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Tips for Communicating with Optum

Date: 
10/23/2020
Author: 
MLRI
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This May 2022 updated memo by MLRI provides contact information for MassHealth's Third Party Administrator for certain Long Term Services and Supports (LTSS), Optum. Optum began making prior authorization decisions for PCA and certain other LTSS services in the summer of 2017. The updated memo includes a table identifying the additional LTSS for which Optum is making decisions, and the name of their appeals coordinator (as of May, 2022) who you can ask for if needed.

The website below takes you to the MassHealth website with more information on the TPA LTSS (Third Party Administrator for Long Term Services and Supports).

 

UPDATE To OPTUM Communications Tip Sheet: In an undated (2021 or 2022) Guidance from MassHealth and Optum (attached), posted on Mass.gov,  they ask that  legal advocates representing people in an appeal call the LTSS Provider Line, 844-368-5184. Choose the menu option for members (currently Option 1) and then select the option for appeals (currently Option 2). 

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