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

- Fertility

- Neonatology

- Pregnancy

To submit a request for access to the OptumHealth Provider website, you must complete all fields in the form below. Upon approval of your request, we will forward your userid and password to you.

All fields below that are bolded and marked with an asterisk (*) are required fields.

Desired User ID* (minimum of 7 characters)

Desired Password* (minimum of 7 characters,

maximum of 15)

Password Requirements

Passwords must be complex, containing at least two of the four bullets below:

Uppercase characters
Lowercase characters
Numeric (0-9)
Non-alphanumeric characters (@#$%^&+=)

Password cannot contain the user id

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.