December 2025

December Payer Processing Issues

Summary

When Optum discovers issues or interruptions to transaction processing, the details* will appear below.

If you're looking for a specific payer or specific transaction type, please use Ctrl + F on Windows or ⌘ + F on Mac to find that term within the page.

*These updates can also be found within Optum Customer Care Hub under Payer Processing Issues: https://customercare.optum.com/public/home.html

VIEW ALL PAYER LISTS →

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Beaver Medical Group
Payer ID: 45967
Payer Enrollment Required: Yes
Remittance Payer Type: Nonpar
Payer Location: California

Payer Name: Pinnacle Medical Group
Payer ID: 95271
Payer Enrollment Required: Yes
Payer Location: California
Payer type: Nonpar

Action Required:

Add the payers to your system to begin using the new payer connection.
Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum.

12/11/2025

Report Generation Delay for CPID 6284 Trillium Health Resources

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted Nov. 12, 2025 and Nov. 18, 2025.

Payer impacted:

CPID 6284 Trillium Health Resources

The payer has been unable to generate and deliver the reports.

Action Required: None. Please resubmit claims if payment has not been received.

If you have any questions, please contact Customer Support and refer to Case Number 09803220.

12/11/2025

Report Generation Delay for CPIDs 7543 and 2803 UPMC Health Plan

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 5, 2025.

Payer impacted:

CPID 7543 UPMC Health Plan
CPID 2803 UPMC Health Plan

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09802832.

12/11/2025

Elips Life Insurance Company Real Time Eligibility 270/271

Effective December 10th, 2025 Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer:

Payer Name: Elips Life Insurance Company
Industry Payer ID: 14330
IMN Real Time ID: 14330
Exchange Real Time ID: ELPSE
CPID(s): N/A
Optum IEDi Real Time ID: 14330
Payer Enrollment Required: No
Connection Type: X12

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Member ID

12/11/2025

Payer Processing Issue for CPIDs 6705 and 9679 Prime Community Care of Central Valley

Due to a payer intermediary processing issue, Institutional and Professional claims transmitted to the payer listed below between Oct. 13, 2025 and Dec. 10, 2025 were not processed by the payer intermediary.

Payer impacted:

CPID 6705 Prime Community Care of Central Valley
CPID 9679 Prime Community Care of Central Valley

A resolution has been implemented and the claims were retransmitted to the payer intermediary on Dec. 11, 2025.

This delay affected claims released to Optum between 5 p.m. CT on Oct. 10, 2025 and 5 p.m. CT on Dec. 10, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09801039.

12/11/2025

Report Generation Delay for CPIDs 2708 and 7595 StandardHealth with Health Choice (HCS)

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 2, 2025.

Payer impacted:

CPID 2708 StandardHealth with Health Choice (HCS)
CPID 7595 StandardHealth with Health Choice (HCS)

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09802631.

12/11/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Beaver Medical Group
Institutional CPID: 1967
Professional CPID: 6275
Payer-assigned Payer ID: 45967
Line of Business (LOB) Code: K40
Payer Enrollment Required: Yes
Payer Location: California

Action Required:

Add the payers to your system to begin using the new payer connection.
Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum.

12/11/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Pinnacle Medical Group
Institutional CPID: 3945
Professional CPID:1106
Payer-assigned Payer ID: 95271
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California

Action Required:

Add the payers to your system to begin using the new payer connection.
Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum.

12/11/2025

Update: Report Generation Delay for CPID 7171 Neighborhood Health Plan of Rhode Island

Update: The payer has been unable to generate and deliver the reports for some claims submitted on Nov. 21, 2025.

Action Required: Please resubmit claims if payment has not been received.

Original notice sent Dec. 2, 2025:

A payer is experiencing issues affecting Professional report generation for some claims submitted on Nov. 21, 2025.

Payer impacted:

CPID 7171 Neighborhood Health Plan of Rhode Island

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted on Nov. 21, 2025.

If you have any questions, please contact Customer Support and refer to Case Number 09792856.

12/11/2025

Report Generation Delay for Multiple CPIDs

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for claims submitted since Dec. 1, 2025.

Payers impacted:

CPID 1086 MDwise Healthy Indiana Plan
CPID 8113 MDwise Healthy Indiana Plan
CPID 1085 MDwise Hoosier Healthwise
CPID 8112 MDwise Hoosier Healthwise

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09802697.

12/11/2025

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below Dec. 10, 2025 were not processed by the payers.

Payers impacted:

8714	Allstate Insurance Company
8454	AllyAlign Health
9712	American Health Plans
9731	American Health Plans
9142	American Health Plans
7854	American Health Plans
9117	American Health Plans
8879	American Health Plans
7782	American Health Plans
7794	Associated Hispanic Physicians IPA
7272	Axminster Medical Group
1407	Blue Cross and Blue Shield of Georgia
3498	Blue Cross and Blue Shield of Illinois
2857	Blue Cross Blue Shield of South Carolina
4881	Cambia Health Solutions
2404	Cambia Health Solutions
2412	Cambia Health Solutions
2788	Cambia Health Solutions
7426	Cambia Health Solutions
7451	Cambia Health Solutions
1209	Cambia Health Solutions
4246	Capital Health Plan
2164	Carelon Health
1194	CareSource
7143	CareSource
3826	CareSource
7263	CareSource
6259	CareSource
3488	CareSource
3293	Carlon Health
1764	Centene
9433	Centene
3706	Centene
9118	Centene
9430	Centene
7763	Columbine Health Plan
6778	Common Ground Healthcare Cooperative
8834	Commonwealth Care Alliance
7760	Community Care Health Plan of Louisiana, Inc.
6865	Community Care Plan
6795	Contra Costa Health Services
3856	Core Administrative Services
1232	Denver Health
8135	Doctors HealthCare Plans Inc
4279	El Paso First Health Plans
1741	Elevance Health
1415	Elevance Health
1420	Elevance Health
1412	Elevance Health
2421	Elevance Health
7446	Elevance Health
1408	Elevance Health
7496	Elevance Health
7422	Elevance Health
4437	Elevance Health
2418	Elevance Health
1413	Elevance Health
1401	Elevance Health
1169	Elevance Health
1167	Elevance Health
9162	Elevance Health
4743	Elevance Health
6127	Elevance Health
8123	Elevance Health
4448	Elevance Health
8867	Elevance Health
9133	Elevance Health
8124	Elevance Health
8473	Elevance Health
1775	Elevance Health
5483	Employee Benefit Management Services
1834	EPIC Insurance Midwest
9215	Everpoint
7738	Evolent Health
5238	Evolent Health
8812	Evolent Health
8708	Evolent Health
8816	Evolent Health
9414	Evry Health
3792	Fidelis Care New York
7435	FirstCare Health Plans
1414	Florida Blue Cross Blue Shield
3417	Florida Blue Cross Blue Shield
9128	Florida Blue Medicare
2298	Gateway Health Plan
1405	Health Care Service Corporation (HCSC)
7403	Health Care Service Corporation (HCSC)
1403	Health Care Service Corporation (HCSC)
1406	Health Care Service Corporation (HCSC)
1243	Health Care Service Corporation (HCSC)
5865	Health Care Service Corporation (HCSC)
5243	Healthcare Management Administrators, Inc
1723	HealthCare Partners, IPA
6220	Heritage Provider Network
2830	Humana
8814	Integrated Homecare Services
5479	IU Health Plans
7715	Johns Hopkins Healthcare
5432	Johns Hopkins Healthcare
6273	Lifepath Hospice
2810	Lucent Health
8860	Medica Health Plan Solutions
7859	Medica Health Plan Solutions
6799	Medica Health Plans
4423	Medical Mutual of Ohio
4714	Medigold
9102	Meridian Health Plan
1421	Michigan Blue Cross Blue Shield
2426	Michigan Blue Cross Blue Shield
2287	Michigan Blue Cross Blue Shield
1402	Minnesota Blue Cross Blue Shield
7892	Minnesota Blue Cross Blue Shield
8723	Minnesota Blue Cross Blue Shield
2411	Noridian
7489	Noridian
8864	North Dakota Blue Cross Blue Shield
7829	Passport Health Plan
8128	Pool Administrators Inc (PAI)
5838	Preferred Administrators
4252	Presbyterian Healthcare Services
2807	Professional Benefit Admin IL
7281	PruittHealth Premier
5428	Qualchoice
7264	Quartz Health Solutions, Inc.
6423	RevClaims
1776	RIS Rx
4464	SCAN Health Plan
7499	Sentara Healthcare
9438	Shared Health
7225	Sharp Community Medical Group
5835	Trilogy Health Network
6849	United Group Programs
7493	Vermont Blue Cross Blue Shield
4258	Visiting Nurse Service of New York
3757	Water Street
1844	Wellcare
3248	Wellcare
1404	Wellmark
6733	Wellmark
2490	Wellmark
9441	Wellspace NEXUS LLC
2720	Zelis Healthcare

