OptumHealth Care Solutions - Complex Medical Conditions Client User Access Request

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Optum offers products for complex medical conditions such as:

Bariatric

Cancer

Chronic Kidney Disease

Congenital Heart Disease

Orthopedics

Transplantation

VAD

Women's Health Services

- Neonatology

- Pregnancy

To submit a request for access to the Optum Client website, you must complete all required fields on the form below. Once your request is submitted, you will receive an approval or denial e-mail within 1-2 business days.

If approved, you will receive a second e-mail from noreply_provisioning@optum.com to create a One Healthcare ID, which you will use to log into the site.

All fields marked with an asterisk (*) are required.

Company Name*:

Site Location*:

Company Type*:

Broker/Producer

HMO

Indemnity

MGU

Reinsurance

Self Insured

Stop-Loss

TPA

Other

First Name*:

Last Name*:

Email*:

Professional Title: (e.g. RN, MD, CCM)

Position Title: (role in your organization)

Address 1*:

Address 2:

Address 3:

City*:

State*:

Zip*:

Phone Number*:

Extension:

Fax Number:

The following role applies to my interaction with OptumHealth Care Solutions - Complex Medical Conditions*:

Role	Provides Access To:
Broker/Producer	Access to tools to assist you in the sale of OptumHealth products and services.
Case Manager	PHI, Facility Search, Facility Contract Information, Facility Rates, Steerage Tools, Volume/Outcome Data, Online NF, Utilization Review Reports, Claims Status
Claims	PHI, Claims Status, Facility Rates, Facility Search, Facility Contract Information, Volume/Outcome Data
Claims Portal	Download Claims, Repriced Claims, Claim Detail Report, Daily Email Feed
Executive	Utilization Review Reports, Facility Search, Facility Contract Information, Facility Rates, Steerage Tools, Volume/Outcome Data
General	Facility Search, Facility Contract Information, Facility Rates, Volume/Outcome Data
Medical Director	PHI, Facility Search, Facility Contract Information, Facility Rates, Steerage Tools, Volume/Outcome Data
Supporting Organization	Facility Search, Facility Contract Information, Volume/Outcome Data

Enter the name of the group you would like to access on the website*:

Comments

PHI = Personal Health Information at Patient Level

You will have to agree to the Disclaimer prior to using your login.