Optum specialty medication guidance program (commercial plans – not applicable to UnitedHealthcare West)

The Optum specialty medication guidance program manages prior authorization process for certain outpatient medical benefit specialty medications

Optum manages prior authorization requests for certain medical benefit injectable medications for these commercial plan members. This includes the affiliate plans UnitedHealthcare of Mid-Atlantic, Inc., Neighborhood Health Partnership and UnitedHealthcare of the River Valley. You will be notified when other commercial plans and lines of business migrate to this new process.

How the process works

Click on the Specialty Pharmacy Transactions tile on your Link dashboard. The system will document clinical requirements during the intake process and prompt you to provide responses to the clinical criteria questions. Attach medical records, if requested. For additional questions, call 1-888-397-8129.