A resolution has been implemented and the claims were retransmitted to the payer intermediary Dec. 11, 2025.

This delay affected claims released to Optum Dec. 10, 2025, 2:00 p.m.-6:00 p.m. CT.

Action Required: Be aware of the processing issue above.

12/11/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Beaver Medical Group
Institutional CPID: 1967
Professional CPID: 6275
Payer-assigned Payer ID: 45967
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California

Action Required:

Add the payers to your system to begin using the new payer connection.
Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum.

12/11/2025

Electronic Routing and Payer ID Change Prime Community Care of Central Valley

Optum will be changing electronic claims routing and Payer ID for the following payer, effective Dec. 12, 2025:

Payer Name: Prime Community Care of Central Valley
Old Payer ID: MVCV1
New Payer ID: MVCV0
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Type: Nonpar

Optum will be terminating electronic claims routing and Payer ID for the following payer, effective Jan. 2, 2026:

Payer Name: Prime Community Care of Central Valley
Payer ID: MVCV1

Action Required: Please consider the following to allow transactions to be processed properly due to the above changes:

Make any necessary system changes.
No Payer Alias name changes are required. Payer name is not changing.

12/10/2025

Report Generation Delay for CPID 5554 Maryland Medicare

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since Dec. 5, 2025.

Payer impacted:

CPID 5554 Maryland Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09800893.

12/10/2025

Report Generation Delay for CPID 2456 Delaware Medicare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Dec. 4, 2025.

Payer impacted:

CPID 2456 Delaware Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09800892.

12/10/2025

Report Generation Delay for CPID 1440 Texas Medicare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Dec. 4, 2025.

Payer impacted:

CPID 1440 Texas Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09800897.

12/10/2025

Update: Report Generation Delay for CPID 5599 Capital Blue Cross of Pennsylvania Facility Contracted Providers

Update: It has been determined that the payer had a processing issue. A resolution has been implemented and the claims were retransmitted to the payer Dec. 10, 2025.

This delay affected claims released to Optum Dec. 1, 2025, 3:00 p.m.-Dec. 2, 2025, 3:00 p.m. CT.

Action Required: Be aware of the processing issue above and of possible invalid duplicate rejections.

Original notice sent Dec. 8, 2025:
A payer is experiencing issues affecting Institutional report generation for some claims submitted Dec. 2, 2025.

Payer impacted:

CPID 5599 Capital Blue Cross of Pennsylvania Facility Contracted Providers

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09798200.

12/10/2025

Update: Report Generation Delay for CPIDs 1997 and 7451 Regence Blue Shield of Washington

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Nov. 10, 2025.

Action Required: Please resubmit claims if payment has not been received.

Original notice sent Nov. 24, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Nov. 10, 2025.

Payer impacted:

CPID 1997 Regence Blue Shield of Washington
CPID 7451 Regence Blue Shield of Washington

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09787853.

12/10/2025

Payer Processing Issue for CPIDs 4405 and 5548 Arizona Medicaid

Due to a payer processing issue, Professional and Institutional claims transmitted to the payer listed below between Sept. 19, 2025 and Sept. 23, 2025 were not processed by the payer.

Payer impacted:

CPID 4405 Arizona Medicaid
CPID 5548 Arizona Medicaid

A resolution has been implemented and the claims were retransmitted to the payer on Oct. 2, 2025.

This delay affected claims released to Optum between 3 p.m. CT on Sept. 18, 2025 and 3 p.m. CT on Sept. 23, 2025.

Action Required: Be aware of the processing issue above and of possible invalid duplicate rejections.

If you have any questions, please contact Customer Support and refer to Case Number 09715241.

12/10/2025

Electronic Routing and Payer ID Change for CPIDs 9679 and 6705 Prime Community Care of Central Valley

Optum will be changing electronic claims routing and Payer ID for the following payer, effective Dec. 10, 2025:

Payer Name: Prime Community Care of Central Valley
Professional CPID: 6705
Institutional CPID: 9679
Old Payer-assigned Payer ID: MVCV1
New Payer-assigned Payer ID: MVCV0
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers.

Enrollment Requirements

Claims:

Payer enrollment for electronic claims is not required.

Action Required: Please consider the following to allow transactions to be processed properly due to the above changes:

Make any necessary system changes.

12/10/2025

Electronic Routing Change for CPID 5159 Prism Univera

Optum will be reactivating and rerouting electronic claims routing for the following payer, effective Dec. 10, 2025:

Payer Name: Prism Univera
Professional CPID: 5159
Payer-assigned Payer ID: 37315
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: $0.10

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Report Changes
You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/9/2025

Electronic Routing Change for CPID 5159 Prism Univera

Optum will be reactivating and rerouting electronic claims routing for the following payer, effective Dec. 10, 2025:

Payer Name: Prism Univera
Professional CPID: 5159
Current Edit Master: PE_E049
New Edit Master: PE_T007
Payer-assigned Payer ID: 37315
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Report Changes
You may see some differences in the payer reports you receive.

