Myoptumhealthcomplexmedical.com

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For your convenience, we have created a hardcopy Notification Form that can be emailed to either your Account Manager or to [email protected] or faxed to Optum at (877) 897-5338. You may also call us at (877) 801-3507, where a trained customer service representative will take your referral information.

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URL: myoptumhealthcomplexmedical.com

OptumHealth Care Solutions

For Health Care Providers. As a health care provider, you strive to provide high-quality health care to patients. At Optum, we share that goal. Our Centers of Excellence networks comprise the nation's most clinically superior health care providers in the areas of organ transplantation, complex cancer, congenital heart disease, bariatric surgery and infertility.

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OptumHealth Care Solutions Complex Medical Conditions

For your convenience, we have created a hardcopy Notification Form that can be emailed to either your Account Manager or to [email protected] or faxed to Optum at (877) 897-5338. You may also call us at (877) 801-3507, where a trained customer service representative will take your referral information.

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OptumHealth Provider

Our Payer ID is 41194. If you have questions or concerns, please contact our customer service department at [email protected] OptumHealth Care Solutions is migrating from paper to electronic claim processes. As OptumHealth focuses on the significance of electronic data, it is important to know that we are not alone.

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Sign In With Your One Healthcare ID

The charges for an average transplant procedure is $598,000, but depending on the circumstances, costs can rise to more than $1 million. As a payer, managing these cases can be time-consuming, costly and difficult. At Optum, we specialize in making the management of complex medical conditions easy - our comprehensive suite of products will help

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OptumHealth Care Solutions

We select our network medical centers through a process of quality measurement and value-driven contracting that are unique in the health care industry. TRS contracts address 100% of the total transplant costs, while similar services control only 60% of transplant-related costs. We cover all phases of patient health care: Evaluation; Pre-transplant

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OptumHealth Care Solutions

Optum's Centers of Excellence networks are the gold standard in complex health care. Our original network, the Optum Transplant Centers of Excellence network, was developed in 1986 and has grown to be the largest network of its kind in the world, managing more than 14,000 transplant referrals in 2013 1 . Today, we offer products and services

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OptumHealth Care Solutions

Complex Medical Conditions Client Services. Each Optum client is assigned a Client Services Team that provides a variety of consulting services to assist them in managing their patients and maximizing their relationship with Optum.

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OptumHealth Care Solutions

A survey conducted in the third quarter of 2014 found 97% of patients satisfied with their overall health care services. Overall Satisfaction with Complex Medical Conditions. 99% satisfied with COE. 97% satisfied with overall nurse services. 97% satisfied with nurses' ability to answer questions. 93% agree that services are valuable.

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OptumHealth Care Solutions

Treatment planning and coordination. Quality of patient/family-oriented services. Proof of a multidisciplinary approach to health care. Evaluation process. Each year, Optum sends a survey to the medical centers and programs being considered for our Centers of Excellence networks. Upon receipt of a completed evaluation, the Clinical Sciences

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OptumHealth Provider

CMC is migrating to Optum ID login credentials to provide enhanced data security and protection of sensitive data. Users will be migrated to the new Optum ID in phases over the next few weeks.

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OptumHealth Care Solutions

Through the Managed Transplant Program, your clients can stabilize their health care budget and provide their employees with access to extraordinary care. Optum has been a leader in transplant products since 1986. To find out how to add a high-demand product to your portfolio and earn additional commission, call 1-800-847-2050 and ask for a

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OptumHealth Provider

Select the following links to access the claims lists for a particular patient. Search to locate claims within a specific date range or for a specific payer. Customer Service Questions. Phone: (877) 801-3507. Prompt: 3. Health Care Provider. Fax: 888-905-9492. Email: [email protected] Please review our claim inquiry guidelines below.

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CMC Claims Portal

Through EDI, claims will be transmitted automatically into your claims platform for immediate claims processing; there is no need to key any claim information into your system as is required with claims pulled from the CMC Claims Portal. Please contact OptumHealth at (877) 801-3507 today to move to EDI or for additional information.

