Forms
We have compiled all of the essential forms in one place for you to utilize. Select the applicable form(s) for reporting, credentialing, claims, and more.
You may need to download Adobe Acrobat Reader to open these files.
Contracting and Practice Changes
HAP Provider Change Form (coming soon) Use this form to submit any changes for your practice and update your information. |
Medical Prior Authorization
Prior Authorization Request Form (coming soon) |
Claims
| Claim Recovery Refund Check Form | Itemized Bill Cover Sheet (coming soon) |
Member Claim Form (coming soon) | Optum Claims Review Process FAQ |
| Overpayment Recovery Form |
Fraud, Waste and Abuse
Fraud, Waste and Abuse Reporting Form (coming soon) |