New online utilization management requirement
Submit prior authorization requests and inpatient notifications online for patients delegated to Optum Care Network in Kansas and Missouri
Starting Sept. 1, 2024, network health care professionals will be required to submit prior authorization requests and inpatient admission/discharge notifications online for patients who are delegated to Optum Care Network-Kansas and Missouri.
You can determine if your patient is delegated to Optum Care Network-Kansas and Missouri by checking their member ID card. The card will list LIFE1 as the payer ID.
By submitting your prior authorization requests and inpatient notifications online, you’ll receive a decision faster than you would with a fax submission.
What this means for you
If you have patients in Kansas or Missouri who are delegated to Optum Care Network, you’ll need to submit prior authorization requests and inpatient admission/discharge notifications for these patients using the Referrals & Prior Authorization platform in the Optum Pro portal. Starting Sept. 1, 2024, Optum Care Network will no longer accept prior authorization or inpatient notifications by fax, except where required by law.
How to submit prior authorization requests and inpatient notifications online
- If you already have an Optum Pro account: Sign in to the Optum Pro portal using your One Healthcare ID and password, then select Referrals & Prior Authorization from the navigation ribbon on the left
- If you don’t already have a One Healthcare ID, visit identity.onehealthcareid.com to get started
- If you need to create an Optum Pro account: Visit optumproportal.com, then select Register Now
- In Kansas and Missouri, the following utilization management (UM) fax numbers will be decommissioned:
- General prior authorizations, clinical submissions for new or existing authorizations, and inpatient notifications and clinical submissions: 888-992-2809 and 844-249-0919
- Medicare Part B: 855-221-1978
Education resources
We offer eLearning modules in the Education & Training section of Optum Pro. To access the eLearning modules:
- Select Education & Training from the navigation ribbon on the left
- eLearnings are available in the Activity section; select + to expand the collapsed Activity section
- Select the Curo Provider Authorization Portal (National) eLearning course from My Learning or Completed
Questions?
If you have questions about the Optum Pro portal, please contact an Optum Health Networks team member. For technical assistance, contact the support team using the Contact Us link located at the bottom of the Optum Pro portal.
PCA-1-24-02024-Clinical-NN_07162024
