PAR Status Change for Payers

Effective 04/01/2026 the PAR Status is changing for the following payer(s):

 

Administrative Concepts

IMN ID: 22384

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Aspirus Medicare Advantage

IMN ID: 36483

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

BayCare Plus Medicare Advantage

IMN ID: 81079

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

CareSource of Georgia

IMN ID: GACS1

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

CareSource of Indiana

IMN ID: INCS1

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Centivo

IMN ID: 45564

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Community Health Choice Medicaid, DSNP, Star+Plus

IMN ID: 48145

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Transitional

 

Community Health First Medicare Advantage

IMN ID: CHFMA

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Cook Childrens Star Plan

IMN ID: CCHP9

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

FirstCare

IMN ID: 94999

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Florida Health Care Plans

IMN ID: 59322

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

GEMCare – Kern County

IMN ID: MCS03

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Gravie Inc.

IMN ID: GRV01

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Great West Healthcare

IMN ID: 80705

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Health Alliance Medical Plans of Illinois

IMN ID: HALLS

Transaction: Eligibility

Old Par Status: Non-Par

New Par Status: Gateway

 

Health Net National

IMN ID: XHNNC

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Healthplans Incorporated

IMN ID: 44273

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Hennepin Health

IMN ID: 60058

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Gateway

 

HMA Hawaii

IMN ID: 86066

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Transitional

 

Hometown Health

IMN ID: HMETH

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Independence Administrators

IMN ID: TA720

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Integrated Mental Health Services

IMN ID: CBHTX

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Kaiser Permanente Southern CA

IMN ID: 94134

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Kempton Group Administrators

IMN ID: 73100

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Key Benefit Administrators

IMN ID: KBKBA

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Lincoln Heritage Life Insurance Company

IMN ID: LCNHG

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

March Vision Care

IMN ID: 52461

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Gateway

 

McLaren Health Care

IMN ID: 38338

Transaction: Eligibility

Old Par Status: Non-Par

New Par Status: Gateway

 

Meritain Health

IMN ID: 41124

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Mountain Health Co-Op

IMN ID: MHC01

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Transitional

 

Mutual of Omaha

IMN ID: 71412

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Par

 

New York Independent Health Assoc (IHA) – Western

IMN ID: SX073

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Passport Health Plan by Molina Healthcare

IMN ID: MLNKY

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Physicians Health Plan of Northern Indiana

IMN ID: 12399

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Gateway

 

Priority Health

IMN ID: 38217

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Royal Neighbors of America

IMN ID: RYLNB

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Scott & White Health Plan

IMN ID: TH002

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

SelectHealth

IMN ID: SX107

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Senior Whole Health, LLC DBA Molina Healthcare

IMN ID: SWHMA

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Sutter and Aetna Insurance Company

IMN ID: 60624

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Univera

IMN ID: SX086

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

UPMC Health Plan (Tristate)

IMN ID: 23281

Transaction: Eligibility

Old Par Status: Non-Par

New Par Status: Par

 

Washington National

IMN ID: 70319

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

WellMed

IMN ID: WELM2

Transaction: Claim Status

Old Par Status: Non-Par

New Par Status: Gateway

 

ZING HEALTH

IMN ID: 83248

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

Action Required: Please be aware of the upcoming PAR status changes.

2/27/2026

---

PAR Status Change for Real-time Payers

Effective 04/01/2026 the PAR Status is changing for the following real-time payer(s):

 

Alliant Health Plans

Industry ID: 58234

Exchange CPIDs: 2589, 3793

Exchange RT ID: ALLIHP

Transaction: Eligibility

Old Par Status: Gateway

New Par Status: Transitional

 

COVID19 HRSA Uninsured Testing and Treatment Fund

Industry ID: 95964

Exchange CPIDs: 4019, 8748

Exchange RT ID: COVID

Transaction: Claim Status

Old Par Status: Transitional

New Par Status: Gateway

 

Fallon Community Health Plan

Industry ID: 22254

Exchange CPIDs: 1576, 3801

Exchange RT ID: FALLON

Transaction: Claim Status, Eligibility

Old Par Status: Gateway

New Par Status: Transitional

 

Luminare Health AZ, IL, IN, MD, MN, NC, PA

Industry ID: 48117

Exchange CPIDs: 4568, 5492

Exchange RT ID: CSFMH

Transaction: Claim Status, Eligibility

Old Par Status: Gateway

New Par Status: Transitional

 

Nippon Life Insurance Company of America

Industry ID: 81264

Exchange CPIDs: 6443, 6539

Exchange RT ID: NLICOA

Transaction: Claim Status, Eligibility

Old Par Status: Gateway

New Par Status: Transitional

 

Samaritan Health Plans

Industry ID: CP001

Exchange CPIDs: 2122, 5952

Exchange RT ID: SAMAR

Transaction: Eligibility

Old Par Status: Gateway

New Par Status: Par

 

UnitedHealthcare Secure Horizons Medicare Supplemental

Industry ID: UHSEC

Exchange RT ID: UHSEC

Transaction: Eligibility

New Par Status: Transitional

Action Required: Please be aware of the upcoming PAR status changes.