Action Required: Please make the following changes to accommodate the routing change:

Revalidate unreleased claims to edit correctly under new edit master.
Modify any bridge routines based on edit masters.
No Payer Alias changes are required. Payer name and CPID are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/9/2025

Electronic Routing and Payer ID Change for CPIDs 9679 and 6705 Prime Community Care of Central Valley

Optum will be changing electronic claims routing and Payer ID for the following payer, effective Dec. 10, 2025:

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers.

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Action Required: Please consider the following to allow transactions to be processed properly due to the above changes:

Make any necessary system changes.

12/9/2025

Payer Name: Prime Community Care of Central Valley
Professional CPID: 6705
Professional Edit Master: PE_T007
Institutional CPID: 9679
Institutional Edit Master: HE9T007
Old Payer-assigned Payer ID: MVCV1
New Payer-assigned Payer ID: MVCV0
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers.

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Action Required: Please consider the following to allow transactions to be processed properly due to the above changes:

Make any necessary system changes.
No Payer Alias changes are required. Payer name and CPIDs are not changing.

12/9/2025

Edit Master for CPIDs 8948 and 4269 Anchor Benefit Consulting

Effective December 9, 2025. Optum will be changing Edit Masters for the following payer:

Payer Name: Anchor Benefit Consulting
Professional CPID: 4269
Current Edit Master: PE_C054
New Edit Master: PE_T007
Institutional CPID: 8948
Current Edit Master: HE9C054
New Edit Master: HE9T007
Payer-assigned Payer ID: 53085

Action Required: Please make the following changes to accommodate the routing change:

Revalidate unreleased claims to edit correctly under new edit master.
Modify any bridge routines based on the edit master.
No Payer Alias changes are required. Payer name and CPIDs are not changing.

12/9/2025

Update: Report Generation Delay for CPID 4946 Texas Medicare

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Nov. 18, 2025 and Nov. 19, 2025.

Action Required: Please resubmit claims if payment has not been received.

Original notice sent Dec. 1, 2025:

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since Nov. 18, 2025.

Payer impacted:

CPID 4946 Texas Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09791933.

12/9/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on Dec. 5, 2025 were not processed by the payer due to a 999 Batch Rejection.

CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer on Dec. 9, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09797075.

12/9/2025

Report Generation Delay for CPID 5526 Horizon Blue Cross Blue Shield of New Jersey

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Nov. 26, 2025 and Nov. 27, 2025.

Payer impacted:

CPID 5526 Horizon Blue Cross Blue Shield of New Jersey

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09799770.

12/9/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on Dec. 8, 2025 were not processed by the payer due to a 999 Batch Rejection.

CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer on Dec. 9, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09799887.

12/9/2025

Electronic Routing Change for CPIDs 7029 and 9413 CorrectCare Integrated Health (Non-LA Jails)

Effective December 10, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: CorrectCare Integrated Health (Non-LA Jails)
Professional CPID: 9413
Institutional CPID: 7029
Payer-assigned Payer ID: CCIHJ
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: $0.10

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/9/2025

Report Generation Delay for CPIDs 2296 and 8972 MetroPlus Health Plan

A payer is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 4, 2025.

Payer impacted:

CPID 2296 MetroPlus Health Plan
CPID 8972 MetroPlus Health Plan

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09799515.

12/9/2025

New Payer Edit for CPID 5823

The payer listed below has informed Optum of a new edit requirement effective immediately. In order to meet the new requirement, we will add the following edit Dec. 15, 2025:

PREF02A138: MISSING SL CLIA NUMBER - When this HCPCS/CPT-4 Code is present, the Service Line CLIA Number is required. Exceptions: 1. When the associated Service Line Referring CLIA Number is present, this requirement does not apply. 2. When the Claim Level CLIA Number is present, this requirement does not apply. 3. When the HCPCS/CPT-4 Code is 88304-88305 or 88312-88314 with an associated Modifier TC, this requirement does not apply. 4. When the CPID is 2418 and HCPCS/CPT-4 Code is 86328, this requirement does not apply. 5. When the CPID is 3429 and the Active Subscriber Filing Indicator Code is other than 2 or 8. this requirement does not apply. 6. When the CPID is 1486, 2400, or 6801 and the associated Modifier is 26, this requirement does not apply. 7. When an associated Modifier QW is present, this requirement does not apply. Notes: 1. If this requirement does not apply to your billing situation, you can override the edit in the Edit/Error Severity application or within the Error Text. 2. Edit is based on Chapter 16 of the CMS Claims Processing Manual. 3. Edit is based on Change Requests 9502, 10446, 11135, and 11640. LINK: https://www.cms.gov/files/document/r4542cp.pdf LOOP 2400 REF02

Edit applies to:

CPID 5823 AETNA BETTER HEALTH - PA

Action Required: Please be aware of updated edit requirements.

12/9/2025

Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Nov. 26, 2025.

Payer impacted:

CPID 6671 HealthSun

The payer intermediary has been unable to generate and deliver the reports.

Action Required: None. Please resubmit claims if payment has not been received.

If you have any questions, please contact Customer Support and refer to Case Number 09799667.

12/9/2025

Error Message for CPID 7450 Blue Cross Blue Shield of Montana

Due to an intermediary processing issue, Professional claims for the payer listed below may have received the following error message(s) on the Payer Batch Totals Report (SB), Payer Batch Totals Data File (SD), Payer Claim Data Report (SR), Payer Claim Data Report (SE), Payer Report Data File (SF):

Reject Code: A3:21
Message: DUPLICATE FILE ID-CANNOT USE TWICE IN 12 MONTHS

Reject Code: MSG-1SG
Message: DUPLICATE FILE ID-CANNOT USE TWICE IN 12 MONTHS

Payer impacted:

CPID 7450 Blue Cross Blue Shield of Montana

This issue affected claims sent to the payer Dec. 4, 2025.

Affected claims were retransmitted to the payer Dec. 9, 2025.

Action Required: Please be aware of the error message.

If you have any questions, please contact Customer Support and refer to Case Number 09799523.

12/9/2025

Electronic Routing Change for CPIDs 7029 and 9413 CorrectCare Integrated Health (Non-LA Jails)

Optum will be reactivating and changing electronic claims routing for the following payer, effective Dec. 10, 2025:

Payer Name: CorrectCare Integrated Health (Non-LA Jails)
Professional CPID: 9413
Current Edit Master: PE_0007
New Edit Master: PE_T007
Institutional CPID: 7029
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: CCIHJ
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Report Changes
You may see some differences in the payer reports you receive.

Action Required: Please make the following changes to accommodate the routing change:

Revalidate unreleased claims to edit correctly under new edit master
Modify any bridge routines based on edit masters.
No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/9/2025

Report Generation Delay for CPID 2846 Hill Physicians Medical Group

A payer is experiencing issues affecting Professional report generation for some claims submitted on Nov. 24, 2025 and Nov. 25, 2025.

