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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

Video

Transforming the pharmacy industry with transparency

Hear how the industry’s most transparent and independent Pharmacy & Therapeutics Committee evaluates drugs for the Optum Rx formulary.

On-demand webinar

Adventist West’s success through redesigning and automating UM

Discover how to leverage automation for centralized, exception-based utilization management.

Article

Promises and pitfalls: AI and clinical decision-making

Learn more about why evidence-based criteria and clinician insight are needed for informed and trustworthy decisions while leveraging AI.

   

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.