OptumRx Address: 3515 Harbor Boulevard Costa Mesa, CA 92626-0000 Website: https://WWW.RXSOLUTIONS.COM Telephone: 800-788-7871 Fax 714-825-3608 Mail Order Disposable Medical SuppliesOr call 1-800-788-7871. Preventive care drugs No charge, deductible does not apply. Not covered You must use a Participating Pharmacy listed in the UFCW Participating Pharmacy Directory of the Southern California Drug Benefit Fund or no coverage. You must have a prescription or no coverage. Coverage is for generic drugsOr call 1-800-788-7871. Preventive care drugs No charge, deductible does not apply. Not covered You must use a Participating Pharmacy listed in the UFCW Participating Pharmacy Directory of the Southern California Drug Benefit Fund or no coverage. You must have a prescription or no coverage. Coverage is for generic drugsSee the benefits. Our research shows Optum Home Delivery reduces medication adherence barriers, drives greater health outcomes and lowers total cost of care.. Higher medication adherence - We analyzed 3 chronic conditions; participants had a 20%+ higher medication adherence with home delivery 90-day vs. 30-day supply at retail. Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNT SERVICE PROVIDER ID QUALIFIER800-788-7871 Paramount Rx Inc 610210 800-928-4301 PBM Plus, Inc. 610106 800-263-2178 PerformRx (Includes: LA Medicaid and Keystone Mercy) 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI 610020, 014955 800-800-7364 Prime Therapeutics 610455, 004915, 012833, 011552, 015905, 014897, 800-821-4795 ProCare Rx 009430, 013501, 014310, 014194 ...Pharmacy Help Desk OptumRx 800-788-7871 MedalistRx Help Desk 855-633 -2579 . Pharmacy Help Desk FlexScripts 800-603-7796 .o For Pharmacists – 800-788-7871 • Member Name . ID CARDS . You may also print a temporary ID card beginning August 1, 2015 by registering and logging onto . Service Number: 800-788-7871 : United Healthcare PPO: Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 : United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 : Western Health Advantage: Rx Vendor: OptumRx Rx BIN 610011 ...Catamaran/Optum at 1-800-788-7871. Mail Order. Active mail order prescriptions • Existing mail order prescriptions will automatically transfer to PrimeMail, but patients will need to create a new mail order account with Prime in order to ensure payment and delivery.Preferred Care Partners: 1 -800 591 6144 Medica Healthcare Plans: 1 -866 273 9444 All other plans: 1 -800 788 7871. Author: SYSTEM Created Date: Allied International Union Med Impact NY 003585 31905 800/788-2949 Alpha Barnes MaxorPlus TX 005377 8253 800-687-0707 American Health Care AHC National 610118 AHC 800/872-8276 American Medical Society Pres Solutions National 610494 9999, Grp AMS 800/788-7871 AmeriChoice Pres Solutions NY/NJ 610494 9999, AMNY/ AMNS 800/788-7871 Amerigroup ...Coast Longshore Division Caucus unanimously votes to send tentative agreement to membership exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788-7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to this review?For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-844-403-1028. This document and others if attached contain information that is privileged, confidential and/or may contain protected health information (PHI).See the benefits. Our research shows Optum Home Delivery reduces medication adherence barriers, drives greater health outcomes and lowers total cost of care.. Higher medication adherence - We analyzed 3 chronic conditions; participants had a 20%+ higher medication adherence with home delivery 90-day vs. 30-day supply at retail. exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788- 7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to Jul 13, 2015 · 800-788-7871 Paramount Rx Inc National Funded Network, National Non Funded Network 610210 800-928-4301 PBM Plus, Inc. National and Limited Networks 610106 800-263-2178 PerformRx National Network, Medicare D, LA Medicaid, Keystone Mercy 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI National Networks, Restricted Networks, Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1 -A1 BIN NUMBER (see above) M 1Ø2 -A2 VERSION/RELEASE NUMB ER DØ M 1Ø3 -A3 TRANSACTION CODE B1, B3 M