Tips for Communicating with Optum
This 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. Initially advocates reported difficulty obtaining files & communicating with Optum in preparation for appeals. We raised these concerns with MassHealth's Office of LTSS and this memo reflects policies clarified in December 2017 for obtaining information from Optum. The memo was revised in January toadd information about how to obtain a case file prior to an appeal.
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).
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