Optimum HealthCare offers a comprehensive Provider Portal designed to streamline administrative processes and enhance communication between healthcare providers and the insurance network. This digital platform provides critical tools and resources to support healthcare professionals in managing patient care and administrative tasks efficiently.
Official Links
- Tools & Resources: https://www.youroptimumhealthcare.com/provider/tools_and_resources
- Claims Portal: https://www.youroptimumhealthcare.com/provider/claims
What Healthcare Providers Can Do
The Optimum HealthCare Provider Portal, known as HealthAxis Provider Portal 3.0, offers multiple critical functionalities for healthcare professionals:
Key Portal Features
- Submit and track medical claims
- Access electronic payments
- Review provider resources
- Download essential documentation
- Submit case management referrals
Access and Login
Portal Access Requirements
- Valid provider credentials
- Active Optimum HealthCare contract
- Registered account with HealthAxis Provider Portal
Critical Resources Available
Provider Tools
- Medicare Quick Reference Guide
- EDI Clearinghouse (Availity)
- Sample ID Card for 2025
- Case/Disease Management Referral Forms
- Cultural Competence Orientation Materials
Compliance Resources
- Training Management System
- Compliance Training Documents
- Conflict of Interest Policy
- Standards of Conduct Documentation
Specialized Portals
Additional Portal Access
- MRA-HEDIS Portal
- Review MRA scores
- Check diagnosis details
- Examine HEDIS key measure information
Clinical Healthcare Resources
Providers can access:
- Clinical Practice Guidelines
- Prescription Drug List
- Pre-Certification Process Information
- SNP (Special Needs Plan) Provider Information
Claims Submission Process
Electronic Claims
- Partner with PaySpan Health
- HIPAA-compliant Electronic Funds Transfer (EFT)
- Electronic Remittance Advice (ERA)
- Direct system integration capabilities
Paper Claims Submission
Mailing Address:
Optimum HealthCare, Inc.
Claims Department
P.O. Box 151258
Tampa, FL 33684
Privacy and Security
Optimum HealthCare ensures:
- HIPAA compliance
- Secure data transmission
- Protected provider and patient information
- Mandatory compliance training
Customer Support
Contact Information:
- Toll-Free: 1-866-245-5360
- TTY/TDD: 711
Operating Hours:
- October 1 to March 31: 7 days/week, 8 a.m. to 8 p.m. EST
- April 1 to September 30: Monday-Friday, 8 a.m. to 8 p.m. EST
Unprovided Information
Some specific details about the exact login process, potential mobile app availability, and comprehensive step-by-step portal navigation were not explicitly detailed in the provided sources.
The Optimum HealthCare Provider Portal represents a robust digital platform designed to support healthcare professionals with efficient, secure, and comprehensive administrative tools.
Last Updated: 06/16/2025
FAQ
What is optimum medical?Who are we? Optimum Medical are a UK based healthcare manufacturer, specialising in Intermittent Self Catheterisation, Urology and Healthcare Lubrication.
Is optimum an hmo?Optimum Gold Plan is a Medicare Advantage Prescription Drug (MAPD) Health Maintenance Organization (HMO) plan that combines hospital, medical, and drug coverage into one streamlined option.
What is Medicare Optima?CalOptima Health OneCare (HMO D-SNP) is a Medicare Advantage Dual Special Needs Plan for low-income seniors and people with disabilities who are enrolled in both Medicare and Medi-Cal.
Are Freedom and Optimum the same company?
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Ritter Insurance Marketinghttps://ritterim.comContract to Sell Freedom Health & Optimum HealthCare ProductsFreedom Health and Optimum HealthCare are part of an Elevance Health company that offers a broad portfolio of affordable and benefit-rich Medicare Advantage pla…
https://www.youroptimumhealthcare.com/provider/tools_and_resources
This section places critical practice resources at your fingertips. From health care to administrative tools, here you’ll find the information you need most.
https://www.youroptimumhealthcare.com/provider/claims
Use the tools in this section to expedite your claims payments by submitting all required information. To obtain claims status, please log into our secured