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Prior Authorization Request Form Fax Back To: 18008533844 Phone: 18007114555 5 AM 7 PM PT MF or visit www.OptumRx.com and click Health Care Professionals for online real-time submission 24/7 Prior
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How to Fill out a Received Electronic Fax:

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Start by opening the electronic fax message. Click on the attachment or link provided to access the document.
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Received this electronic fax is a digital document transmitted over a network, typically over the internet, to a recipient's electronic device.
The recipient or the intended recipient of the electronic fax is required to file it.
Received electronic faxes can be filled out by using a computer or electronic device with appropriate software for viewing and editing digital documents.
The purpose of receiving an electronic fax is to provide a paperless method of sending and receiving documents quickly and securely.
The information to be reported on received electronic faxes may vary depending on the content of the document being transmitted.
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