Commercial Transplant Facilities (Pediatric)
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Defines in-network access and network alignment for Alliant Health pediatric members needing transplant services, describing use of Optum's Commercial Pediatric Transplant Centers of Excellence and who within the organization it affects.
No material clinical or coverage changes in this revision.
Pediatric Transplant Network Coverage
Pediatric transplant network coverage
Covered when the following network-access and member-option statements apply:
Member options
- Members seeking access to transplant facilities outside Optum's Pediatric COE Network may contact Client Services for guidance on appeals or alternative options.
Coding and Program Selection Criteria
| No codes listed |
Network Access and Member Support
Network access and member support — in‑network access, cost‑share parity, and Client Services assistance
Alliant pediatric members have in‑network access to transplant programs included in Optum’s Commercial Pediatric Transplant Centers of Excellence (COE) Network and receive identical cost‑share terms as other in‑network facilities. Providers should direct families to Client Services for members who request care outside the Optum Pediatric COE Network; Client Services can provide guidance on appeals or alternative options and member support resources. Details of the Pediatric COE Network are available at MyOptumHealthComplexMedical.com and members may contact Alliant Client Services or visit AlliantPlans.com for additional questions.
- Treat referrals to Optum Pediatric COE programs as in‑network for Alliant pediatric members with the same cost‑share as other in‑network facilities.
- If a member requests a non‑COE facility, contact Alliant Client Services to initiate guidance on appeals or alternative options and to coordinate member support.
- Use MyOptumHealthComplexMedical.com for Pediatric COE network details and AlliantPlans.com or Client Services for additional member resources.
Definitions
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