2/27/2026

---

PAR Status Change for Claim Payers

Effective 04/01/2026 the PAR Status is changing for the following claim payer(s):

 

Allegeant, LLC

Industry ID: 52193

Exchange CPIDs: 3691, 5121

Old Par Status: Par

New Par Status: Transitional

 

Anchor Benefit Consulting

Industry ID: 53085

Exchange CPIDs: 4269, 8948

Old Par Status: Transitional

New Par Status: Non Par

 

Avmed Inc Encounters

Industry ID: 59275

Exchange CPIDs: 3787

Old Par Status: Gateway

New Par Status: Non Par

 

Butler Benefit

Industry ID: 42150

Exchange CPIDs: 3250, 8946

Old Par Status: Transitional

New Par Status: Non Par

 

COVID19 HRSA Uninsured Testing and Treatment Fund

Industry ID: 95964

Exchange CPIDs: 6016, 9157

Old Par Status: Non Par

New Par Status: Gateway

 

Claims Development Corporation

Industry ID: 43056

Exchange CPIDs: 7191

Old Par Status: Non Par

New Par Status: Par

 

Colonial Medical Eastern Caribbean

Industry ID: 22287

Exchange CPIDs: 4043, 8772

Old Par Status: Non Par

New Par Status: Gateway

 

Consolidated Associates Railroad

Industry ID: 75284

Exchange CPIDs: 2233, 7967

Old Par Status: Transitional

New Par Status: Non Par

 

Crescent Health Solutions

Industry ID: 56213

Exchange CPIDs: 5664

Old Par Status: Gateway

New Par Status: Transitional

 

EMI-KP Ambulance

Industry ID: 59299

Exchange CPIDs: 8852

Old Par Status: Gateway

New Par Status: Transitional

 

Fringe Benefit Coordinators (Medical and Accident)

Industry ID: 59204

Exchange CPIDs: 5247, 8944

Old Par Status: Transitional

New Par Status: Non Par

 

Global Excel Management

Industry ID: GEM01

Exchange CPIDs: 4658

Old Par Status: Non Par

New Par Status: Par

 

H.E.R.E.I.U. Welfare Pension Plan

Industry ID: 37114

Exchange CPIDs: 2865, 8532

Old Par Status: Non Par

New Par Status: Gateway

 

Health Services Preferred (HSP) Emerald Health

Industry ID: 34167

Exchange CPIDs: 6664, 6768

Old Par Status: Transitional

New Par Status: Non Par

 

HealthCare Solutions Group

Industry ID: 73147

Exchange CPIDs: 3965, 4267

Old Par Status: Transitional

New Par Status: Non Par

 

HealthSmart ACCEL Network

Industry ID: 75237

Exchange CPIDs: 9584

Old Par Status: Transitional

New Par Status: Non Par

 

High Desert Medical Group

Industry ID: 95393

Exchange CPIDs: 3290, 9670

Old Par Status: Par

New Par Status: Non Par

 

Hometown Health

Industry ID: 88023

Exchange CPIDs: 2839, 2960

Old Par Status: Non Par

New Par Status: Gateway

 

ICARE Health Options TPA

Industry ID: 26054

Exchange CPIDs: 5299

Old Par Status: Non Par

New Par Status: Gateway

 

Ingham Health Plan

Industry ID: 38343

Exchange CPIDs: 7252, 8670

Old Par Status: Non Par

New Par Status: Gateway

 

InnovAge

Industry ID: 31182

Exchange CPIDs: 1634

Old Par Status: Non Par

New Par Status: Par

 

Innovante Benefit Administrators

Industry ID: 31172

Exchange CPIDs: 5685

Old Par Status: Transitional

New Par Status: Non Par

 

Insurance TPA.com Administrators

Industry ID: 39182

Exchange CPIDs: 2176, 2688

Old Par Status: Non Par

New Par Status: Par

 

Integra Group

Industry ID: 31127

Exchange CPIDs: 1864, 3955

Old Par Status: Non Par

New Par Status: Par

 

Integrated Medical Solutions

Industry ID: 20050

Exchange CPIDs: 4644, 6163

Old Par Status: Non Par

New Par Status: Par

 

John Morrell Company - AHPBA

Industry ID: 38310

Exchange CPIDs: 4291

Old Par Status: Gateway

New Par Status: Non Par

 

Landmark Healthcare

Industry ID: LNDMK

Exchange CPIDs: 3294

Old Par Status: Par

New Par Status: Non Par

 

Life Trac

Industry ID: 41136

Exchange CPIDs: 3844, 3907

Old Par Status: Non Par

New Par Status: Par

 

MedAdmin Solutions(PHC)

Industry ID: 58204

Exchange CPIDs: 1892

Old Par Status: Non Par

New Par Status: Par

 

MedCom

Industry ID: 59231

Exchange CPIDs: 3271, 4939

Old Par Status: Transitional

New Par Status: Non Par

 

MediView Travis County MAP

Industry ID: TCMAP

Exchange CPIDs: 7891

Old Par Status: Transitional

New Par Status: Non Par

 

Mental Health Consultants Inc

Industry ID: 37050

Exchange CPIDs: 1050, 7878

Old Par Status: Non Par

New Par Status: Gateway

 

Merchants Benefit Administration

Industry ID: 86087

Exchange CPIDs: 1274, 6518

Old Par Status: Non Par

New Par Status: Gateway

 

Mid-America Associates

Industry ID: 37281

Exchange CPIDs: 1613

Old Par Status: Non Par

New Par Status: Gateway

 

Mondial Assistance

Industry ID: 50749

Exchange CPIDs: 1669, 5180

Old Par Status: Non Par

New Par Status: Gateway

 

Municipal Health Benefit Fund

Industry ID: 81883

Exchange CPIDs: 5956

Old Par Status: Non Par

New Par Status: Par

 

My Patient Prepaid

Industry ID: PREPD

Exchange CPIDs: 2737, 7920

Old Par Status: Par

New Par Status: Gateway

 

NAHGA Claim Services

Industry ID: 67788

Exchange CPIDs: 1223, 4520

Old Par Status: Non Par

New Par Status: Gateway

 

NAMCI/Global Care

Industry ID: L0110

Exchange CPIDs: 2076, 8221

Old Par Status: Transitional

New Par Status: Non Par

 

