Provider Forms

Note: PDF forms require Adobe Acrobat Reader.

If you are a provider wanting to appeal a claim determination, please click here.

Credentialing - Email: credentialingahp@optum.com or Fax Forms to 763-847-4814

Medical Management - Fax Forms to 763-847-4014

Provider Relations - Fax Forms to assigned Provider Relations Representative or 763-847-4010 Attn: Provider Relations