For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-844-403-1028. This document and others if attached contain information that is privileged, confidential and/or may contain protected health information (PHI). For technical website issues or password resets:1-800-788-4863 TTY (for the hearing impaired): 711 Physician Contacts: Prior authorization or exception request: 1-800-711-4555, option 2 If you are having a medical crisis, please call 911, or contact your local emergency assistance service immediately.Customer Service Center (877) 453-9198 Pharmacy (800) 788-7871 CCSB Agent Service Center (855) 777-6782 Group Service / Administration (800) 591-9911 CCSB New Business Sales (844) 332-8384 Enrollment & Eligibility Fax (866) 372-1316 Delta Dental VSP Member Services Member Services (800) 877-71951-800-464-4000 (English) 1-800-788-0616 (Spanish) Appointments and Nurse Advice Line: ... 1-800-788-7871: iphone. Android. Teamsters’ Assistance Program (TAP) Website 800-788-7871 Paramount Rx Inc 610210 800-928-4301 PBM Plus, Inc. 610106 800-263-2178 PerformRx (Includes: LA Medicaid and Keystone Mercy) 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI 610020, 014955 800-800-7364 Prime Therapeutics 610455, 004915, 012833, 011552, 015905, 014897, 800-821-4795 ProCare Rx 009430, 013501, 014310, 014194 ... Pres Solutions National 610494 9999 800/788-7871<br /> PacificSource Health Caremark National 610415 Varies 800-345-5413<br /> Paradigm- Missouri<br />OptumRx Provider Manual: 2016 2nd edition 4 The information contained in this document is proprietary and confidential to OptumRx. B. Images used in the PM Friendly FYI for our valued Network Pharmacy Providers Service Number: 800-788-7871 UnitedHealthcare PPO Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871 UnitedHealthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 Western Health Advantage Rx Vendor: OptumRx RX BIN 610011 PCN: IRX Delta Dental 800-765-6003 www.deltadentalins.com HMC HealthWorks 866-268-2510 https://hmc.personaladvantage.com (Access Code: SCDBF) Kaiser 800-464-4000 www.kp.org OptumRx 800-788-7871 www.optumrx.com Podiatry Plan, Inc. 800-367-7762 www.podiatryplan.com United Concordia 800-937-6432 www.unitedconcordia.com Prescription Solutions. (800) 788-7871. This website is intended to be accessible and usable by people with and without disabilities. Nov 4, 2022 · PCN: ADV. Total Benefit Solutions (Aetna International) 610502 (Aetna) PCN: 00670000. United Healthcare HMO. Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871. United Healthcare PPO. Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871. 800-788-7871 800-603-7796 ProAct Pharmacy Help Desk: 877-635-9545 MedalistRx Help Desk 855-633-2579 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNTDelta Dental 800-765-6003 www.deltadentalins.com HMC HealthWorks 866-268-2510 https://hmc.personaladvantage.com (Access Code: SCDBF) Kaiser 800-464-4000 www.kp.org OptumRx 800-788-7871 www.optumrx.com Podiatry Plan, Inc. 800-367-7762 www.podiatryplan.com United Concordia 800-937-6432 www.unitedconcordia.com Service Number: 800-788-7871 : United Healthcare PPO: Rx Supplier: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 : United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Reports Rx Grp: UHEALTH Service Number: 800-788-7871 : Western Your Advantage: Rx Vendor: OptumRx Rx BIN 610011 ...OptumRx: 800-788-7871 FlexScripts: 800-603-7796 ProAct: 877-635-9545 MedalistRx: 855-633-2579 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M Medical Plans. Phone: Please check the number on the back of the health plan ID card. Online: myuhc.com. Technical Support: 1-877-844-4999. Behavioral Health: myuhc.com or liveandworkwell.com 1-800-842-2065. OptumRx®. Phone: 1-800-788-7871. Authorization: 1-800-711-4555. Oct 13, 2022 · Read more than 2 user reviews and security ratings for number 8007887871 / +1 800-788-7871, mostly rated as negative Unsolicited call. Get our Free protection against unwanted calls. 