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An updated and reformatted Provider Manual with Supplements is now available online. Providers can easily access the manual by clicking the “Provider Manual” link that appears at the bottom of each page on this site.

Please note:

  • There is a core Provider Manual with separate Supplements for Optima Family Care, Hospital and Ancillary, and Optima Medicare HMO.
  • The core Provider Manual has the basic information that applies to our commercial products and policies and procedures that apply across all products and provider types.
  • The Supplements have information and exceptions that are specific to Optima Family Care, Hospital and Ancillary providers or the Optima Medicare HMO.

Providers that have a web link referenced in their Provider Agreement should note that the information has changed to the location and format referenced above. There are no longer separate manuals for Hospitals or Behavioral Health; all information is contained in the core Provider Manual and the supplements.

These changes are part of a larger effort to simplify and improve our provider education tools, and we will continue to refine this process.

If you have any questions about the Provider Manual, please contact your Network Educator at 1-877-865-9075.