Payer impacted:

CPID 2846 Hill Physicians Medical Group

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09799456.

12/9/2025

Aliera Health Care Real Time Eligibility 270/271 No Longer Available

Effective immediately, Real Time Eligibility 270/271 for the payer listed below will no longer be available at Optum.

Payer Name: Aliera Health Care
Optum IEDi Real Time ID: ALH01
Connection Type: X12

Reason: Payer no longer offers an electronic connection

Action Required: None

12/9/2025

Report Generation Delay for CPIDs 2589 and 3793 Alliant Health Plan

A payer is experiencing issues affecting Institutional and Professional report generation for some claims submitted Nov. 30, 2025.

Payer impacted:

CPID 2589 Alliant Health Plans
CPID 3793 Alliant Health Plans

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09799397.

12/9/2025

New Payer Edit for CPID 5568

The payer listed below has informed Optum of a new edit requirement effective immediately. In order to meet the new requirement, we will add the following edit Dec. 9, 2025:

ISBR0135FI: INVALID PAYER RESP SEQ NUM CODE - For an electronic claim, the Payer Indicator must be A. Exceptions: 1. When the CPID is other than 1935 and the Billing Provider State is MN, this requirement does not apply. 2. When the CPID is 2557 and the Other Payer Paid Amount is zero, this requirement does not apply. LOOP 2000B SBR01

Edit applies to:

CPID 5568 GLOBAL HEALTHCARE ALLIANCE

Action Required: Please be aware of updated edit requirements.

12/9/2025

UPDATE: Electronic Claims Connection Suspended - Facey Medical Foundation

Update: This payer has been reactivated.

Due to a processing issue, claims for Facey Medical Foundation may have received the following error message:

PAYER NAME MATCHING REQUIRED. X12 INFO- 2010BB-NM1.PAYER NAME MATCHING REQUIRED

This issue began on November 1, 2025. The issue has been resolved, and providers may resubmit claims.

Original notification sent November 20, 2025:

Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Facey Medical Foundation
Payer ID: 95432
Reason: Payer unavailable electronically

Action Required: Please refrain from submitting claims until further notice.

12/8/2025

Report Generation Delay for CPID 1457 New Mexico Medicare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Nov. 28, 2025.

Payer impacted:

CPID 1457 New Mexico Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09798578.

12/8/2025

Report Generation Delay for CPID 1460 Louisiana Medicare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Nov. 28, 2025.

Payer impacted:

CPID 1460 Louisiana Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09798585.

12/8/2025

Report Generation Delay for CPID 8920 Healthcare Management Administrators

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Nov. 24, 2025.

Payer impacted:

CPID 8920 Healthcare Management Administrators

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09798275.

12/8/2025

Report Generation Delay for CPIDs 9002 and 3452 Edenbridge PACE of West Baltimore

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Nov. 22, 2025.

Payer impacted:

CPID 9002 Edenbridge PACE of West Baltimore
CPID 3452 Edenbridge PACE of West Baltimore

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09798189.

12/8/2025

Report Generation Delay for CPID 5599 Capital Blue Cross of Pennsylvania Facility Contracted Providers

A payer is experiencing issues affecting Institutional report generation for some claims submitted on Dec. 2, 2025.

Payer impacted:

CPID 5599 Capital Blue Cross of Pennsylvania Facility Contracted Providers

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09798200.

12/8/2025

Electronic Routing Change for CPIDs 7116 and 7672 Group Benefit Services

Effective December 8, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Group Benefit Services
Professional CPID: 7116
Edit Master: PE_T007
Institutional CPID: 7672
Edit Master: HE9T007
Payer-assigned Payer ID: 80241
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you receive.

Action Required: Please make the following changes to accommodate the routing change:

Edit Masters are not changing, no modification to the bridge routines needed.
No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/8/2025

Electronic Routing Change for Group Benefit Services (80241)

Optum is changing electronic claims routing for the following payer, effective Dec. 8, 2025:

Payer Name: Group Benefit Services
Payer ID: 80241
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Report Changes
You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.

12/8/2025

Electronic Routing Change for American Postal Workers Union (44444)

Optum has reactivated and changed electronic claims routing for the following payer, effective immediately:

Payer Name: American Postal Workers Union
Payer ID: 44444
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Report Changes
You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.

12/8/2025

Report Generation Delay for CPID 8714 Allstate

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Nov. 25, 2025.

Payer impacted:

CPID 8714 Allstate

The payer intermediary has been unable to generate and deliver the reports.

Action Required: None. Please resubmit claims if payment has not been received.

If you have any questions, please contact Customer Support and refer to Case Number 09798382.

12/8/2025

Report Generation Delay for CPID 2287 Michigan Medicare Plus Blue (MAP)

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Nov. 24, 2025.

Payer impacted:

CPID 2287 Michigan Medicare Plus Blue (MAP)

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09798244.

12/8/2025

Report Generation Delay for CPID 9435 OhioRISE - Aetna Better Health of Ohio

The payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 1, 2025.

Payer impacted:

CPID 9435 OhioRISE - Aetna Better Health of Ohio

The payer intermediary has been unable to generate and deliver the reports.

Action Required: None. Please resubmit claims if payment has not been received.

If you have any questions, please contact Customer Support and refer to Case Number 09798212.

12/8/2025

Electronic Routing Change for CPIDs 7116 and 7672 Group Benefit Services

Effective Dec. 8, 2025, Optum is changing electronic claims routing for the following payer:

Payer Name: Group Benefit Services
Professional CPID: 7116
Institutional CPID: 7672
Payer-assigned Payer ID: 80241
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Report Changes
You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/8/2025

Update: Report Generation Delay for CPIDs 9010 and 3480 ArchCare

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Oct. 28, 2025.

Action Required: Please resubmit claims if payment has not been received.

Original notice sent Nov. 11, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Oct. 28, 2025.

Payer impacted:

CPID 9010 ArchCare
CPID 3480 ArchCare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09768755.

12/8/2025

Error Message for CPIDs 8176, 2038 Saint Johns Health Clinic

Due to a processing issue, claims for the payer listed below may have received the following error message:

PAYER NAME MATCHING REQUIRED. X12 INFO- 2010BB-NM1.PAYER NAME MATCHING REQUIRED

This issue began on November 1, 2025. The issue has been resolved, and providers may resubmit claims.

Payer Name: Saint Johns Health Clinic
CPIDs: 8176, 2038
Payer ID: SJHC1

12/8/2025

Update: Electronic Claims Connection Suspended

Update:

This payer has been reactivated.

Due to a processing issue, claims for Facey Medical Foundation may have received the following error message:

PAYER NAME MATCHING REQUIRED. X12 INFO- 2010BB-NM1.PAYER NAME MATCHING REQUIRED

This issue began on November 1, 2025. The issue has been resolved, and providers may resubmit claims.

