Abbreviations
KB0083125
KB0054345
KB0082488
"New" CCSI Tool
100

CMC 

What is Complex Medical Conditions (CMC) Transplant Claims 

100

KB0083125

What is Optum Member Support KB

100

KB0054345

What is Optum Provider Service Expectations KB

100

KB0082488

What is Provider Eligibility and Provider Information Calls

100

The link to open the NEW CCSI tool 

200

OPES

What is Optum Patient Engagement Solutions - formerly known as PAR

200

EOC Hot Phrase for Additional routine foot care 

What is Callu or Calluses

200

Our CORE Values 

What are Integrity, Compassion, Relationships, Innovation and Performance 

200

Facets 

What is the claims platform

200

Home

What is the button that displays the options for CLAIMS, GPS, Prospective UM, Explanation Codes and Provider Eligibility
300

EOC

What is Evidence of Coverage  - Evidence which provides a member with detailed information on their plan benefits 

300

Benefits/Service Type when looking up a HUMANA member in Availity.

What is Health Benefit Plan Coverage 

300

ACW Goal

What is 60seconds or less

300

Rally

What is the tool is considered the source of truth for provider network status as it is member, provider, and Medicare facing for UnitedHealthcare (UHC) members only 

300

Categories under Provider Eligibility Tab 

What are Practitioner Details, Group Details and Facility Details 

400

Non-Par

What is A non-participating provider/non-contracted provider 

400

CMintake@optumpnw.com

What is the email address for WA/OR to request a Care Coordinator. You need to include the member's name, date of birth (DOB), and reason for referral.  

400

CIPS Turn-Around-Time

What is 24 hours or better 

400

HUMANAWACARE

What is Washington HMO Network ID for HUMANA WA MEDICARE Borrowed 

400

External Links 

What are links to get you into other systems such as facets/Macess and Rally

500

LOS

What is Length of Stay 

500

DL_casemanagemment@optumcare.com

What is the email address for New Mexico Providers to request a Case Manager

500

ACE the Customer Experience

What is 

A - Accuracy: We strive for accurate and consistent results with every interaction through accountability and clear communication.

C - Compassion: We pledge to show compassion through empathy and kindness that will provide peace of mind.

E - Exceeding Expectations: We are committed to delivering results that exceed the expectations of our patients, providers, and partners.

We support the markets with a customer-focused culture that eliminates inefficiencies using a commonsense approach.

500

Not given access to the Optum Provider Portal

Who are Out of Network Providers

500

Admission Date 

What is the Date of Service on the claims details