Forms and resources for health care professionals (9)
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Claims provider manual
Our provider claims guide offers our network providers key information and support in submitting claims.
Optum Care ACE quick reference guide
Get important details about the Advanced Communication System.
Optum Care ACE Smart Edits
Learn more about the Advanced Communication Engine and the edits currently in place.
Optum Care management intake form
To refer to Optum Care management, submit a completed intake form.
Prior authorization list (BCBS)
Get a list of codes for Optum Care-Arizona (BCBS Members).
Prior authorization list (UHC)
Get a list of codes for Optum Care-Arizona (UHC Members).
Prior authorization request form
Use this form to request prior authorization of necessary services in the Optum West markets. See the prior authorization grid for a list of this year's services.
Provider Claim Reconsideration Request Form
Challenge, appeal or request reconsideration of a claim.
SNF list
Providers directing community SNF admissions should reference the Arizona contracted SNF list.