Summary
Effective Jan. 1, 2024, Presbyterian expanded its contractual relationship with Optum Care Network of New Mexico, LLC, so Optum administers authorization requests and hospital admission notifications for Presbyterian Medicare Advantage members assigned to an Optum-employed primary care provider or to a PCP participating with Optum's IPA network. Claims for all Presbyterian Medicare Advantage members must still be submitted to Presbyterian, and providers who are not contracted with Optum will see no change to their claims process. Members not assigned to an Optum-employed or IPA PCP keep the current authorization and inpatient notification process.
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