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Optum behavioral health billing trips up experienced billers because the rules live in two places. Optum, operating as United Behavioral Health, administers behavioral benefits on behalf of UnitedHealthcare, while medical authorizations and claims follow UnitedHealthcare’s own process. A claim can be clinically sound and still stall because it went to the wrong payer ID, skipped an authorization, or reached Optum on day 91.
https://mentalhealthbilling.us/optum-behavioral-health-billing-authorization-and-claims-submission-guide/
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MENTALHEALTHBILLING.US
Optum Behavioral Health Billing: Authorization and Claims Submission Guide
Optum behavioral health billing guide: which services need authorization, how Gold Card waivers work, and how to submit claims with payer ID 87726.
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