Claim Entry through Provider Express

Introduction

Optum's clinician website, Provider Express, supports entry of outpatient behavioral health claims by a registered user. This time-saving and secure transaction feature is designed to streamline the claim submission process with Provider Express.

Here are some advantages we think you will find:

  • Faster claim payment and disposition
  • Reduced mailing time and expense
  • Faster claim form completion
  • More accurate claim information
  • Higher level of auto-adjudication

Claims Supported by Provider Express Claim Entry

  • Claims for traditional behavioral health services
  • Claims for EAP services 
  • Claims from a participating clinician
  • Claims from a non-participating clinician

Claims Not Supported by Provider Express Claim Entry

  • Claims from clinicians in some specialized arrangement status with Provider Express (e.g., clinicians who only see patients from a specific employer group, or Autism claims)
  • Claims for services administered on external claims systems
  • Claims for any facility-based behavioral health service (such as residential, inpatient, partial hospitalization, or intensive outpatient treatment)

Frequently Asked Questions About Claim Entry through Provider Express