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FAQs

Find answers to common questions here.

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Why choose Optum

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  • We focus on care designed to keep each patient healthy. We do this by building a health care team, led by their doctor, that works together to meet each patient’s needs.

    This, along with our organization’s size and influence, helps us make the nation’s health system work better for everyone.

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  • Above all else, people want to be well. This is a priority for us and our patients. That’s why our doctors don’t focus on the number of patients they see each day. Instead, they work hard to keep each patient as healthy as possible.

    We urge our doctors to build strong relationships with patients and take the time to answer every question. Our goal is to keep you out of the hospital so you can live a healthy, active life. We track results and find ways to help our doctors deliver better care. 

    We also have processes in place that help make sure patients get the care they need. And when we do recommend specific care, it’s measured by one simple standard. It must always be in the patient’s best interest.

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  • At Optum, we work hard to keep you healthy, not just care for you when you’re sick. Our care is always in your best interest, both physically and financially. And it starts with our doctors.

    All of our doctors keep up with the latest research and proven care plans. This helps them create a personal wellness plan that’s right for you. They also work with other health care professionals across the country to find new ways to deliver better care.

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  • Our family of medical groups and physician networks offer care throughout Los Angeles, Orange, San Diego, Riverside and San Bernardino counties. 

    If you move to another city in Southern California, change jobs or switch insurance plans, the Optum family is near you and ready to help meet your health care needs.  

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Care and coverage 

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  • Getting the right care at every stage of life is important. That’s where primary care doctors come in. They help meet your everyday health needs and connect you to specialists if needed. 

    This gives you the benefit of having one doctor who knows you and your medical history, and who can oversee all aspects of your health care needs. 

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  • To change your doctor, call your health insurance plan’s member services department. The phone number is listed on your plan identification card. You can also visit patient support to learn more.

    Please have your card on hand when you call. We’ll need to get some information from you, including your member ID number.

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  • We have a large network that includes skilled medical professionals in almost every specialty. The specialists we contract with are carefully chosen and will work closely with your doctor to provide the care you need.

    If there’s a certain specialist you’d like to see, talk to your primary care doctor. He or she will recommend a specialist based on your needs. The choice will also depend on your health plan.

    If you have a question about the specialists in our network, visit patient support.

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  • Both Optum and our partner hospitals offer a variety of programs to help you take charge of your health. These include health screenings and one-on-one education. Many programs are available at no cost.

    For information, visit patient support.

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  • HMOs (health maintenance organizations) and PPOs (preferred provider organizations) are different types of health insurance plans. They differ by: 

    • The plan’s network 
    • The ability to see specialists without a referral 
    • Cost  
    • Coverage for out-of-network services 

    If you’re part of an HMO, your doctor needs to refer you to a specialist. This allows your doctor to coordinate care with the specialist.

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  • Optum is not an insurance plan. We’re a group of medical providers who contract with major health insurance plans. These include HMOs, PPOs, Original Medicare, Medicare Advantage plans and supplement plans. 

    The health insurance plans we accept may vary by location. Call the office of the Optum Care Network doctor you want to see to make sure they accept your health plan. You can also contact your health plan to find out if you can see an Optum provider.  

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Appointments and billing

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  • To schedule an in-person or virtual care appointment, call your doctor’s office. If your doctor thinks you need specialty care, you’ll be connected to a specialist. 

    Once you have a doctor, you can make appointments online using our secure portal. If you’re a new patient, we urge you to make an appointment right away so your doctor can get to know you and your health needs. 

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  • Bring your health insurance card, photo ID and copayment, if needed. We ask that you pay all copayments at the time of service. Copays are preset dollar amounts that you pay for covered health care services. These include appointments, medical equipment and prescriptions.

    You will be billed if the services received during your appointment aren’t covered by your health plan.

    General appointment information:

    • Please arrive at least 30 minutes before your first appointment. 
    • This allows time for you to complete paperwork if needed. It also gives us a chance to get acquainted. 
    • We suggest that you fill out the new patient registration form before your first appointment and bring it with you. This will help us serve you quickly. Learn more about preparing for your visit.
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  • Your doctor can approve a referral to a specialist during your visit. You can also ask for a referral by leaving a message with your doctor’s office. Depending on the type of specialist you want to see, your doctor may need to see you.

    If you have a PPO plan, no referral is needed. 

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  • Please call the office where you scheduled the appointment. We ask for at least 24 hours’ notice or as much notice as possible. That way, another patient might be able to fill your time slot. 

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  • The fastest way to refill a prescription is to call your pharmacy three to five business days before you run out. If there are no refills left, the pharmacy will call or fax your doctor’s office. You may need to see your doctor before your prescription can be renewed. 

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  • If you get a billing statement from Optum and have questions, please call 1-800-403-4160.

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Helpful resources

 

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Virtual care

Get the care you need, when you need it, without leaving home.

Primary care

Your primary care doctor helps you meet health needs small and large.

Specialty and surgical care

You're one of a kind. Your care should be, too.