UM Program

UM Program (California only)

Clinical Policies

  Clinical Policies

The services described in OptumHealth Care Solutions, LLC. policies are subject to the terms, conditions and limitations of the Member's contract or certificate. OptumHealth reserves the right, in its sole discretion, to modify policies as necessary without prior written notice unless otherwise required by OptumHealth's administrative procedures.

Certain policies may not be applicable to Self-Funded Members and certain insured products. Refer to the Member's plan of benefits or Certificate of Coverage to determine whether coverage is provided or if there are any exclusions or benefit limitations applicable to any of these policies. If there is a difference between any policy and the Memberís plan of benefits or Certificate of Coverage, the plan of benefits or Certificate of Coverage will govern.

The materials provided to you are guidelines used by this plan to authorize, modify, or deny care for persons with similar illnesses or conditions. Specific care and treatment may vary depending on individual need and the benefits covered under your contract.

Please forward any commentary or feedback on OptumHealth Policies to: policy.inquiry@optumhealth.com

Please select one of the Clinical Policy's presentation views from the menu.