Texas: Pharmacy prior authorization, step therapy change
Effective June 1, 2023, Optum®, an affiliate of Golden Rule Insurance Company, will manage prior authorization and step therapy requests for prescription medications that are reviewed under the Optum Rx® Pharmacy Utilization Management (UM) program. This change applies to Texas residents who have pharmacy coverage.
How to submit requests
You can submit a prior authorization or step therapy request through the UnitedHealthcare Provider Portal:
- Go to UHCprovider.com and select Sign In at the top-right corner
- Sign in to the portal using your One Healthcare ID and password
- If you are a new user and don’t have a One Healthcare ID, visit UHCprovider.com/access to get started
- In the menu, select Prior Authorizations
- In the Prior Authorization and Notification tool, go to “Create a new notification or prior authorization request” and click Create New Submission
- Enter the required information and submit
To support our review, we’ll document clinical requirements within the request submission. You may also be asked to attach medical records.
Questions?
If you have questions or need more information about this update, call Optum at 888-397-8129, 8 a.m.–5 p.m. local time, Monday–Friday. You can also find more tools and resources at professionals.optumrx.com.
