Explore our resources
Case management brochure
Learn about Optum case management services and how we can help you improve patients’ health and well-being.
Claims payment practices
Read our claims payment policies regarding being a management services organization (MSO) for contracted IPAs.
Claims processing policy
This document outlines proper procedures for processing claims.
CMS non-contracted provider appeal process
Request a CMS appeal for denial of payment within 60 calendar days of the remittance date.
CMS provider disputes
Learn how to file a payment dispute for Medicare Advantage plan payment determination.
CMS waiver of liability form
See the Medicare Managed Care Reconsideration Project Waiver of Liability Statement.
Dispute form
Complete this form to submit a provider dispute resolution request.
Downstream provider notice
Learn your rights, responsibilities and procedures for claim settlement practices and claim disputes.
Medicare Managed Care Manual
Read about Medicare Managed Care Beneficiary Grievances and more.
Processing emergency air ambulance claims
Learn about required language when processing emergency air ambulance services for out-of-network claims.
Provider dispute resolution information
Quickly access the information you need to help your managed care and business operations.