Skip to main content

Resources

Access important provider information in one location.

 

Explore our resources

Case management brochure

Learn about Optum case management services and how we can help you improve patients’ health and well-being.

Download

Claims payment practices

Read our claims payment policies regarding being a management services organization (MSO) for contracted IPAs.

Download

Claims processing policy

This document outlines proper procedures for processing claims.

Download

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. 

Download

Dispute form

Complete this form to submit a provider dispute resolution request.

Download

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.

Download

Provider dispute resolution information

Quickly access the information you need to help your managed care and business operations.