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Solution suite

Optimal Pharmacy Network Strategy

Our full-spectrum pharmacy services are designed to provide affordable access to prescription medications and therapies.

Network resources

Join the Optum Rx network

Network participation request form

Take the first steps towards impactful collaboration by joining the Optum Rx  pharmacy network. We look forward to partnering with you to optimize healthcare for all. 

Access digital tools

Pharmacy eServices registration

When you register for Pharmacy eServices, you’ll get access to digital tools to assist patients. You can also:

  • View patient claims history and eligibility information, including Rx BIN, Rx PCN and Rx Group details
  • Perform real-time refill too soon overrides for vaccination, lost or stolen medication, mail order delay, and long-term care facility admit/discharge
  • View claims status and details of approved, denied, and pending claims
  • Check Prior Authorizations
  • Search for drug pricing and alternative medication options specific to the patient’s formulary

Pharmacy portal sign-in

Here’s how to register for a One Healthcare ID to use the Optum Rx Pharmacy Portal:

  1. Go to https://professionals.optumrx.com
  2. Under Pharmacy Sign In, click on Register for a One Healthcare ID
  3. Select Create a One Healthcare ID
  4. Provide the required information, and select I Agree  

Health equity products

Depending upon market availability.

Resource Bridge

Addresses the social determinants of health affecting Optum Rx members and aims to connect underserved members with local community resources.

Bridge to Wellness

Provides high-touch medication services that closes gaps in care, promotes medication adherence and improves health outcomes. This product partners with Community Pharmacy Enhanced Services Network (CPESN) USA.  

  

Independent Pharmacy Strategy

Depends on market availability. Only available in certain markets at this time.

Enhanced reimbursement and payment predictability

Still receiving paper checks? Receive your payments faster by eliminating mailing-time lags and sign up for EFT today. Utilize the 835 electronic remittance form to receive detailed listings of claim activity. Reference the Optum Rx PLB codes and increase the ease of reconciliation.

Downlod EFT form Download 835 form

Related healthcare insights

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Data collection for risk adjustment compliance

Learn the 4 core pillars of a strong data collection process — a strategic imperative for improving healthcare outcomes. 

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Patient education: The secret to success in risk adjustment and VBC

Effective patient education fosters adherence to medical treatments and promotes healthy patient behaviors, in turn facilitating successful risk adjustment and value-based care.

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Using biosimilars to treat chronic inflammatory conditions

In today’s healthcare landscape, the introduction and increasing use of biosimilars offers a promising solution to rising medication costs.

   

Product information and resources

  • PDF

     

    Guide

    Pharmacy provider manual

    Our provider claims guide offers our network providers key information and support in submitting claims.

    Download guide

Complementary solutions

Pharmacy services

Drive better engagement, medication adherence and outcomes for patients.

Pharmacy Network Solutions

A claims-management tools that help pharmacies expedite claims editing, submission and adjudication.