Optum Behavioral Health
Resource Guide

Registration

New Users: Create a One Healthcare ID  to access secure transactions.

Eligibility and Benefits

Check a Member’s eligibility for services and benefits.

Claim Submission Options

• EDI/Electronic claim: Payor ID #87726
• Provider Express Secure Portal: Claim Entry through Provider Express supports entry of outpatient behavioral health claims by a registered user.
• Paper Claim: To ensure timely claim processing, Optum uses multiple claim addresses. Always verify the consumer’s claim mailing address before claim submission: Where to Submit Your Optum Claim.

Claim Submission Options details are available in the National Network Manual.

Authorization

• Determine whether an authorization is required.
• Plans administered by Optum do not require prior authorization for routine outpatient services. To access the correct authorization forms, select your state to view the appropriate requirements and documents.

• Providers should call the appropriate number for authorization requests:

  CHIP: 1‑800‑424‑3701
  Individual and Family Plans/Medicare Advantage: 1‑800‑424‑3704

Appeal

Submit appeals and check your appeals status online. An appeals representative is available via chat 7 a.m. - 7 p.m. CST, Monday-Friday.