Original notification sent November 20, 2025:

Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Facey Medical Foundation
CPID: 4896
Payer ID: 95432
Reason: Payer unavailable electronically

Action Required: Please refrain from submitting claims until further notice.

12/8/2025

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective Dec. 4, 2025:

Payer Name: CSI Life Insurance Company
Industry Payer ID: 34186
IMN Real Time ID: 34186
Exchange Real Time ID: CSILF
CPID(s): 4626, 6145
Optum IEDi Real Time ID: 11160
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber

Member ID, First Name, Last Name, Date of Birth

Eligibility Dependent

Member ID, Dependent First Name, Dependent Last Name, Dependent Date of Birth

Action Required by customer:

Please update your system to take advantage of this payer transaction. For assistance with submitting Real-Time transactions, please contact your Practice Management System Vendor or Optum Customer Care Hub ticket.

12/5/2025

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective Dec 4,, 2025:

Payer Name: Spectrum Health
Industry Payer ID: 10936
IMN Real Time ID: 10936
Exchange Real Time ID: SPTMH
CPID(s): N/A
Optum IEDi Real Time ID: 10936
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Member ID, First Name, Last Name, Date of Birth
First Name, Last Name, Date of Birth
Member ID

Action Required by customer:
Please update your system to take advantage of this payer transaction. For assistance with submitting Real-Time transactions, please contact your Practice Management System Vendor or Optum Customer Care Hub ticket.

12/5/2025

Update: Electronic Routing Change and Payer ID Change for CPIDs 3412 and 9570 St. Joseph Heritage Healthcare

Update: Optum will not reroute or change the Payer ID for St. Joseph Heritage Healthcare, and no system updates are required.

Original notification sent Dec. 3, 2025:
Effective Dec. 10, 2025, Optum will be changing electronic claims routing and Payer ID for the following payer:

Payer Name: St. Joseph Heritage Healthcare
Professional CPID: 3412
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 9570
Current Edit Master: HE9O007
New Edit Master: HE9T007
Previous Payer ID: STJOE
New Payer ID: IP106
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers.

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Report Changes:
You may see some differences in the payer reports you receive.

Action Required: Please make the following changes to accommodate the routing change:

Revalidate unreleased claims to edit correctly under new edit master.
Modify any bridge routines based on edit masters.
No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/5/2025

Original notification sent Dec. 3, 2025:  
Effective December 10, 2025, Optum will be changing electronic claims routing and Payer ID for the following payer:

Payer Name: St. Joseph Heritage Healthcare
Professional CPID: 3412
Institutional CPID: 9570
Previous Payer ID: STJOE
New Payer ID: IP106
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers.

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Report Changes:
You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/5/2025

New Electronic Claim Status Connection Available

Optum is pleased to announce the availability of Real-time Claim Status Inquiry and Response 276/277 for the below payer, effective December 01, 2025:

Payer Name: OSCAR HEALTH
Industry Payer ID: OSCAR
IMN Real Time ID: OSCAR
Exchange Real Time ID: OSCAR
CPID(s): 9638, 7468
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Claim Status Inquiry Dependent

Member ID, dep first name, dep last name, dep date of birth, subscriber last name

Optional additional elements:

Payer claim number, Total submitted charges

Action Required by customer:

12/5/2025

Allegiance Benefit Management New Claim Status Connection

Effective November 21, 2025 Optum is pleased to announce the availability of Real Time Claim Status Inquiry and Response (276/277) transactions for the below payer:

Payer Name: Allegiance Benefit Plan Management
IMN Payer ID: 81040
Exchange CPID: ALLBE CPID (2295 & 1651)
IEDI Payer ID: 81040

Updated Payer Lists may be obtained from your software vendor or Payer Lists | Optum

12/4/2025

Electronic Reactivation and Routing Change for CPIDs 9486 and 7083 Orange County Medical Clinic

Effective December 4, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: Orange County Medical Clinic
Professional CPID: 9486
Institutional CPID: 7083
Payer-assigned Payer ID: DB497
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: N/A

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/4/2025

Electronic Reactivation and Routing Change for CPIDs 9486 and 7083 Orange County Medical Clinic

Effective December 4, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: Orange County Medical Clinic
Professional CPID: 9486
Edit Master: PE_T007
Institutional CPID: 7083
Edit Master: HE9T007
Payer-assigned Payer ID: DB497
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you receive.

Action Required: Please make the following changes to accommodate the routing change:

Edit Masters are not changing, no modification to the bridge routines needed.
No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/4/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on Dec. 3, 2025 were not processed by the payer due to a 999 Batch Rejection.

CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer on Dec. 4, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09796029.

12/4/2025

Report Generation Delay for CPID 7567 Sentara Health Plans

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Nov. 21, 2025.

Payer impacted:

CPID 7567 Sentara Health Plans

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09795609.

12/4/2025

New Assurance Attach Assist Medical Attachment Connections Available
Optum has new electronic medical attachment connections available:

Payer Name: Healthy Blue North Carolina
Professional CPID: 9133
Institutional CPID: 5086
Payer-assigned Payer ID: 00602
Accepted Attachment Type: Solicited and Unsolicited
Payer Enrollment Required: No
Payer Location: North Carolina

Action Required:

Inform users of this change.
Assurance providers must be contracted with Assurance Attach Assist to submit electronic medical attachments. Please contact support at 1-800-457-1209 option 2, or by emailing [email protected] for additional information.
If you have not yet contracted for Attach Assist, contact your Client Executive to learn more about Attach Assist functionality.
When a payer requires enrollment, forms must be submitted and approved to begin submitting transactions.

12/4/2025

New Electronic Medical Attachment Connections Available
Optum has new electronic medical attachment connections available:

Payer Name: Healthy Blue North Carolina
Professional CPID: 9133
Institutional CPID: 5086
Payer-assigned Payer ID: 00602
Accepted Attachment Type: Solicited and Unsolicited
Payer Enrollment Required: No
Payer Location: North Carolina

Action Required:

Exchange providers must be contracted with Optum to submit electronic medical attachments. Please contact Support at 1-800-527-8133 option 2, or by emailing [email protected] for additional information.
Add the payers to your system to begin using the new payer connection.
When a payer requires enrollment, forms must be submitted and approved to begin submitting transactions.

Please update your system and procedures to take advantage of the new connection. For assistance with Medical Attachments, please contact your Practice Management System Vendor.

NOTE: The above Payer ID(s) is for Medical Attachments and may require Providers and/or their vendor to be contracted with Optum for the Medical Attachment transaction services.

12/4/2025

Report Generation Delay for CPID 7939 Virginia Health Network Inc.

The payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Nov. 21, 2025.

Payer impacted:

CPID 7939 Virginia Health Network Inc

The payer intermediary has been unable to generate and deliver the reports.

Action Required: None. Please resubmit claims if payment has not been received.

If you have any questions, please contact Customer Support and refer to Case Number 09795465.

12/4/2025

Update: Payer Change for CPID 4492 Massachusetts Medicaid Format 5

Update: New Effective Date for 4492 Massachusetts Medicaid Format 5.

