Optum Provider Services Master Agreement
Optum delivers provider management through NASPO ValuePoint.
Pre-approved through ValuePoint, Optum Provider Management Services offers a self-service gateway and support system to enroll, credential and verify providers. States can also choose additional options, including full-service, outsourced, end-to-end provider services.
Our core offering includes:
- Provider enrollment and self-service portal
- Provider database
- Verification workbench
The solution also includes remote mail office, enterprise content management, and provider and staff training.
Additional options:
Option A enhances self-service capabilities for your providers. Additional system functionality includes:
- Real-time member eligibility and claim status inquiries
- Warrant and remittance advice inquiries
- Claims-based medical history feature
- Batch eligibility inquiry and response of HIPAA-compliant health care transactions
- Online provider appeal request
- Primary care case management (PCCM) inquiry tool
- Online direct entry claims for all claim types, including corrections, voids and replacement claims
Option B offers full-service, outsourced, end-to-end provider management services, including:
- Provider enrollment portal and enhancements
- Supporting operations
- Call center
- Training of providers and provider site visits to train and support your network
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