Optum is closely monitoring the COVID-19 situation for providers
Last updated: February 8, 2021
Providers are encouraged to confirm member benefits and coverage provided by their health plan at the time of service due to the rapidly changing situation.
- Optum will review claims that may be impacted by cost-sharing waivers and reprocess them automatically. The provider will not need to request a claim adjustment or appeal.
- Due to the rapidly changing environment around patient cost-sharing waivers, providers may want to allow their claim to be fully processed before collecting any patient cost-sharing responsibility.
See specific policy pages for applicable policy effective dates.
The health of our members and the safety of those who deliver care are our top priorities. We’re taking action and providing resources to support our members and providers during this challenging time.
United Behavioral Health (dba Optum Behavioral Health) and EAP are taking action to ensure health plan members affected by COVID-19 (coronavirus) have the support and resources they need. In order to make it easier for our members to receive appropriate treatment during this challenging time, we are encouraging providers and members to observe social distancing, isolation and quarantine rules as outlined by the CDC. To support this, consistent with an applicable Notice of Enforcement Discretion from the Office for Civil Rights (OCR) at the Department of Health and Human Services (Notice), on a temporary basis, health care providers, qualified and licensed in accordance with applicable regulations, may use audio or video communications technology immediately to deliver telephonic and telehealth care to Optum Behavioral Health plan members in addition to any HIPAA-approved telehealth technology as long as this method will effectively support the behavioral health needs of the individual member.
Similarly, the Substance Abuse and Mental Health Services Administration (SAMHSA) has issued guidance regarding the medical emergency section to 42 CFR Part 2 to ensure that substance use disorder treatment services are uninterrupted during this public health emergency. With respect to the latter, we encourage providers covered by 42 CFR Part 2 to confirm the application of the medical emergency exception, or some other permission, and proceed with the guidance below.
Telehealth Care and Services
Updated 10/8/2020 – 04:53 p.m. CDT
Effective immediately, Optum Behavioral Health is expanding our policies around telehealth services for our Medicare Advantage, Medicare Part B, Medicaid and commercial membership, making it easier for patients to connect with their behavioral health provider. Optum Behavioral Health will waive the Centers for Medicare and Medicaid’s (CMS) originating site restriction for Medicare Advantage, Medicaid and commercial members, so that care providers can bill for telehealth services performed while a patient is at home.
General Guidance Updates & FAQs
Updated 7/24/2020 – 10:43 a.m. CDT
United Behavioral Health (dba Optum Behavioral Health) is working to help people access health care to the fullest extent possible as we come together to address this national emergency. We’re adopting measures that will reduce administrative burden for physicians and facilities, helping members more easily access the care they need under their benefit plan, and adjusting programs and services, as needed, to protect members and help limit the spread of the COVID-19 virus in communities. Click here for FAQs.
Coding and Reimbursement
Updated 7/24/2020 – 11:05 a.m. CDT
Optum Behavioral Health is monitoring the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS) and other national and local resources to establish and update coding guidelines and reimbursement amounts.
Updated 3/26/2020 – 07:05 p.m. CDT
We’re expanding access to care, support and resources to help our members navigate through this unprecedented time. For more information, please visit Live and Work Well for Member Support Line and other resources.
Care providers can connect to the latest Centers for Disease Control and Prevention (CDC) guidance for health professionals, as well as travel advisories from the U.S. State Department. We will continue to add more resources when available.
- FREE COVID-19 Mental Health Resource Hub
- COVID-19 Resources for UnitedHealthcare members
- UnitedHealthcare COVID-19 Provider Resources and Information
- UnitedHealth Group Press Release – What We’re Doing
- COVID-19 Safety Tips
- FAQs - COVID-19 and temporary virtual visit policies (Revised 5/21/2020)
- Optum virtual visit telemental health platform
- UnitedHealth Group news release – COVID-19 Partner Resource Hub
- UnitedHealth Group news release – Access to Care and Coverage
- UnitedHealth Group news release – What We’re Doing
Taking care of our employees, who serve you every day
Our teams are working hard to serve our members and health care professionals. Due to the increased concerns related to COVID-19 you may experience longer than expected hold times. As a first step we are asking you to access the latest COVID updates and resources at our provider portal at provider express.com to resolve your immediate inquiry. If after utilizing our portal you are unable to resolve your inquiry, please call us back for assistance.
Optum Behavioral Health is not currently experiencing any delays to general business operations such as pre-authorizations, provider service lines or claims and reimbursement and is running at normal capacity and turnaround times. We are continually monitoring this situation and if we experience any disruptions to our normal processes we will communicate updates on Provider Express. We greatly appreciate your patience and understanding as we work through this together.
Optum remains committed to supporting you, our network of behavioral health providers, during this unprecedented and challenging time. We want to thank and commend you all for the difficult work you are doing to support the delivery of care to our members as you also work to ensure your personal safety and wellbeing and that of your loved ones.
We are monitoring the inquires we’re receiving on an ongoing basis and working hard to answer your questions. We will be making frequent updates to this page. Please be sure to check back often for the latest information.
The benefits described within this website describe federal and state requirements and Optum and its managed payors’ national policies. Additional benefits may be available in some states and under some plans, and applicable state insurance and similar laws and regulations are followed as indicated.