Effective February 11, 2026, claims and remittance currently exchanged with the following payer must use a different CPID:

Payer Name: Massachusetts Medicaid Format 5
Professional CPID: 4492
Payer-assigned Payer ID: DMA7384

Claims and remittance must begin using the following on January 14, 2026:

Payer Name: MassHealth
Professional CPID: 4491
Payer-assigned Payer ID: DMA7384
Claim Fee: N/A

CPID 4492 Massachusetts Medicaid Format 5 will be terminated effective January 14, 2026.

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is required.
- Providers currently sending electronic claims through Optum for CPID 4492 Massachusetts Medicaid Format 5 do not need to complete a new enrollment form.
- New providers must complete a new enrollment form for CPID 4491 MassHealth.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum for CPID 4492 Massachusetts Medicaid Format 5 do not need to complete a new enrollment form.
- Providers not receiving remittance through Optum for CPID 4492 must complete a new enrollment form for CPID 4491 MassHealth.
- New providers must complete a new enrollment form for CPID 4491 MassHealth.

Action Required:

Please be aware of the changes above and make any necessary changes in your system.
To access the new enrollment forms, please visit Enrollment Central.

12/4/2025

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective November 21, 2025.

Payer Name: Sage
Industry Payer ID: SAGE1
IMN Real Time ID: SAGE1
Exchange Real Time ID: SAGE
CPID(s): 7924, 2746
Optum IEDi Real Time ID: SAGE1
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Subscriber

Member ID, First Name, Last Name, Date of Birth
Member ID, Last Name, Date of Birth
Member ID, Last Name, First Name

Dependent

Member ID, Dependent Last Name, Dependent First Name, Dependent Date of Birth
Member ID, Dependent Last Name, Dependent Date of Birth
Member ID, Dependent Last Name, Dependent First Name

Action Required by customer:

12/4/2025

Report Generation Delay for CPID 5582 Blue Cross of Idaho Boise

A payer is experiencing issues affecting Institutional report generation for some claims submitted since Dec. 1, 2025.

Payer impacted:

CPID 5582 Blue Cross of Idaho Boise

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09794842.

12/3/2025

Report Generation Delay for CPID 1464 NC Medicare

The payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Nov. 19, 2025 and Nov. 20, 2025.

Payer impacted:

CPID 1464 NC Medicare

The payer intermediary has been unable to generate and deliver the reports.

Action Required: None. Please resubmit claims if payment has not been received.

If you have any questions, please contact Customer Support and refer to Case Number 09794620.

12/3/2025

Report Generation Delay for Multiple CPIDs
A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Nov. 14, 2025.

Payers impacted:

CPID 1029 Physician Health Associates/Midland Mgmt
CPID 3770 Physician Health Associates/Midland Mgmt
CPID 1851 Lake County Physicians Association
CPID 3017 Gonzaba Medical Group
CPID 8266 Gonzaba Medical Group
CPID 3026 Essential Health Partners
CPID 8275 Essential Health Partners
CPID 3088 Lake County Physicians Association
CPID 6137 West Suburban Health Providers
CPID 7245 Oak West Physician Association
CPID 8664 Oak West Physician Association

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09794594.

12/3/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: March Vision Care
Institutional CPID: 9047
Payer-assigned Payer ID: 52461
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National
Claims Fee: N/A

Action Required: 

Add the payers to your system to begin using the new payer connection.
When a payer requires enrollment, forms must be submitted and approved to begin submitting transactions.

Please note: We are providing you with a list of new electronic connections. Please review and choose payers that are appropriate for your business.

12/3/2025

Electronic Routing Change and Payer ID Change for CPIDs 3412 and 9570 St. Joseph Heritage Healthcare

Effective December 10, 2025, Optum will be changing electronic claims routing and Payer ID for the following payer:

Payer Name: St. Joseph Heritage Healthcare

Professional CPID: 3412

Current Edit Master: PE_O007

New Edit Master: PE_T007

Institutional CPID: 9570

Current Edit Master: HE9O007

New Edit Master: HE9T007

Previous Payer ID: STJOE

New Payer ID: IP106

Payer Claim Enrollment Required: No

Secondary Claims Accepted: Yes

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers.

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you receive.

Action Required: Please make the following changes to accommodate the routing change:

Revalidate unreleased claims to edit correctly under new edit master.
Modify any bridge routines based on edit masters.
No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/3/2025

Electronic Routing Change and Payer ID Change for CPIDs 3412 and 9570 St. Joseph Heritage Healthcare

Effective December 10, 2025, Optum will be changing electronic claims routing and Payer ID for the following payer:

Payer Name: St. Joseph Heritage Healthcare

Professional CPID: 3412

Institutional CPID: 9570

Previous Payer ID: STJOE

New Payer ID: IP106

Payer Claim Enrollment Required: No

Secondary Claims Accepted: Yes

Claims Fee: $0.10

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers.

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/3/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Health Services Management
Professional CPID: 1712
Payer-assigned Payer ID: 41150
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National

Action Required:

Add the payers to your system to begin using the new payer connection.
When a payer requires enrollment, forms must be submitted and approved to begin submitting transactions.

Please note: We are providing you with a list of new electronic connections. Please review and choose payers that are appropriate for your business.

12/3/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Action Required:

Add the payers to your system to begin using the new payer connection.
When a payer requires enrollment, forms must be submitted and approved to begin submitting transactions.

Please note: We are providing you with a list of new electronic connections. Please review and choose payers that are appropriate for your business.

12/3/2025

Update: Report Generation Delay for CPID 2426 Michigan Blue Care Network

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Nov. 3, 2025.

Action Required: Please resubmit claims if payment has not been received.

Original notice sent Nov. 17, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Nov. 3, 2025.

Payer impacted:

CPID 2426 Michigan Blue Care Network

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09777827.

12/3/2025

Report Generation Delay for CPID 7241 TransactRX Part D

A payer is experiencing issues affecting Professional report generation for some claims submitted Nov. 25, 2025.

Payer impacted:

CPID 7241 TransactRX Part D

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09794027.

12/3/2025

New Payer ID for NYCE

Effective January 1, 2026, claims submitted to NYCE with a date of service starting in 2026 will need to utilize a different payer ID:

Payer Name: NYCE

Payer ID: 26992

Optum will be the front end for all EDI transactions (837P, 837I, 837D, 270/271 and 835/ERA).

As a result, all clearinghouse service organizations that submit transactions to 26992 must send their transactions directly to Optum and or a clearinghouse that has an established connection with Optum.

This change will take effect on Thursday, January 1, 2026.

Enrollment Requirements:

Claims/Real Time:

Payer enrollment for electronic claims and real time transactions are not required.

ERAs:

Payer enrollment for ERAs is required under payer ID 39026 (UMR)

Action Required:

Please be aware of the changes above and make any necessary changes in your system.

