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GUIDELINES & POLICIES

Optum follows national guidelines and policies to ensure the integrity of our network.  

Best Practice Guidelines

Click here to view the Optum Best Practice Guidelines which are located at our partner website, Provider Express.  

Level of Care Guidelines

Idaho Medicaid Supplemental Clinical Criteria (Optum Idaho Level of Care Guidelines) - Effective 1/01/2021

Network Provider Audit Tools

Network Provider Manual  

Provider Manual
Provider Manual Change Index

Optum Idaho will publish the updated Provider Manual on February 1, 2021. Please review the following notable provider alerts related to changes to the IBHP, effective January 1, 2021:
December 1, 2020 - Change in Minimum Provider Age for Respite Services
December 1, 2020 - Opioid Treatment Programs
December 1, 2020 - Peer Services Opportunities and Updates

If you have any questions, please contact your Provider Relations Advocate.

Provider Clinical Questions: (855) 202-0983  | Primary Care Provider Psychiatric Consult press option 1