Transcription of Provider Manual
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Provider Manual
Optum Care Network Provider Manual 2021 1 Table of Contents Welcome Letter .. 3 Provider Manual Overview .. 4 Delegation Defined .. 4 Contact Information .. 5 Practice Engagement .. 6 Summary .. 6 Practice Advocate Responsibilities .. 6 Credentialing .. 6 Providers Joining Your Practice .. 7 Types of Providers Credentialed .. 7 Facilities Adding Location(s) .. 7 Types of Facilities Credentialed .. 7 Sub-Delegation of Credentialing .. 8 Recredentialing .. 8 Corrective Action .. 8 Provider /Facility Rights .. 8 Changes to Your Practice/Facility .. 9 Termination of Participation .. 9 Closing your Practice .. 9 Contracting .. 10 Delegation by Plan .. 10 Claims .. 10 Claims Submission .. 11 Reimbursement .. 11 Electronic Funds Transfer .. 12 Charging Members .. 12 Clinical Claims Review .. 13 Releasing a Patient from your Practice .. 13 Patient Re-Assignment .. 13 Compliance .. 13 Medicare Compliance Expectations and Training.
Customer Service 8 a.m.‒5 p.m., Monday‒Friday Eligibility, claims/auth status, Phone 877-836-6806 General billing question Fax 888-205-1128 Prior Authorization Intake Fax 855-402-1684 Claims Payer ID LIFE1 Claims Mailing Address PO Box 30788, Salt Lake City, UT 84130-0788 Claims Issue Escalation opshelp@optum.com
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