12/2/2025

Electronic Routing Change for Angle Health (39856)

Optum is changing electronic remittance routing for the following payer, effective immediately:

Payer Name: Angle Health
Payer ID: 39856
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A

Enrollment Requirements
Remittance:

Payer enrollment for electronic remittance is required.
Providers currently receiving electronic remittance through Optum must complete a new enrollment form.
New providers must complete a new enrollment form.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from IEDI.

12/2/2025

Prudent Medical Group Electronic Claims Connection No Longer Available

Effective Dec. 2, 2025, the payer listed below is no longer available at Optum for claims processing.

Payer Name: Prudent Medical Group
Payer ID: MPM25
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: Please be aware the payer alias entries will be removed and claims for this payer must now be submitted on paper. Please make the following changes to accommodate the payer no longer offering an electronic connection:

After the edit release date above, revalidate unreleased claims to edit correctly to send paper claims.
Modify any bridge routines based on Edit Masters for paper claims.

12/2/2025

RESOLVED - National Medicare CMS (CMSEL) Eligibility And Benefits Error

This issue is now resolved.

Root Cause: A database migration table issue that was resolved

Original Notification:

We are aware of an issue causing users to get an error when searching E&B for National Medicare CMS patients. Error states user is not enrolled for this transaction but have an approved enrollment on file in transaction enrollment.

Error: YOUR REQUEST WAS INVALID. THE PROVIDER NPI IS NOT APPROVED FOR NATIONAL MEDICARE/CMS 270/271 TRANSACTIONS.

We continue to monitor this issue with the payer. If you have any questions, please contact Customer Support and refer to Global Incident Number INC-000003400

Action Required: Please be aware of the ongoing issue.

12/2/2025

Update: Payer Processing Issue for CPIDs 5594 and 1487 North Dakota Medicaid

Update: Optum continues to work with the payer to resolve this processing issue. We will notify you once this issue has been resolved.

Action Required: None. Please be aware of the processing issue above.

Original notice sent: Nov. 18, 2025:

Due to a payer processing issue, Professional and Institutional claims transmitted to the payer listed below on Nov. 14, 2025 through present were not processed by the payer.

Payer impacted:

CPID 5594 North Dakota Medicaid
CPID 1487 North Dakota Medicaid

Optum is working with the payer to resolve this processing issue. We will notify you once this issue has been resolved. Action Required: None. Please be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09780106.

12/2/2025

Update: Delay in Electronic Remittance Advice (ERA) for CPIDs 1487 and 5594 North Dakota Medicaid

Update: Optum continues working diligently with the payer to resolve the issue and ensure ERA are received.

Action Required: Please be aware of a delay in the delivery of ERA for check dates above.

Original notice sent: Nov. 19, 2025:

There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for check dates since Nov. 14, 2025:

CPID 1487 North Dakota Medicaid
CPID 5594 North Dakota Medicaid

Optum is working diligently with the payer to resolve the issue and ensure ERA are received.

Action Required: Please be aware of a delay in the delivery of ERA for check dates above.

If you have any questions, please contact Customer Support and refer to Case Number 09780106.

12/2/2025

Payer ID Consolidation - First Choice VIP Care

Effective Jan. 1, 2026 claims with DOS on or after Jan. 1, 2026 must be sent to Payer ID 32456.

Payer ID 32456 CPIDs (6087, 9248)

All claims with a DOS on or prior to Dec. 31, 2025 will continue to be sent to Payer ID 77009.

Payer ID 77009 CPIDs (8631, 7193)

There will be a one year run out period and all claims on or after Jan. 1, 2027 must be submitted to Payer ID 32456.

12/2/2025

Prudent Medical Group Electronic Claims Connection No Longer Available

Effective Dec. 2, 2025, the payer listed below is no longer available at Optum for claims processing.

Payer Name: Prudent Medical Group
Claims CPIDs: 7259, 8696
Payer-assigned Payer ID: MPM25
Reason: Payer no longer offers an electronic connection to which Optum can connect.

After the edit release date above, revalidate unreleased claims to edit correctly to send paper claims.
Modify any bridge routines based on Edit Masters for paper claims.

12/2/2025

Prudent Medical Group Electronic Claims Connection No Longer Available

Effective Dec. 2, 2025, the payer listed below is no longer available at Optum for claims processing:

Payer Name: Prudent Medical Group
Claim CPIDs: 7259, 8696
Payer-assigned Payer ID: MPM25

Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: None.

12/2/2025

Report Generation Delay for CPID 7171 Neighborhood Health Plan of Rhode Island

A payer is experiencing issues affecting Professional report generation for some claims submitted Nov. 21, 2025.

Payer impacted:

CPID 7171 Neighborhood Health Plan of Rhode Island

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted Nov. 21, 2025.

If you have any questions, please contact Customer Support and refer to Case Number 09792856.

12/2/2025

Report Generation Delay for CPID 2451 Mississippi Medicare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Nov. 20, 2025.

Payer impacted:

CPID 2451 Mississippi Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09792852.

12/2/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum Dec. 1, 2025 were not processed by the payer due to a 999 Batch Rejection.

CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer Dec. 2, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09792688.

12/2/2025

Payer Change for CPID 4492 Massachusetts Medicaid Format 5

Effective Jan. 14, 2026, claims and remittance currently exchanged with the following payer must use a different CPID:

Payer Name: Massachusetts Medicaid Format 5
Professional CPID: 4492
Payer-assigned Payer ID: DMA7384

Claims and remittance must begin using the following Jan. 14, 2026:
Payer Name: MassHealth
Professional CPID: 4491
Payer-assigned Payer ID: DMA7384
Claim Fee: N/A

CPID 4492 Massachusetts Medicaid Format 5 will be terminated effective Jan. 14, 2026.

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is required.
- Providers currently sending electronic claims through Optum for CPID 4492 Massachusetts Medicaid Format 5 do not need to complete a new enrollment form.
- New providers must complete a new enrollment form for CPID 4491 MassHealth.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum for CPID 4492 Massachusetts Medicaid Format 5 do not need to complete a new enrollment form.
- Providers not receiving remittance through Optum for CPID 4492 must complete a new enrollment form for CPID 4491 MassHealth.
- New providers must complete a new enrollment form for CPID 4491 MassHealth.

Action Required:

Please be aware of the changes above and make any necessary changes in your system.
To access the new enrollment forms, please visit Enrollment Central.

12/2/2025

New Payer Edit for CPID 1937 Global Care

The payer listed below has informed Optum of a new edit requirement effective immediately. In order to meet the new requirement, we will add the following edit Dec. 8, 2025.

IHI-01A108: MISSING PATIENT RSN FOR VISIT - When the following conditions are present, the Patient Reason for Visit is required. 1. Type of Bill 13x, 78x, or 85x; and 2. Revenue Code 45x, 516, 526, or 762; and 3. Type of Admission 1, 2, 3, or 5. LOOP 2300 HI01-2

Edit applies to: 

CPID 1937 GLOBAL CARE

Action Required: Please be aware of updated edit requirements.