National Association of Letter Carriers

Industry ID: 53011

Exchange CPIDs: 7224

Old Par Status: Par

New Par Status: Non Par

 

National Telecommunications Cooperative Association (NTCA Staff)

Industry ID: 52104

Exchange CPIDs: 3944

Old Par Status: Non Par

New Par Status: Par

 

National Telecommunications Cooperative Association (NTCA)

Industry ID: 52103

Exchange CPIDs: 3987

Old Par Status: Non Par

New Par Status: Par

 

Netcare Life and Health Insurance

Industry ID: 66055

Exchange CPIDs: 4915, 7277

Old Par Status: Non Par

New Par Status: Gateway

 

New York State Department of Health Uncompensated Care Program

Industry ID: 14142

Exchange CPIDs: 3665

Old Par Status: Non Par

New Par Status: Gateway

 

Northern Illinois Health Plan

Industry ID: 36347

Exchange CPIDs: 2291, 8969

Old Par Status: Non Par

New Par Status: Par

 

Ohio Health Choice PPO

Industry ID: 34189

Exchange CPIDs: 1860, 7553

Old Par Status: Non Par

New Par Status: Par

 

Partners Health Plan

Industry ID: 14966

Exchange CPIDs: 1111

Old Par Status: Transitional

New Par Status: Non Par

 

Payer Fusion

Industry ID: 27048

Exchange CPIDs: 7636

Old Par Status: Non Par

New Par Status: Gateway

 

Pennsylvania Pace

Industry ID: 20172

Exchange CPIDs: 5603, 6228

Old Par Status: Non Par

New Par Status: Gateway

 

Preferred Benefit Administrators (Longwood, Florida)

Industry ID: 53476

Exchange CPIDs: 1652, 3198

Old Par Status: Transitional

New Par Status: Non Par

 

Primary Health Network

Industry ID: 82048

Exchange CPIDs: 1938

Old Par Status: Gateway

New Par Status: Transitional

 

Priority Health of Michigan

Industry ID: 38217

Exchange CPIDs: 3591

Old Par Status: Non Par

New Par Status: Par

 

Regency Employee Benefits

Industry ID: 38221

Exchange CPIDs: 4668

Old Par Status: Non Par

New Par Status: Gateway

 

Sante Community Physicians Medical Group

Industry ID: SNTMC

Exchange CPIDs: 1134, 1537

Old Par Status: Non Par

New Par Status: Par

 

Selman & Company

Industry ID: 52214

Exchange CPIDs: 2028, 8164

Old Par Status: Non Par

New Par Status: Par

 

South Country Health Alliance

Industry ID: 81600

Exchange CPIDs: 1039, 7868

Old Par Status: Non Par

New Par Status: Par

 

Superior Select Health Plan

Industry ID: 61184

Exchange CPIDs: 1065, 7893

Old Par Status: Non Par

New Par Status: Par

 

Tall Tree Administrators

Industry ID: 88067

Exchange CPIDs: 4935

Old Par Status: Non Par

New Par Status: Par

 

Trusteed Plans Service

Industry ID: 91078

Exchange CPIDs: 2238, 2941

Old Par Status: Non Par

New Par Status: Par

 

U.S. Networks and Administrative Services

Industry ID: USN01

Exchange CPIDs: 4035, 8763

Old Par Status: Non Par

New Par Status: Gateway

 

UMC Health Plan

Industry ID: 75130

Exchange CPIDs: 1670, 5711

Old Par Status: Non Par

New Par Status: Gateway

 

UMWA Health and Retirement Funds

Industry ID: 52180

Exchange CPIDs: 2991

Old Par Status: Transitional

New Par Status: Non Par

 

US Benefits

Industry ID: 93092

Exchange CPIDs: 2241, 4970

Old Par Status: Transitional

New Par Status: Non Par

 

Unified Group Services

Industry ID: 35198

Exchange CPIDs: 4542

Old Par Status: Non Par

New Par Status: Par

 

Unified Health Services

Industry ID: 62170

Exchange CPIDs: 7576

Old Par Status: Non Par

New Par Status: Par

 

UnitedHealthcare Ohio Medicaid

Industry ID: 88337

Exchange CPIDs: 7074, 9465

Old Par Status: Non Par

New Par Status: Gateway

 

University of Illinois at Chicago Division of Specialized Care for Children

Industry ID: 37601

Exchange CPIDs: 8800

Old Par Status: Non Par

New Par Status: Gateway

 

Upper Peninsula Health Group (TPA)

Industry ID: 37324

Exchange CPIDs: 1792, 2686

Old Par Status: Non Par

New Par Status: Gateway

 

Valor Health Plan

Industry ID: 43259

Exchange CPIDs: 2000

Old Par Status: Non Par

New Par Status: Par

 

Wellfleet Group

Industry ID: 87843

Exchange CPIDs: 2670

Old Par Status: Non Par

New Par Status: Gateway

 

Western Growers/Pinnacle

Industry ID: 24735

Exchange CPIDs: 6587

Old Par Status: Non Par

New Par Status: Par

 

Western Health Advantage

Industry ID: 68039

Exchange CPIDs: 6267

Old Par Status: Non Par

New Par Status: Par

 

William C Earhart

Industry ID: 93050

Exchange CPIDs: 3465, 3919

Old Par Status: Transitional

New Par Status: Non Par

 

Action Required: Please be aware of the upcoming PAR status changes.

2/27/2026

---

Restored and New Electronic Eligibility and Claim Status Connection

Effective February 27, 2026, Optum is pleased to announce the restored Real-Time transactions for the payer specified below. Restored Exchange Eligibility transactions. Added both Eligibility and Claim Status for as new payer on iEDI.

