OptumHealth Care Solutions - Complex Medical Conditions Facility User Access Request

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Optum offers products for complex medical conditions such as:

Bariatric

Cancer

Chronic Kidney Disease

Congenital Heart Disease

Orthopedics

Transplantation

VAD

Women's Health Services

- Neonatology

- Pregnancy

To submit a request for access to the Optum Provider 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.

First Name*:

Last Name*:

Email*:

Professional Title: (e.g. RN, MD, CCM)

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:

Claims

Works with claims. Provides access to view the patient detail page, enter notes on the case, view all claims.

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.

Education Presenter

Presenter for a OptumHealth conference or educational event. This access allows user to upload presentations to OptumHealth

Marketing

Performs marketing functions for the health care provider. This access allows the user to submit and review program and medical center descriptions, pictures, news for OptumHealth's payer client web site.

Facility*:

Use the SEARCH button at the right to select a facility from a list

Access Request Reason / Notes:

You will have to agree to the Disclaimer prior to using your login.