resources and tools for providers and health care professionals

We invite you to use this website, created especially for health care professionals, to find resources that can help you as you care for your patients. Here you can find our medical policies, stay up to date on the latest news or get training on our many tools and benefit plans.

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News

How to identify Optum Care delegated claims online

Get alerts for delegated claims managed by Optum Care. View claim information by selecting the Optum Care payer ID.

NM providers: Avoid denials for incorrect taxonomy

Claims submitted with a missing or incorrect taxonomy code and/or ZIP code will be rejected or denied.

Help reduce cancer risk for Hispanic populations

Promote cancer prevention during Hispanic Heritage Month with cultural resources to support cancer screening conversations.

New York Medicaid: Change to Direct Home Care Worker claims

Effective Oct. 1, 2026, changes will be made to how claims are submitted for all Direct Home Care Worker claims.

New York Medicaid: PT/OT Codes added to Non-Covered Code List

Starting Dec. 1, 2026, physical and occupational therapy evaluation codes 97161-97168 will no longer be covered.

NC Medicaid: Appropriate use of CR modifier

The CR modifier isn’t billable outside of federal or state-declared emergencies. Ensure you’re using it correctly.

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