Eligibility Inquiry and Response 270/271 with updated Search Options

Real-time Claim Status Inquiry 276/277

Payer Name: CareFirst Blue Cross Blue Shield Medicare Advantage

Industry Payer ID: 45282

IMN Real Time ID: 45282

Exchange Real Time ID: CFBMA

CPID(s): 7487, 9643

Optum IEDi Real Time ID: 45282

Payer Enrollment Required: No

Connection Type:  X12 5010

Search Options:

  Eligibility Subscriber:

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

  Claim Status Inquiry Subscriber:

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

Optional additional elements:

• Payer Claim Number
• Total Submitted Charges

Action Required by customer:

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

2/27/2026

---

Resolved: Delay in Electronic Remittance Advice (ERA) for Payer ID MIMCD, SKMI0, 12K37 Michigan Medicaid

Resolved: This issue is resolved. All impacted ERAs have been processed.

Original Notify sent February 24, 2026:

Due to a payer processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for the check date of Jan. 15, 2026.

• Michigan Medicaid: MIMCD, SKMI0, 12K37

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004105.

2/27/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Optum San Diego Public Sector County

Institutional CPID: 9070

Payer-assigned Payer ID: CNTY1

Payer Claim Enrollment Required: No

Secondary Claims Accepted: No

Payer Location: California

Claims Fee: N/A

 

Payer Name: Optum San Diego Skilled Nursing Facilities

Institutional CPID: 9071

Payer-assigned Payer ID: COSNF

Payer Claim Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: California

Claims Fee: N/A

 

Payer Name: Optum San Diego County Funded Hospital

Institutional CPID: 9072

Payer-assigned Payer ID: COHOSP 

Payer Claim Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: California

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.

2/27/2026

---

Life Pittsburgh Electronic Claims and Remittance Connection No Longer Available

Effective immediately, the payer listed below will no longer be available at Optum for claims, remittance processing.

Payer Name: Life Pittsburgh
Claim and Remittance CPIDs: 3043, 8292
Remittance LOB: J5P
Payer-assigned Payer ID: 25181

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

Action Required: None.

2/27/2026

---

Life Pittsburgh Electronic Claims and Remittance Connection No Longer Available

Effective immediately, the payer listed below will no longer be available at Optum for claims, remittance processing.

Payer Name: Life Pittsburgh
Claim and Remittance CPIDs: 3043, 8292
Payer-assigned Payer ID: 25181

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

Action Required: None.

2/27/2026

---

Update: Report Generation Delay for CPID 2872 TRICARE East Region

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Feb. 10, 2026.

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

Original Notice Sent Feb. 19, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 10, 2026.

Payer impacted:

• CPID 2872 TRICARE East Region

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 09896102.

2/26/2026

---

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 Feb 24, 2026:

Payer Name: CORPORATE BENEFITS SERVICES
Industry Payer ID: 56116
IMN Real Time ID: CPBNS
Exchange Real Time ID: CPBNSV
Optum IEDI Real Time ID: CPBNS
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber

• Member ID, First Name, Last Name, 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.

2/26/2026

---

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 Feb 18, 2026:

Payer Name: Christian Brothers Services
Industry Payer ID: 38308
IMN Real Time ID: 38308
Exchange Real Time ID: CBSER
Optum IEDI Real Time ID: 38308
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.

2/26/2026

---

New Electronic Eligibility & Claim Status Connection Available

Optum is pleased to announce the availability of Real-time Eligibility 270/271 & Claim Status Inquiry and Response 276/277 for the below payer, effective Feb 24, 2026:

Payer Name: PARTNERS INSURANCE COMPANY OF NEW JERSEY INC
Industry Payer ID: NJ099
IMN Real Time ID: NJ099
Exchange Real Time ID: PICNJ
CPID(s): 9013 (I), 3483 (P)
IEDI Real Time ID: NJ099
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber

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

Claim Status Inquiry subscribe

• Member ID, First name, Last name, date of birth

Optional additional elements:

• Payer claim number, Total submitted charges

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.

2/26/2026

---

Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Feb. 12, 2026.

Payer impacted: 

• CPID 6671 HealthSun

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 09903886.

2/26/2026

---

Report Generation Delay for CPIDs 1913 and 2287 Michigan Medicare Plus Blue (MAP)

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 12, 2026.

Payer impacted: 

• CPID 1913 Michigan Medicare Plus Blue (MAP)
• 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 09903805.

2/26/2026

---

New Electronic Eligibility Connection

Optum is pleased to announce the New Real-Time transactions for the payer specified below, effective February 26, 2026.

Real-Time Transaction Types:
Eligibility Inquiry and Response 270/271

Payer Name: Aspire Health Plan
Industry Payer ID: 46156
IMN Real Time ID: 46156
Exchange Real Time ID: ASPHPL
CPID(s): 2507, 1163
Optum iEDI Real Time ID: 46156
Payer Enrollment Required: No

Search Options:

Eligibility Subscriber

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

Action Required by customer:

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

2/26/2026

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Medicare HETS - HETS2026-1 System Release Update

CMS announces publication of the HETS2026-1 Companion Guide. 

The HETS2026-1 system release will introduce potential changes to the HETS 271 response. CMS urges all HETS submitters to use the HETS2026-1 Release Summary and this HETS2026-1 Companion Guide to prepare for this release. 

HETS2026-1 Release Summary (version 2.0): https://www.cms.gov/files/document/hets2026-1-hets-270-271-release-summary.pdf

HETS2026-1 Companion Guide (version 15.0): https://www.cms.gov/files/document/hets2026-1-hets-270-271-companion-guide-v15-0.pdf

The HETS2026-1 release is scheduled for March, 2026. Submitters will be notified when additional information is available regarding this release. 

Action Required: Review updated details on the potential changes that are linked above and distribute as appropriate within your facility.