800-788-7871 Paramount Rx Inc 610210 800-928-4301 PBM Plus, Inc. 610106 800-263-2178 PerformRx (Includes: LA Medicaid and Keystone Mercy) 012353, 600428 800-684-5502 Pharmacy BenefitDirect-PDMI 610020, 014955 800-800-7364 Prime Therapeutics 610455, 004915, 012833, 011552, 015905, 014897, 800-821-4795 ProCare Rx 009430, 013501, 014310, 014194 ... Delta Dental 800-765-6003 www.deltadentalins.com HMC HealthWorks 866-268-2510 https://hmc.personaladvantage.com (Access Code: SCDBF) Kaiser 800-464-4000 www.kp.org OptumRx 800-788-7871 www.optumrx.com Podiatry Plan, Inc. 800-367-7762 www.podiatryplan.com United Concordia 800-937-6432 www.unitedconcordia.comIf you are covered under an Anthem Blue Cross Indemnity medical plan option, please refer to your Summary Plan Description (SPD), contact the Trust Fund Office or contact OptumRx at 800-788-7871 to determine the exact amount of your prescription co-pays.Catamaran/Optum at 1-800-788-7871. Mail Order. Active mail order prescriptions • Existing mail order prescriptions will automatically transfer to PrimeMail, but patients will need to create a new mail order account with Prime in order to ensure payment and delivery.For technical website issues or password resets:1-800-788-4863 TTY (for the hearing impaired): 711 Physician Contacts: Prior authorization or exception request: 1-800-711-4555, option 2 If you are having a medical crisis, please call 911, or contact your local emergency assistance service immediately.1-800-788-2949 MedImpact Greystone & Co., Inc 003585 ASPROD1 GRE01 Commercial VA 1-800-788-2949 MedImpact Tanner Health System 003585 ASPROD1 PHI03 Commercial Georgia 1-877-403-6031 1-800-729-1174 MedImpact 1.1.2015. EFFECTIVE 07.27.2015 Subject to Change Page 40PBM/Payor Plan Name/Contract Name BIN PCN GROUP Type Network Location Help Desk ...Nov 5, 2022 · Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871. United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871. Western Health Advantage. Rx Vendor: OptumRx Rx BIN 610011. PCN: IRX. Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ MKaiser Permanente – Northern CA. HMO Rx BIN: 3585 Rx Group: Not Required Tax ID: 94-1340523 Medicare Part D Rx BIN: 11842 Rx Group: NC Tax ID: 94-1340523 COB Address P.O. Box 7012 Downey, CA 90242. Rx PCN for MMA: NCCMS Rx PCN for HDHP: NCHDP Rx PCN for HMO: 70000. Kaiser Permanente – Southern CA.LiveHealth Online: 24/7 video chat access to doctors and therapists from the comfort of your home. 100% coverage for preventive care when you see Anthem network doctors (including routine preventive health screenings, immunizations, and routine annual exams) A wealth of tools and resources available to help you live your healthiest life.All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field ... Mailing Address BOX 29044 Hot Springs, AR 71903. Member Website Medical & Pharmacy Member Service TFN 800-357-1371. UHC Provider Website UHC Provider TFN 877-842-3210. OptumRx Prior Auth TFN. 800-788-7871 (access to Prior Auth Tool via ). OptumRx Pharmacist TFN 800-788-7871. 800-788-7871 (access to Prior Auth Tool via www.unitedhealthcareonline ... Service Number: 800-788-7871 UnitedHealthcare PPO Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871 UnitedHealthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 Western Health Advantage Rx Vendor: OptumRx RX BIN 610011 PCN: IRX All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION : Transaction Header Segment Claim Billing/Claim Rebill ...Prescription Solutions. (800) 788-7871. This website is intended to be accessible and usable by people with and without disabilities. Jul 28, 2021 · 800-788-7871. Get a call from 8007887871? Read comments below to find details about this number. Report unwanted calls to help identify who is calling. Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNT SERVICE PROVIDER ID QUALIFIERRx BIN: 004336 Rx Group: Rx21CQ. PCN: ADV. Total Benefit Solutions (Aetna International) 610502 (Aetna) PCN: 00670000. United Healthcare HMO. Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871. United Healthcare PPO. Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871.exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788-7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to this review?Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M Delta Dental 800-765-6003 www.deltadentalins.com HMC HealthWorks 866-268-2510 https://hmc.personaladvantage.com (Access Code: SCDBF) Kaiser 800-464-4000 www.kp.org OptumRx 800-788-7871 www.optumrx.com Podiatry Plan, Inc. 800-367-7762 www.podiatryplan.com United Concordia 800-937-6432 www.unitedconcordia.comPOS message: LA Opioid Dup Therapy, MD Cnslt: use TD-M0-1G; Exmpt:use PPS code; RxHelp 800-788-7871 Reject code: 88. Pharmacist conducts additional safety review to determine if the patient’s opioid use is safe and clinically appropriate. Use standard NCPDP PPS codes to resolve at POS. 1-800-464-4000 (English) 1-800-788-0616 (Spanish) Appointments and Nurse Advice Line: ... 1-800-788-7871: iphone. Android. Teamsters’ Assistance Program (TAP) Website All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field ... calling 1-800-788-7871. Generic drugs $12 copay/prescription. Deductible does not apply. Not covered. • You must use a Participating Pharmacy listed in the UFCW Participating Pharmacy Directory of the Southern California Drug Benefit Fund or no coverage. • Your cost sharing applies to the prescription drug out-or liveandworkwell.com 1-800-842-2065 OptumRx® • Phone: 1-800-788-7871 Authorization: 1-800-711-4555 • Online: optumrx.com Dental National Options PPO (10, 20 or 30) • Phone: 1-877-816-3596 • Online: myuhc.com California Select Managed Care DHMO • Phone: 1-877-813-4259 • Online: myuhc.com Vision • Phone: 1-800-638-3120Delta Dental 800-765-6003 www.deltadentalins.com HMC HealthWorks 866-268-2510 https://hmc.personaladvantage.com (Access Code: SCDBF) Kaiser 800-464-4000 www.kp.org OptumRx 800-788-7871 www.optumrx.com Podiatry Plan, Inc. 800-367-7762 www.podiatryplan.com United Concordia 800-937-6432 www.unitedconcordia.comPharmacy Help Desk OptumRx 800-788-7871 MedalistRx Help Desk 855-633 -2579 . Pharmacy Help Desk FlexScripts 800-603-7796 .All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field ...Coast Longshore Division Caucus unanimously votes to send tentative agreement to membership Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNT SERVICE PROVIDER ID QUALIFIERPharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNT SERVICE PROVIDER ID QUALIFIERexceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788-7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to this review?(800) 788-7871 (for coverage verification) (888) 543-1369 or www.optumrx.com (Customer Service) 4 NCDS Healthcare Plan (Rev. January 2021) SUMMARY SCHEDULE OF BENEFITS See the benefits. Our research shows Optum Home Delivery reduces medication adherence barriers, drives greater health outcomes and lowers total cost of care.. Higher medication adherence - We analyzed 3 chronic conditions; participants had a 20%+ higher medication adherence with home delivery 90-day vs. 30-day supply at retail. 1-800-788-2949 MedImpact Greystone & Co., Inc 003585 ASPROD1 GRE01 Commercial VA 1-800-788-2949 MedImpact Tanner Health System 003585 ASPROD1 PHI03 Commercial Georgia 1-877-403-6031 1-800-729-1174 MedImpact 1.1.2015. EFFECTIVE 07.27.2015 Subject to Change Page 40PBM/Payor Plan Name/Contract Name BIN PCN GROUP Type Network Location Help Desk ... Prescription Solutions. (800) 788-7871. This website is intended to be accessible and usable by people with and without disabilities.Service Number: 800-788-7871 United Healthcare PPO Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 Western Health Advantage Rx Vendor: OptumRx RX BIN 610011 PCN: IRX 1-800-464-4000 (English) 1-800-788-0616 (Spanish) Appointments and Nurse Advice Line: ... 1-800-788-7871: iphone. Android. Teamsters’ Assistance Program (TAP) Website calling 1-800-788-7871. Generic drugs $12 copay/prescription. Deductible does not apply. Not covered. • You must use a Participating Pharmacy listed in the UFCW Participating Pharmacy Directory of the Southern California Drug Benefit Fund or no coverage. • Your cost sharing applies to the prescription drug out- Nov 4, 2022 · Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871 : United Healthcare PPO : Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 : United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 Nov 4, 2022 · Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871. United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871. Western Health Advantage. Rx Vendor: OptumRx Rx BIN 610011. PCN: IRX. 9665 Rockside Road, Valley View, Ohio 44125 Pension: 216-781-6869 H&W: 216-781-6858(800) 788-7871 (for coverage verification) (888) 543-1369 or www.optumrx.com (Customer Service) 4 NCDS Healthcare Plan (Rev. January 2021) SUMMARY SCHEDULE OF BENEFITS
