Utilization and care management delegation for select members

Beginning Jan. 1, 2025, care management and utilization management of medical services and Medicare Part B drugs for CarePartners of Connecticut members with an Advance Plus Network – Connecticut (APN-CT) primary care provider will be delegated to APN-CT, a partnership of Optum® and Hartford Healthcare. Part D pharmacy benefit drugs will continue to be reviewed by CarePartners of Connecticut. 

Current CarePartners of Connecticut prior authorization requirements and medical necessity guidelines will continue to apply for these members. 

How to obtain prior authorization through APN-CT

If you are aware that one of your CarePartners of Connecticut patients has an APN-CT primary care provider (PCP), you can request authorization for medical services and Part B drugs directly with APN-CT.  You can submit the request to APN-CT in one of the following ways:

  • Online: via the Optum Pro portal at optumproportal.com (Have questions? Select Contact Us in the portal to submit your question or issue.)
  • Phone: 1-888-556-7048, 8 a.m.– 6 p.m. ET, Monday–Friday (only if online unavailable)

If you are unsure whether the patient has an APN-CT PCP, continue to utilize the CarePartners of Connecticut provider portal as you do today; in the event that the patient does fall under this delegation agreement, you will be automatically redirected to the Optum Pro portal. 

Register for Optum Pro
If you don’t have an Optum Pro account, please register for an account today to get started. Registered users have access to several eLearning resources to help navigate the portal. To view eLearnings:

  • Sign in to Optum Pro
  • Select Education & Training from the navigation ribbon on the left
  • eLearnings are available in the Activity section:
    • Select + to expand the collapsed Activity section
    • Select Start to begin the eLearning(s) in the expanded Activity section 

For additional support, contact APN-CT at 1-888-556-7048, 8 a.m.–6 p.m. ET, Monday–Friday.

Appeals and claims

This delegation only includes utilization management and care management. Please continue to follow the existing process for all other requests including:

  • Appeals: If a prior authorization is denied by APN-CT, you or the member have the option to file an appeal through CarePartners of Connecticut.
  • Claims: Submit claims to CarePartners of Connecticut. For the fastest processing time, we recommend submitting claims electronically. 

For further guidance on these transactions, please refer to the CarePartners of Connecticut Provider Manual.