2/26/2026

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Enrollment Form Change for CPID[s] 1786, 8561 / Payer ID 46045, Avera Health Plans

The following payers have changed their Remittance enrollment form:

• CPID 1786, 8561 / Payer ID 46045, Avera Health Plans

Providers already approved to submit and receive transactions through Optum do not need to complete a new enrollment form.

To access the new enrollment form, please visit Enrollment Central.

Action Required: None for existing providers. New providers should begin using the new enrollment form immediately.

2/26/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Rincol Health Network
Institutional CPID: 9084
Professional CPID: 3868
Payer-assigned Payer ID: RHN01
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
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. 

2/25/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Rincol Health Network
Institutional CPID: 9084
Professional CPID: 3868
Payer-assigned Payer ID: RHN01
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
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. 

2/25/2026

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Payer Processing Issue for Multiple CPIDs

Due to a UHIN processing issue, some Professional and Institutional claims transmitted to the payers listed below on Feb. 18, 2026 were not processed by the payer intermediary.

Payers impacted:

• CPID 8213 Mint Health Plans/Samera Health
• CPID 5053 Mint Health Plans/Samera Health
• CPID 4727 Public Employee Health Plan (PEHP)
• CPID 1673 Public Employee Health Plan (PEHP)
• CPID 4480 SelectHealth
• CPID 1532 SelectHealth
• CPID 4728 Deseret Mutual Benefit Associates
• CPID 8995 Deseret Mutual Benefit Associates
• CPID 6886 Optum Salt Lake County Public Sector

A resolution has been implemented and the claims were retransmitted to the payer intermediary on Feb. 25, 2026.

This delay affected claims released to Optum between 4 p.m. CT on Feb. 17, 2026 and 4 p.m. CT on Feb. 18, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09901695.

2/25/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Manhattan Life Insurance and Annuity Company
Institutional CPID: 9080
Professional CPID: 3851
Payer-assigned Payer ID: 28148
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.

2/25/2026

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Report Generation Delay for CPID 7489 Blue Cross Blue Shield of Wyoming

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 11, 2026.

Payer impacted: 

• CPID 7489 Blue Cross Blue Shield of Wyoming

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 09901765.

2/25/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: SGRX Health
Institutional CPID: 9082
Professional CPID: 3867
Payer-assigned Payer ID: 29094
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Michigan
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.

2/25/2026

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Resolved: Delay in Electronic Remittance Advice (ERA) Medicaid MI

Resolved: ERAs for Michigan Medicaid for the check date of January 15th are now being delivered. We apologize for any inconvenience this may have caused.

Action Required: none 

Original Notification sent February 18, 2026: 

Due to a payer processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for the check date of January 15, 2026.

• CPID 5935 Michigan Medicaid Long Term Care
• CPID 2480 Michigan Medicaid
• CPID 3512 Michigan Medicaid

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004105 

2/24/2026

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999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on Feb. 23, 2026 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 Feb. 24, 2026.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09900931.

2/24/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Yuzu Health
Institutional CPID: 1524
Professional CPID: 1426
Payer-assigned Payer ID: IHS15
Line of Business (LOB) Code: E52
Payer Enrollment Required: Yes
Payer Location: National

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. 

2/24/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Yuzu Health
Institutional CPID: 1524
Professional CPID: 1426
Payer-assigned Payer ID: IHS15
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National

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. 

2/24/2026

Payer Name Change

Effective immediately, please be aware of the following payer name change(s):

Previous Name: Behavioral Health Systems
New Name: TELUS Health

Action Required: Please make the appropriate changes to accommodate the name change. 

2/24/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Esperanza IPA
Institutional CPID: 9079
Professional CPID: 3859
Payer-assigned Payer ID: EIPA8
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
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. 

2/24/2026

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Report Generation Delay for CPID 9010 ArchCare

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Feb. 10, 2026.

Payer impacted: 

• CPID 9010 ArchCare

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 09900640.

2/24/2026

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Report Generation Delay for CPID 5568 Global Healthcare Alliance

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Feb. 10, 2026.

Payer impacted: 

• CPID 5568 Global Healthcare Alliance

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 09900404.

2/24/2026

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Enrollment Form Change for 5562/1492 - 77048 - New Mexico Medicaid

The following payers have changed their Remittance enrollment form:

• CPID 5562 / Payer ID- 77048 / New Mexico Medicaid
• CPID 1492/ Payer ID- 77048 / New Mexico Medicaid

Providers already approved to submit and receive transactions through Change Healthcare do not need to complete a new enrollment form.

To access the new enrollment form, please visit Enrollment Central.

Action Required: None for existing providers. New providers should begin using the new enrollment form immediately.

2/24/2026

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Report Generation Delay for CPID 4743 Carelon Behavioral Health

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 6, 2026.

Payer impacted: 

• CPID 4743 Carelon Behavioral 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 09900353.

2/24/2026

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Report Generation Delay for CPIDs 7743 and 6589 Inland Empire Health Plan

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted on Feb. 18, 2026.

Payer impacted:

• CPID 7743 Inland Empire Health Plan
• CPID 6589 Inland Empire 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 09900357.

2/24/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Positive Healthcare
Institutional CPID: 6608
Professional CPID: 6884
Payer-assigned Payer ID: 95411
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California, Florida

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.

2/24/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Positive Healthcare
Institutional CPID: 6608
Professional CPID: 6884
Payer-assigned Payer ID: 95411
Line of Business (LOB) Code: U4E
Payer Enrollment Required: Yes
Payer Location: California, Florida

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.

2/24/2026

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Report Generation Delay for CPID 3740 S & S Healthcare Strategies dba Reflect Health

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 16, 2026.

Payer impacted:

• CPID 3740 S & S Healthcare Strategies dba Reflect 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 09891638.

