Colorado: Administrative changes for Medicare

Last modified: January 14, 2021

Optum Care, an affiliate of UnitedHealthcare, will now manage the following services for some UnitedHealthcare Medicare Advantage HMO members in Colorado:

• Member eligibility verification
• Prior authorization requests
• Hospital inpatient notifications
• Claim submissions

This means you’ll follow a new process for some of your patients who are members of the affected plans.

Affected members will have the Payer ID LIFE1 listed on their member ID card. For all other members, continue to follow the UnitedHealthcare processes outlined in the Administrative Guide.

Who’s affected by this change?

Members of the following UnitedHealthcare Medicare Advantage HMO plans who have chosen an Optum Care Network, Optum Colorado Springs or New West Physicians primary care provider (PCP) will be managed by Optum Care:

• Optum Colorado Springs
• Optum Care Network Denver (Physician Alliance of the Rockies)
• Optum Care Network South
• Optum Care Network North
• New West Physicians

Verifying member eligibility

You can verify UnitedHealthcare member eligibility online or by phone: 

• Online: Sign in at UHCprovider.com > Eligibility and Benefits
• Phone: 877-842-3210

Requesting prior authorization

Prior authorization is required for certain services based on the member’s plan. Request prior authorization at least 14 days before the planned date of elective services in one of the following ways:

• Online: Sign in at optumcare.com
• Phone: 888-685-8491

Hospital inpatient notifications

Call 888-685-8491 to notify Optum Care of hospital admissions within one business day of the admission.

Submitting claims

Submit claims for the affected Optum Care members in one of the following ways:

• Online: Sign in at optumcare.com
• Electronic: Use Payer ID LIFE1
• Mail: Optum Care Claims, P.O. Box 30539, Salt Lake City, UT 84130

Questions? 

Call UnitedHealthcare at 866-574-6088.