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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 fax back to 1-800-853-3844:

1. Gather the necessary documents that need to be faxed. These could include completed forms, contracts, or any other paperwork required.
2. Make sure you have a fax machine or access to a fax service. You can use a traditional fax machine if you have one, or utilize online fax services that allow you to send faxes via email or through a web interface.
3. Dial the fax number, 1-800-853-3844, on your fax machine or input it into the online fax service.
4. Prepare the fax cover sheet. Include the sender's contact information, recipient's information, and any additional instructions or notes. This cover sheet is like the envelope for your fax and provides important details for the recipient.
5. Organize the documents you want to fax in the correct order. If there are multiple pages, make sure they are numbered or clearly marked to avoid confusion.
6. Place the documents face down in the fax machine's document feeder or attach them to an email if using an online fax service. Ensure that the pages are free of creases, wrinkles, or tears as this may affect the quality of the fax.
7. Double-check that the fax number is correct, and press the send button on your fax machine or click the send button in your online fax service. The machine will start dialing and transmitting the fax to the recipient's fax machine.
8. Wait for the transmission to complete. It may take a few minutes depending on the length and complexity of the document being faxed.
9. Once the fax has been successfully sent, you can check for a confirmation receipt or confirmation email from the recipient. This will help ensure that the fax was received and delivered correctly.

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Fax back to 1-800-853-3844 is a form to submit information through fax to the provided number.

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