2/24/2026

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New Electronic Eligibility and Claim Status Connection

Optum is pleased to announce the New Real-Time transactions for the payer specified below, effective February 19, 2026.

Real-Time Transaction Types: 

Eligibility Inquiry and Response 270/271
Real-time Claim Status Inquiry 276/277

Payer Name: Regence Blue Cross Blue Shield of Oregon
Industry Payer ID: DCA62
IMN Real Time ID: DCA62
Exchange Real Time ID: DCADM
CPID(s): 9685, 7736
Optum iEDI Real Time ID: DCA62
Payer Enrollment Required: No

Search Options:

Eligibility Subscriber

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

Eligibility Dependent

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

Claim Status Inquiry subscriber

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

Optional additional elements:

• Payer Claim Number
• Total Submitted Charges

Claim Status Inquiry Dependent

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

Optional additional elements:

• Payer Claim Number
• Total Submitted Charges

Action Required by customer:

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

2/24/2026

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Delay in Electronic Remittance Advice (ERA) for Payer ID MIMCD, SKMI0, 12K37 Michigan Medicaid

Due to a payer processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for the check date of Jan. 15, 2026.

• Michigan Medicaid: MIMCD, SKMI0, 12K37

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004105.

2/24/2026

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Update: Invalid Error Message for CPIDs 5547/4426 Arizona Blue Cross Blue Shield

Update: This issue is still under review with the payer. Additional notifications will be sent as updates become available.

Original notify sent on: March 27, 2025

Due to a payer processing issue, Professional and Institutional claims for the payer listed below may have received the following invalid error message on the Payer Claim Data Report (SR), Payer Claim Data Report (SE), Payer Report Data File (SF):

• Reject Code: 601
• Message: CLM: MISPLACED SEGMENT DTP (DATE - REPRICER RECEIVED DATE) AT 2-1350 WITHIN LOOP CLM (2300)(CLAIM INFORMATION) AT 2-1300, THIS SEGMENT, LOOP/GROUP MAY NOT BE IN THE CORRECT POSITION FOR LOOP/GROUP

This issue began November 2024 and is still ongoing. The payer is working to resolve the invalid error message in their system. Currently, the payer does not have an ETA on correcting the error, however any affected claims can be resubmitted.

Payers affected:

• 5547 Arizona Blue Cross Blue Shield
• 4426 Arizona Blue Cross Blue Shield

Action Required: Please be aware of the invalid error message.

2/24/2026

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New Real-time Claim Status Availability for West Virginia Medicaid

Effective February 20th, 2026, Optum is pleased to announce the availability of Real-time Claim Status Inquiry and Response (276/277) transactions for the below payer:

West Virginia Medicaid
IMN Payer ID: SKWV0
IEDI Payer ID: WVMCD
Exchange: CPIDs: 5532 and 2477

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 https://customercare.changehealthcare.com/public/home.html

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

2/24/2026

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Update: Payer Reactivation - Yuzu Health

Update: This payer has been reactivated and rerouted. Providers may submit claims to this payer.

Payer Name: Yuzu Health
CPIDs: 1426, 1524
Payer ID: IHS15
Payer Claim Enrollment Required: No
Secondary claims accepted: Yes
Claims Fee: N/A

Original Notification sent on 1/8/2026

Electronic Claims Connection Suspended

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

Payer Name: Yuzu Health
CPIDs: 1426, 1524
Payer ID: IHS15
Reason: Payer unavailable electronically.

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

2/23/2026

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Update: Report Generation Delay for CPID 3740 S & S Healthcare Strategies dba Reflect Health

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Jan. 26, 2026.

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

Original notice sent Feb. 16, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Jan. 26, 2026.

Payer impacted:

• CPID 3740 S & S Healthcare Strategies dba Reflect Health

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

2/23/2026

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Update: Report Generation Delay for CPID 3740 S & S Healthcare Strategies dba Reflect Health

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Feb. 2, 2026 and Feb. 9, 2026.

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

Original notice sent Feb. 16, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 2, 2026 and Feb. 9, 2026.

Payer impacted:

• CPID 3740 S & S Healthcare Strategies dba Reflect Health

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

2/23/2026

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AmericasHealth Plan Electronic Claims Connection No Longer Available

Effective immediately, the payer listed below will no longer be available at Optum for claims processing.

Payer Name: AmericasHealth Plan
Claim CPIDs: 9281, 7001
Payer-assigned Payer ID: AHP01
Reason: Payer no longer in business.

Action Required: None.

2/23/2026

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Update: Report Generation Delay for CPIDs 5909 and 4743 Carelon Behavioral Health

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Jan. 30, 2026.

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

Original notice sent Jan. 26, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 12, 2026.

Payer impacted: 

• CPID 5909 Carelon Behavioral Health
• CPID 4743 Carelon Behavioral 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 09840558.

2/23/2026

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Report Generation Delay for CPID 3787 AvMed (Encounters)

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 9, 2026.

Payer impacted: 

• CPID 3787 AvMed (Encounters)

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 09899489.

2/23/2026

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Delay in Electronic Remittance Advice (ERA) for Michigan Medicaid

Update: CPID 2908 was included in the previous notification in error. That CPID is not affected and has been removed from this issue. We are continuing to try and retrieve the ERAs from Michigan Medicaid for check date January 15, 2026

Due to a payer processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for the check date of January 15, 2026.

• CPID 5935 Michigan Medicaid Long Term Care
• CPID 2480 Michigan Medicaid
• CPID 3512 Michigan Medicaid

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004105.

2/23/2026

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Update: Report Generation Delay for CPIDs 7567 and 7499 Sentara Health Plans

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Jan. 21, 2026 through Feb. 9, 2026.

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

Original notice sent Jan. 20, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 1, 2026.

