Abbreviations
CMC
What is Complex Medical Conditions (CMC) Transplant Claims
KB0083125
What is Optum Member Support KB
KB0054345
What is Optum Provider Service Expectations KB
KB0082488
What is Provider Eligibility and Provider Information Calls
OPES
What is Optum Patient Engagement Solutions - formerly known as PAR
EOC Hot Phrase for Additional routine foot care
What is Callu or Calluses
Our CORE Values
What are Integrity, Compassion, Relationships, Innovation and Performance
Facets
What is the claims platform
Home
EOC
What is Evidence of Coverage - Evidence which provides a member with detailed information on their plan benefits
Benefits/Service Type when looking up a HUMANA member in Availity.
What is Health Benefit Plan Coverage
ACW Goal
What is 60seconds or less
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
Categories under Provider Eligibility Tab
What are Practitioner Details, Group Details and Facility Details
Non-Par
What is A non-participating provider/non-contracted provider
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.
CIPS Turn-Around-Time
What is 24 hours or better
HUMANAWACARE
What is Washington HMO Network ID for HUMANA WA MEDICARE Borrowed
External Links
What are links to get you into other systems such as facets/Macess and Rally
LOS
What is Length of Stay
DL_casemanagemment@optumcare.com
What is the email address for New Mexico Providers to request a Case Manager
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.
Not given access to the Optum Provider Portal
Who are Out of Network Providers
Admission Date
What is the Date of Service on the claims details