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OptumHealth Care Solutions

Transplant Resource Services: The Centers of Excellence Network. Optum's Clinical Sciences Institute evaluates transplant programs throughout the U.S. Optum only includes transplant programs that meet our strict Centers of Excellence criteria in the Optum Transplant Centers of Excellence Network.

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OptumHealth Client

Sign In With Your One Healthcare ID. Welcome to Optum's Extranet site. We are excited to provide you with online access to the valuable data we collected regarding our Transplant Network medical centers. We hope you will find this information useful as you work with your Optum clinical consultant in managing your transplant patients' benefits.

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How to Find a Health Care Provider Online (U.R.N. Clarity Tool

How to Find a Health Care Provider (U.R.N. Clarity Tool) ©2007 UNITED RESOURCE NETWORKS 6. Other Product tabs - Other U.R.N. products have similar geographical and product specific searches. Each product tab also has custom “Tools and Resources” where you can locate patient and case management information.

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OptumHealth Care Solutions

12% lower reoperation rate for bariatric procedures 5. $4,239 lower average cost per surgical episode 6. To ensure our COEs continue to meet professional standards for top specialty care, we take the added step to annually review and recertify each bariatric COE program. The result is better quality of care for the patients we serve.

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OptumHealth Care Solutions

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 [email protected] to create a One Healthcare ID, which you will use to log into the site. Please select the type of user you are: If you are a health plan, case management

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OptumHealth Care Solutions

At OptumHealth, we have been evaluating transplant programs across the country since 1986. Our Transplant Centers of Excellence network is the nation's leading transplant network, managing more than 12,000 potential transplant patients each year. Learn more about Transplant Resource Services: Products and Services.

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OptumHealth Care Solutions

Managed Transplant Program. Transplant costs can be extremely unpredictable. The cost for an average transplant episode is almost $472,000 1, but depending on the circumstances, it can rise to more than one million dollars. Your medical stop loss insurance or reinsurance coverage may not provide complete protection.

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Optum Complex Medical Conditions Operations Guide

Health care provider training Concurrent with the execution of a new agreement, training is scheduled with clinical and billing staff at your medical center. All processes and tools provided by Optum and referenced in this guide are discussed during these training sessions. Health care provider onboarding

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OptumHealth Care Solutions

To reduce costs and improve outcomes, Neonatal Resource Services (NRS) provides telephonic case management to help manage NICU cases both inpatient and post-discharge. NRS possesses a dedicated team of specialized and experienced NICU nurse case managers as well as full-time medical directors capable of caring for fragile neonates.

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www.myoptumhealthcomplexmedical.com

IndependenceCare Cariten Health Plan/Cariten Insurance Company IndependenceCare Mesquite ISD IndependenceCare Ventura County Health Care Plan 888-769-8787 J Allen Hall City of Daytona Beach J Allen Hall Freeport School District UHC of the River Valley (fka John Deere Health Care) 800-624-7130 J Allen Hall KVAT Food Stores, Inc.

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www.myoptumhealthcomplexmedical.com

To provide you with information that we believe may be useful to you, such as information about health products or services provided by us or other businesses. To perform analytics and to improve our products, websites, and advertising. To comply with applicable laws, regulations, and legal process. To protect someone's health, safety, or welfare.

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Mechanical Circulatory Support Devices

contracting on our behalf, to render covered health services for the treatment of specified diseases or conditions. A designated facility may or may not be located within the member’s geographic area. The fact that a Hospital is a network hospital does not mean that it is a designated facility.

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TRANSPLANT REVIEW GUIDELINES

understand and support the ongoing health care needs of the patient. • Post-transplant lymphoproliferative disease (PTLD) unless no active disease demonstrated by negative positron emission tomography (PET) scan and resolved adenopathy on computed tomography (CT) and/or magnetic resonance imaging (Blaes, Khedmat)

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How to Use the Online Active Case Report

United Resource Networks(U.R.N.) clients should work with patients’ health care providers to manage the patient process. The Active Case Report (Active Patient List Report) provides a record of the clinical dates for each patient and assists case managers in following their patients’ progress and enables correct pricing of claims.

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