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

Dialysis Network Solutions

Congenital Heart Disease

Orthopedics

Transplantation

Cell and Gene Therapy

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*:

This information is required to validate appropriate access based on your scope of practice and responsibilities.

Credentials*: (e.g. RN, MD, CCM, LPN. If none, enter N/A)

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
Clinical	Manages the clinical information pertaining to a patient's case, including communication of phase dates to OptumHealth Provides access to active case lists, patient detail page, case notes, and claims.
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
testingsomething	testingsomething

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

Comments

PHI = Personal Health Information at Patient Level

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