OptumRx Address: 3515 Harbor Boulevard Costa Mesa, CA 92626-0000 Website: https://WWW.RXSOLUTIONS.COM Telephone: 800-788-7871 Fax 714-825-3608 Mail Order Disposable Medical Supplies. Used cars dollar3000
Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ M Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M 1Ø2-A2 VERSION/RELEASE NUMBER DØ MService Number: 800-788-7871 United Healthcare PPO Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 Western Health Advantage Rx Vendor: OptumRx RX BIN 610011 PCN: IRX OptumRx Provider Manual: 2016 2nd edition 4 The information contained in this document is proprietary and confidential to OptumRx. B. Images used in the PM Friendly FYI for our valued Network Pharmacy Providers 1. Instant Checkmate - Largest reverse phone lookup directory. This company is known for its all-inclusive public records checks. It allows the client to do background checks, reverse phone ...exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788-7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to this review?All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION : Transaction Header Segment Claim Billing/Claim Rebill ...Delta Dental 800-765-6003 www.deltadentalins.com HMC HealthWorks 866-268-2510 https://hmc.personaladvantage.com (Access Code: SCDBF) Kaiser 800-464-4000 www.kp.org OptumRx 800-788-7871 www.optumrx.com Podiatry Plan, Inc. 800-367-7762 www.podiatryplan.com United Concordia 800-937-6432 www.unitedconcordia.com If the patient is not able to meet the above standard prior authorization requirements, please call 1-800-711-4555. For urgent or expedited requests please call 1-800-711-4555. This form may be used for non-urgent requests and faxed to 1-844-403-1028.exceeding 4 grams per day, please have the patient’s pharmacy contact the OptumRx Pharmacy Helpdesk at (800) 788- 7871 at the time they are filling the prescription for a one-time override. Are there any other comments, diagnoses, symptoms, medications tried or failed, and/or any other information the physician feels is important to Service Number: 800-788-7871. PCN . United Healthcare PPO (Large Group) Rx BIN Number. Rx Vendor: OPTUMRx Rx Bin: 610279. Rx PCN: 9999 Key Accounts Rx Grp: UHEALTHOptumRx: 800-788-7871 FlexScripts: 800-603-7796 ProAct: 877-635-9545 MedalistRx: 855-633-2579 Other versions supported: ONLY D.0 CLAIM BILLING/CLAIM REBILL TRANSACTION Transaction Header Segment Claim Billing/Claim Rebill Field # NCPDP Field Name Value Payer Usage Payer Situation 1Ø1-A1 BIN NUMBER (see above) M Pharmacy Help Desk OptumRx 800-788-7871 Other versions supported: ONLY D.0 Transaction Header Segment NCPDP Field Name Claim Billing/Claim Rebill Field # Value Payer Payer Situation Usage M M M M M M M 1Ø1-A1 BIN NUMBER VERSION/RELEASE NUMBER TRANSACTION CODE PROCESSOR CONTROL NUMBER TRANSACTION COUNT SERVICE PROVIDER ID QUALIFIER(800) 788-7871 (for coverage verification) (888) 543-1369 or www.optumrx.com (Customer Service) 4 NCDS Healthcare Plan (Rev. January 2021) SUMMARY SCHEDULE OF BENEFITS Nov 4, 2022 · Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871 : United Healthcare PPO : Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871 : United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Key Accounts Rx Grp: UHEALTH Service Number: 800-788-7871 All other Plans: 800-788-7871 Other versions supported: ONLY D.0 . CLAIM BILLING/CLAIM REBILL TRANSACTION : Transaction Header Segment Claim Billing/Claim Rebill ...Rx BIN: 004336 Rx Group: Rx21CQ. PCN: ADV. Total Benefit Solutions (Aetna International) 610502 (Aetna) PCN: 00670000. United Healthcare HMO. Rx Vendor: OPTUMRx Rx BIN: 610279 Rx PCN: 9999 Rx Grp: UHCNICE Service Number: 800-788-7871. United Healthcare PPO. Rx Vendor: OPTUMRx Rx Bin: 610279 Rx PCN: 9999 Rx Grp: UHC Service Number: 800-788-7871.1-234-201. Mahoning. Youngstown. Cellco Partnership Dba Verizon Wireless - Oh. 1-234-202. Summit. Akron. Cellco Partnership Dba Verizon Wireless - Oh. 1-234-203..