12/1/2025

Electronic Routing Change for CPIDs 2290 and 2935 Mutual Health Services

Optum is changing electronic claims and remittance routing for the following payer, effective Dec. 1, 2025:

Payer Name: Mutual Health Services
Professional CPID: 2290
Institutional CPID: 2935
Payer-assigned Payer ID: 34192
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
Providers currently receiving electronic remittance through Optum must complete a new enrollment form.
New providers must complete a new enrollment form.

Report Changes
You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/1/2025

Electronic Routing Change for CPIDs 4423 and 3506 Medical Mutual of Ohio

Optum is changing electronic claims and remittance routing for the following payer, effective Dec. 1, 2025:

Payer Name: Medical Mutual of Ohio
Professional CPID: 4423
Current Edit Master: PE_T007
New Edit Master: PE_B800
Institutional CPID: 3506
Current Edit Master: HE9T007
New Edit Master: HE9B801
Payer-assigned Payer ID: 29076
Line of Business Code (LOB): H17
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum must complete a new enrollment form.
- New providers must complete a new enrollment form.

Report Changes:
You may see some differences in the payer reports you receive.

Action Required: Please make the following changes to accommodate the routing change:

Revalidate unreleased claims to edit correctly under new edit master.
Modify any bridge routines based on edit masters.
No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/1/2025

Electronic Routing Change for CPIDs 2290 and 2935 Mutual Health

Optum will be changing electronic claims and remittance routing for the following payer, effective Dec. 1, 2025:

Payer Name: Mutual Health Services
Professional CPID: 2290
Current Edit Master: PE_T007
New Edit Master: PE_C051
Institutional CPID: 2935
Current Edit Master: HE9T007
New Edit Master: HE9C051
Payer-assigned Payer ID: 34192
Line of Business Code (LOB): H78
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum must complete a new enrollment form.
- New providers must complete a new enrollment form.

Report Changes
You may see some differences in the payer reports you receive.

Action Required: Please make the following changes to accommodate the routing change:

Revalidate unreleased claims to edit correctly under new edit masters.
Modify any bridge routines based on edit masters.
No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/1/2025

Electronic Routing Change for CPIDs 4423 and 3506 Medical Mutual of Ohio

Optum is changing electronic claims and remittance routing for the following payer, effective Dec. 1, 2025:

Payer Name: Medical Mutual of Ohio
Professional CPID: 4423
Institutional CPID: 3506
Payer-assigned Payer ID: 29076
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements
Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum must complete a new enrollment form.
- New providers must complete a new enrollment form.

Report Changes:
You may see some differences in the payer reports you receive.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/1/2025

Report Generation Delay for CPID 7893 Superior Select Health

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Nov. 20, 2025.

Payer impacted:

CPID 7893 Superior Select Health

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09791940.

12/1/2025

Report Generation Delay for CPID 4946 Texas Medicare

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since Nov. 18, 2025.

Payer impacted:

CPID 4946 Texas Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09791933.

12/1/2025

Report Generation Delay for CPID 2824 The Health Plan of West Virginia

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Nov. 18, 2025.

Payer impacted:

CPID 2824 The Health Plan of West Virginia

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09791925.

12/1/2025

Report Generation Delay for CPID 1558 Oklahoma Medicare

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Nov. 18, 2025.

Payer impacted:

CPID 1558 Oklahoma Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09791921.

12/1/2025

Report Generation Delay for CPID 1448 Florida Medicare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Nov. 20, 2025.

Payer impacted:

CPID 1448 Florida Medicare

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09791909.

12/1/2025

Report Generation Delay for CPIDs 1474 and 3501 Indiana Medicaid

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Nov. 25, 2025.

Payer impacted:

CPID 1474 Indiana Medicaid
CPID 3501 Indiana Medicaid

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09791837.

12/1/2025

Report Generation Delay for CPID 1780 Managed Care Advisors - Sedgwick

A payer is experiencing issues affecting Professional report generation for some claims submitted since Nov. 21, 2025.

Payer impacted:

CPID 1780 Managed Care Advisors - Sedgwick

Optum is working diligently with the payer to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09791791.

12/2/2025

Update: Report Generation Delay for CPID 7264 Quartz ASO

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Nov. 4, 2025-Nov. 6, 2025.

Action Required: Please resubmit claims if payment has not been received.

Original notice sent Nov. 17, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Nov. 4, 2025.

Payer impacted:

CPID 7264 Quartz ASO

Optum is working diligently with the payer intermediary to resolve the issue and ensure reports are received.

Action Required: None. Please be aware of delays in the report generation for claims submitted during the time frame above.

If you have any questions, please contact Customer Support and refer to Case Number 09777986.

12/1/2025

Payer Processing Issue for CPID 7074 UnitedHealthcare Ohio Medicaid

Due to a payer intermediary processing issue, some Institutional claims transmitted to the payer listed below Nov. 18, 2025 were not processed by the payer intermediary.

Payer impacted:

CPID 7074 UnitedHealthcare Ohio Medicaid

A resolution has been implemented and the claims were retransmitted to the payer intermediary Dec. 1, 2025.

This delay affected claims released to Optum Nov. 18, 2025, 10:00 a.m.-5:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09791686.

12/1/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum Nov. 26, 2025 were not processed by the payer due to a 999 Batch Rejection.

CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer Dec. 1, 2025.

Action Required: None.

If you have questions, please contact Customer Support and refer to Case Number 09791663.

12/1/2025

Electronic Routing Change for CPIDs 9184 and 6032 Angle Health

Optum is changing electronic remittance routing for the following payer, effective immediately:

Payer Name: Angle Health
Professional CPID: 9184
Institutional CPID: 6032
Payer-assigned Payer ID: 39856
Line of Business Code (LOB): N26
Payer Remittance Enrollment Required: Yes

Enrollment Requirements
Remittance:

Payer enrollment for electronic remittance is required.
Providers currently receiving electronic remittance through Optum must complete a new enrollment form.
New providers must complete a new enrollment form.

Action Required: Please make the following changes to accommodate the routing change:

Edit Masters are not changing, no modification to the bridge routines needed.
No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/1/2025

Electronic Routing Change for CPIDs 9184 and 6032 Angle Health

Optum is changing electronic remittance routing for the following payer, effective immediately:

Payer Name: Angle Health
Professional CPID: 9184
Institutional CPID: 6032
Payer-assigned Payer ID: 39856
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A

Enrollment Requirements
Remittance:

Payer enrollment for electronic remittance is required.
Providers currently receiving electronic remittance through Optum must complete a new enrollment form.
New providers must complete a new enrollment form.

Action Required: Please consider the following to allow transactions to process properly due to the above changes:

Make any necessary system changes.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

12/1/2025

Older Payer Updates

Click the link below to access payer updates prior to December 1st, 2025.

GET OLDER UPDATES

CHC Payer Updates (December 2025)

December 2025

December Payer Processing Issues

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