Payer impacted: 

• CPID 7567 Sentara Health Plans
• CPID 7499 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 09834767.

2/23/2026

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Payer Processing Issue for CPIDs 4425 and 5550 District of Columbia Medicaid

Due to a payer processing issue, Professional and Institutional claims transmitted to the payer listed below on Feb. 20, 2026 were not processed by the payer.

Payer impacted:

• CPID 4425 District of Columbia Medicaid
• CPID 5550 District of Columbia Medicaid

Starting Feb. 20, 2026, 3 p.m. CT, the web portal will be available in an INQUIRY ONLY mode through Feb. 28, 2026, and will no longer allow Claim or Prior Authorization submissions.

Additional information on this transition will be provided by Gainwell/DHCF as the transition date approaches. You can also visit https://medicaid.dc.gov for more information.

Effective March 2, 2026, DHCF will transition to a new Medicaid Management Information System (MMIS) and all fiscal agent services will transition to Gainwell.

This affected claims released to Optum between 9 p.m. CT on Feb. 19, 2026 and 9 p.m. CT on Feb. 20, 2026.

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

If you have any questions, please contact Customer Support and refer to Case Number 09899148.

2/23/2026

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Electronic Routing Change for CPIDs 7148 and 7693 Highmark Blue Cross Blue Shield of Delaware Health Options

Effective February 25, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: Highmark Blue Cross Blue Shield of Delaware Health Options
Professional CPID: 7148
Institutional CPID: 7693
Payer-assigned Payer ID: 47181
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 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.

2/23/2026

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Electronic Routing Change for CPIDs 7148 and 7693 Highmark Blue Cross Blue Shield of Delaware Health Options

Effective February 25, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: Highmark Blue Cross Blue Shield of Delaware Health Options
Professional CPID: 7148
Current Edit Master: PE_N000New Edit Master: PE_T007
Institutional CPID: 7693
Current Edit Master: HE9N000
New Edit Master: HE9T007
Payer-assigned Payer ID: 47181
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 CPIDs are not changing.
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

2/23/2026

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Electronic Claims Connection Suspended - District of Columbia Medicaid

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

Payer Name: District of Columbia Medicaid
Payer ID: 77033, DCMCD, SKDC0, 12001

Reason: Effective March 2, 2026, DHCF will transition to a new Medicaid Management Information System (MMIS) and all fiscal agent services will transition to Gainwell.

Starting Feb. 20, 2026, 4:00 PM Eastern Time, the web portal will be available in an INQUIRY ONLY mode through Feb. 28, 2026, and will no longer allow Claim or Prior Authorization submissions.

Additional information on this transition will be provided by Gainwell/DHCF as the transition date approaches. You can also visit https://medicaid.dc.gov for more information.

NOTE: Claims submitted after Feb. 19, 2026, 10:00 PM ET will not be eligible for processing by the payer.

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

2/23/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Highmark Health Options Duals West Virginia
Payer ID: 88831
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: West Virginia

Payer Name: SKAI Blue Cross Blue Shield
Payer ID: BSKAI
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Arkansas 

Action Required:  

• Add the payers to your system to begin using the new payer connection.

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

2/23/2026

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Electronic Claims Connection Suspended

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

Payer Name: District of Columbia Medicaid
CPID(s): 5550, 4425
Payer ID: 77033
Reason:

Effective March 2, 2026, DHCF will transition to a new Medicaid Management Information System (MMIS) and all fiscal agent services will transition to Gainwell.

Starting Feb. 20, 2026, 4:00 PM Eastern Time, the web portal will be available in an INQUIRY ONLY mode through Feb. 28, 2026, and will no longer allow Claim or Prior Authorization submissions.

Additional information on this transition will be provided by Gainwell/DHCF as the transition date approaches. You can also visit https://medicaid.dc.gov for more information.

NOTE: Claims submitted after Feb. 19, 2026, 10:00 PM ET will not be eligible for processing by the payer.

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

2/20/2026

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Resolved: Delay in Electronic Remittance Advice (ERA) for multiple Payers

Resolved: This issue is resolved. All impacted ERAs have been processed.

Original notice sent Feb. 19, 2026:

There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates Jan. 30, 2026 through February 7, 2026:

• CPID 6147 PacificSource Medicare
• CPID 4627 PacificSource Medicare
• CPID 6575 PacificSource Health 
• CPID 5441 PacificSource Health
• CPID 4972 PacificSource Community Health Solutions
• CPID 4794 PacificSource Community Health Solutions

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

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 INC-000004118.

2/20/2026

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Resolved: Delay in Electronic Remittance Advice (ERA) for multiple Payers

Resolved: This issue is resolved. All impacted ERAs have been processed.

Original notice sent Feb. 19, 2026:

There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates Jan. 30, 2026 through February 7, 2026:

• 93029 PacificSource Health Plans
• 20377 PacificSource Medicare

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

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 INC-000004118.

2/20/2026

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Report Generation Delay for CPIDs 2593 and 5428 QualChoice of Arkansas

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 6, 2026.

Payer impacted: 

• CPID 2593 QualChoice of Arkansas
• CPID 5428 QualChoice of Arkansas

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 09897565.

2/20/2026

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Update: Report Generation Delay for CPIDs 4792 and 5928 Ohio Bureau of Children with Medical Handicaps

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Jan. 26, 2026.

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

Original notice sent Feb. 6, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 26, 2026.

Payer impacted:

• CPID 4792 Ohio Bureau of Children with Medical Handicaps 
• CPID 5928 Ohio Bureau of Children with Medical Handicaps

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 09877081.

2/20/2026

---

Transmit Delay for CPID 7241 TransactRX Part D

Due to a payer system issue, a delay occurred in some of the transmissions to the following payer Feb. 18, 2026 and Feb. 19, 2026.

