Need to check on your spouse's claims? Did you recently move and would like to update each member of your family’s address at one sitting?
These are two examples of when a signed Authorization for Use or Disclosure form is required.
With a signed form on file, Optima Health will allow you or the person(s) you authorize (designated agents) to obtain and/or change your health information. For example you could designate someone to do any or all of the following with an Authorization for Use or Disclosure of Medical Information or a Designated Representative Authorization:
- Obtain claims information
- Change your primary care physician (PCP)
- Update an address, phone or email
- Update other policy information
The signed form authorizes Optima Health to make the change or release specified information to you or your designated agent. Please note:
- The signed forms are valid for 2 years unless you elect a shorter time frame on the form.
- You may revise or revoke this authoriization at any time by contacting Optima Health. There is a Revocation of Authorization form that must be completed.
- The signed form must be received by Optima Health in order for it to be effective.
- Include your Member ID number
Once this form is on file, you may also authorize your spouse to make specified changes when visiting My Optima. Simply follow the prompts for authorizing spouse privileges to view claims, referrals and authorizations. If you have any questions, contact Member Services.
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