Plan Name: Optima Health Plans - Optima Medicaid, Exchange & Commercial plans
BIN: 610011
PCN: OHPMCAID/OHPCOMM/OHPQHP
Due to inclement weather, Optima Health Plans has decided to implement the
disaster recovery edit, which lifts all Prior Authorization edits. This edit will allow
claims to pay for prescriptions that require Prior Authorization and/or a DUR to
ensure there is no member disruption. If you have a rejected claim for an Optima
Health Commercial, Exchange or Medicaid member please reprocess the claim
and complete member outreach.
*Please see attached for more information.