OptumRx prior authorization fax number (2026)

OptumRx says it is "retiring most fax numbers" for pharmacy prior authorization (PA) requests on every plan it manages, except in Massachusetts, Rhode Island, South Carolina and Texas. Optum gives no date and prints no fax number on its guidelines or electronic prior authorization pages. It strongly encourages electronic requests (ePA) and gives 1-800-711-4555 for urgent ones.

Fax lines do appear on the PDF request forms that Optum links from its e-PA page, and those forms print at least five different ones.

Which OptumRx route fits my request?

Optum's drug-specific guidelines cover plans on its standard drug lists only, and they may not apply to a plan with its own formulary. The guidelines page gives the urgent line 5 a.m. to 10 p.m. PST, Monday through Friday. The e-PA page gives the verbal line the same weekday hours in PT, adds 6 a.m. to 3 p.m. PT on Saturday and closes Sunday. It also lists 1-800-791-7658 as a Home Delivery Pharmacy contact, for provider relations (press 1, then 5) and a provider-dedicated pharmacist (press 1, then 2).

Which states does the fax retirement leave out?

Optum excepts four: Massachusetts, Rhode Island, South Carolina and Texas. The e-PA page links four Massachusetts forms and one Texas form among its state forms, a Rhode Island form among its UnitedHealthcare forms and no South Carolina form. The Massachusetts, Rhode Island and Texas forms print the same fax line as the Arizona and Florida forms, and Optum does not say which lines it keeps.

What do the fax lines on Optum's forms say?

The e-PA page links 43 request forms under four headings, and the general form appears under two of them. At least 22 print the same line, among them five of the seven UnitedHealthcare forms, Rhode Island's included, and the Arizona, Florida, Massachusetts and Texas forms. The general request form and the benzodiazepine, opioid and hospice forms print a second. The Optum Rx healthcare reform copay waiver form, the California delegated-group form and the three Emergient plan forms print a third, a fourth and a fifth. Four of the five differ only in the last digit, so a number copied from the wrong form is easy to miss.

The general form says not to copy it for later use, since forms are updated frequently and may be barcoded. It asks for the office's own fax number, so enter the line the practice receives on.

What does Optum want in place of a fax?

Electronic prior authorization. The guidelines page says Optum strongly encourages it, and the e-PA page says ePA decisions can come two to three times faster than phone or fax, with the faster determinations at no additional cost. Optum names six portals: CoverMyMeds, Surescripts, PreCheck MyScript, DrFirst, CenterX and Allscripts. Chart notes go into the same request as JPEG, TIFF or PDF files, so no separate fax of notes follows, and a portal that lacks the upload needs its vendor to turn it on.

What does the OptumRx general form ask for?

Page two says the request is not for a buy and bill drug. A medication the physician's office supplies is outside what OptumRx may review, and the form sends those questions to the patient's medical benefit. For everything else it asks for:

• The member's name, insurance ID, date of birth, address and phone
• The provider's name, NPI, specialty, address, office phone and office fax
• The drug, dosage form, strength and directions, with boxes for a brand request and a continuation of therapy
• The diagnosis and ICD-10 codes, every drug tried with its strength, trial length and reason it stopped, any contraindication or intolerance, and supporting labs
• For a quantity limit request, the quantity per day and the reason for exceeding the limit

The prescriber attests that the answers are true, with notice that OptumRx may audit them, and signs. A line beside the signature names whoever completed the form, so someone other than the prescriber can prepare it. HIPAA counts preauthorization of services as part of payment (45 CFR 164.501) and asks a covered entity to make reasonable efforts to limit a disclosure to the minimum necessary (45 CFR 164.502(b)). The form's fields mark what a request needs.

How do you send an OptumRx request from a HIPAA fax account?

1. Call 1-800-711-4555 and ask whether a fax line applies to the patient's plan and state, and which one.
2. Save the signed form as a PDF and send it from your browser or your email.
3. Enter the line Optum gave you and compare it with your call notes, digit by digit.
4. Send, then file the delivery certificate with the request.

The business associate definition in 45 CFR 160.103 includes a person who handles protected health information for a covered entity by creating, receiving, maintaining or transmitting it (why a BAA is required). Every Fax Pigeon plan includes a signed BAA, executed at signup. Basic is $4.99 a month billed annually for 200 pages, sent and received combined (plans and pricing). The cover sheet and the packet are covered in How to fax a prior authorization request.

What if the fax fails or the number changes?

If the sent fax has no delivery certificate to open, call 1-800-711-4555 before you send again, since a line printed on a form may be one Optum has retired. It has retired lines before: a Culinary Health Fund provider newsletter dated September 6, 2019 says six OptumRx pharmacy prior authorization fax numbers would retire on October 1, 2019. It also names 1-800-711-4555 as the number to call. Download the form from Optum's e-PA page each time instead of reusing a saved copy. A misdirected fax is its own HIPAA problem, covered in Is a fax sent to the wrong number a HIPAA breach?.

A practice changing fax providers keeps its number by porting it in before it cancels. A port-in costs nothing on a paid plan, and most transfers finish in 5 to 15 business days.

* Phone numbers, hours, states and form details verified October 11, 2026, on Optum's own pages: the prior authorization guidelines and procedures page (https://business.optum.com/en/support/professionalrx-resources/pa-guidelines-procedures.html), the electronic prior authorization page (https://business.optum.com/en/pharmacy-services/electronic-prior-authorization.html) and the request forms it links. The 2019 notice is in the Culinary Health Fund's PPO provider newsletter of September 6, 2019 (https://www.culinaryhealthfund.org/library/provider_notices/2019/PPO_Provider_Newsletter_English_2019_09_06.pdf). Confirm the fax line by phone before you send patient information. Fax Pigeon is not affiliated with OptumRx, Optum or the Culinary Health Fund.