Prescribing with OptumRx

Mail order pharmacy

You have three options for prescribing with OptumRx Home Delivery starting January 1, 2022:

  1. ePrescribe – Add the OptumRx profile in your electronic medical record (EMR) system using the following information: OptumRx Mail Service, 2858 Loker Ave East, Suite 100, Carlsbad, CA 92010; NC PDP ID = 0556540; PID = P00000000020173.
  2. Call an OptumRx pharmacist at 1-800-791-7658
  3. Fax a completed form to OptumRx at 1-800-491-7997

Prescribing for specialty medications

  1. Phone – 1-855-427-4682
  2. Address – P.O. Box 2975, Mission, KS 66201
  3. Fax (for prescription submissions only – no PAs) – 1-877-342-4596

ePrescribing with OptumRx

First, add the OptumRx profile in your EMR system to send the prescription directly to OptumRx. Make sure to verify your EMR software is certified for e-prescribing controlled substances (EPCS) to comply with the 1/1/2020 requirement of eRx for all controlled substances.

Check the Fallon member’s benefit plan for current prescription coverage and price. Identify possiblemedication alternatives. If necessary, submit a prior authorization request using your preferred electronic prior authorization portal—CoverMyMeds or Surescripts, for example. Then submit the e-prescription to OptumRx.

For more help on successfully submitting a prescription to OptumRx, please visit https://professionals.optumrx.com/resources/manuals-guides/successful-prescription-submission.html.