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Delegated Relationship with Optum Medical Network in Utah Effective January 1, 2015

Effective January 1, 2015, Optum Medical Network will be delegated for claims payment and utilization management for all UnitedHealthcare Group Medicare Advantage HMO and AARP® Medicare Complete benefit plans in Utah. Optum Medical Network provides local support services and offers innovative value-based arrangements that align incentives with improved outcomes.

The following information will change on UnitedHealthcare Medicare Advantage member identification (ID) cards as of Jan. 1:

What is changing?

  • 1. New Payer ID: LIFE1
  • 2. New Claims Address:
    Optum Medical Network Claims
    PO Box 46770
    Las Vegas, NV 89114-6770
  
New Sample Card for AARP MedicareComplete Essential (HMO)

For dates of service beginning January 1, 2015 and forward, call Optum Medical Network at 877-370-2845 or go to OptumMedicalNetwork.com for claims questions, referrals, prior authorization requests or hospital admission notifications.

The list of services requiring prior authorization remains the same as today for specialists, ancillary providers and hospitals. If you care for a member who will require a new prior authorization for dates of service after January 1, please continue to use the process you do today. The prior authorization will transfer to Optum Medical Network effective Jan. 1.

New AARP MedicareComplete Plan 2 (HMO) Coming Jan. 1, 2015

We are also introducing a new Medicare Advantage benefit plan for individual members in the Utah area Jan. 1, 2015. The plan requires a member’s primary care physician (PCP) to coordinate care and refer them to network specialists or other licensed medical professions prior to the member seeking care.

Some of the key features of the new plan include:

  • 1. Online referral process – The member’s PCP can generate referrals online at OptumMedicalNetwork.com for members to obtain services from network specialists or other care providers.
  • 2. Member ID card display – The ID card includes helpful information such as the member’s plan name, PCP name and a Referral Required indicator on the back.
  • 3. Eligibility and Referral Confirmation – When confirming eligibility at OptumMedicalNetwork.com, the results will display with a message indicating that referrals from the patient’s PCP are required for services from specialists and other care providers.
  
Sample Card for AARP MedicareComplete Plan 2 (HMO)

If you have questions, please contact Optum Medical Network Provider Services at 877-370-2845 or OptumMedicalNetwork.com. Thank you.