Payer impacted: 

• CPID 7241 TransactRX Part D

A resolution has been implemented and the affected claims were transmitted to the payer Feb. 20, 2026.

This delay affected claims released to Optum Feb. 17, 2026, 9:00 p.m.-Feb. 19, 2026. 9:00 CT.

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 09897360.

2/20/2026

---

Report Generation Delay for CPID 9057 Sentara PACE

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Feb. 5, 2026.

Payer impacted: 

• CPID 9057 Sentara PACE

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 09897514.

2/20/2026

---

Update: Report Generation Delay for CPID 1405 Blue Cross Blue Shield

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Jan. 20, 2026.

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

Original notice sent Feb. 2, 2026:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Jan. 20, 2026.

Payer impacted: 

• CPID 1405 Blue Cross Blue Shield of Illinois

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 09876720.

2/20/2026

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999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on Feb. 18, 2026 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 Feb. 19, 2026.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09896345.

2/20/2026

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Claim processing delay

Some claims are delayed for Healthgram for some providers since Feb. 12, 2026.

Payer name: Healthgram
Payer id: 56144
CPID 6595
CPID 1757

The claims are being reviewed to ensure they are processed and distributed to the payer as expected.

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

If you have any questions, please contact Customer Support and refer to INC-000004124.

2/20/2026

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Update: Report Generation Delay for CPID 2872 TRICARE East Region

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Jan. 15, 2026.

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

Original Notice Sent Jan. 28, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Jan. 15, 2026.

Payer impacted:

• CPID 2872 TRICARE East Region

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 09844401.

2/19/2026

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Report Generation Delay for CPID 2872 TRICARE East Region

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 10, 2026.

Payer impacted:

• CPID 2872 TRICARE East Region

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 09896102.

2/19/2026

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Update: Report Generation Delay for CPIDs 8980 and 7279 PACE Southeast Michigan

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Jan. 19, 2026.

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

Original notice sent Feb. 2, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Jan. 19, 2026.

Payer impacted: 

• CPID 8980 PACE Southeast Michigan
• CPID 7279 PACE Southeast Michigan

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 09876452.

2/19/2026

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Delay in Electronic Remittance Advice (ERA) for multiple payers

There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates Jan. 30, 2026-Feb. 7, 2026:

• CPID 6147 PacificSource Medicare
• CPID 4627 PacificSource Medicare
• CPID 6575 PacificSource Health 
• CPID 5441 PacificSource Health
• CPID 4972 PacificSource Community Health Solutions
• CPID 4794 PacificSource Community Health Solutions

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

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 INC-000004118.

2/19/2026

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Report Generation Delay for CPID 5440 Fox Valley Medicine

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 5, 2026.

Payer impacted: 

• CPID 5440 Fox Valley Medicine

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 09895920.

2/19/2026

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Report Generation Delay for CPIDs 2845 and 7542 SVCMC USFHP

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted Feb. 17, 2026.

Payer impacted:

• CPID 2845 SVCMC USFHP
• CPID 7542 SVCMC USFHP

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 09895544.

2/19/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: American Plan Administrators
Institutional CPID: 3027
Professional CPID: 8276
Payer-assigned Payer ID: 95606
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: New York

 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. 

2/18/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: American Plan Administrators
Institutional CPID: 3027
Professional CPID: 8276
Payer-assigned Payer ID: 95606
Line of Business (LOB) Code: E50
Payer Enrollment Required: Yes
Payer Location: New York

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.

2/18/2026

---

Update: Report Generation Delay for Multiple CPIDs

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Nov. 14, 2025 through Feb. 16, 2026.

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

Original Notice Sent Dec. 03, 2025:

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.

2/18/2026

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Electronic Routing Change for CPIDs 8993 and 2274 Essence

Effective February 18, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: Essence  
Professional CPID: 2274
Institutional CPID: 8993
Payer-assigned Payer ID: 20818
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. 

2/18/2026

---

Electronic Routing Change for CPIDs 8993 and 2274 Essence

Effective February 18, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: Essence  
Professional CPID: 2274
Institutional CPID: 8993
Payer-assigned Payer ID: 20818
Line of Business Code (LOB): U4G
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:  

• 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. 

2/18/2026

---

Report Generation Delay for CPIDs 8612 and 7171 Neighborhood Health

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Jan. 29, 2026.

Payer impacted:

• CPID 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP)
• CPID 7171 Neighborhood Health Plan of Rhode Island - Integrity (MMP)

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 09894377.

2/18/2026

---

Electronic Routing Change for CPIDs 2298 and 2912 Gateway Health Plan - Medicare Assured Pennsylvania

Optum will be changing electronic claims routing for the following payer, effective Feb. 20, 2026:

Payer Name: Gateway Health Plan - Medicare Assured Pennsylvania
Professional CPID: 2298
Current Edit Master: PE_B800
New Edit Master: PE_T007
Institutional CPID: 2912
Current Edit Master: HE9B801
New Edit Master: HE9T007
Payer-assigned Payer ID: 60550
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: 

• 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. 

2/18/2026

---

Electronic Routing Change for CPIDs 8472 and 4569 Gateway Health Plan - Medicaid Pennsylvania

Optum will be changing electronic claims routing for the following payer, effective Feb. 20, 2026:

Payer Name: Gateway Health Plan - Medicaid Pennsylvania
Professional CPID: 8472
Edit Master: PE_T007
Institutional CPID: 4569
Edit Master: HE9T007
Payer-assigned Payer ID: 25169
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. 

2/18/2026

---

Electronic Routing Change for Gateway Health Plan Pennsylvania - Multiple

Optum will be changing electronic claims routing for the following payers, effective Feb. 20, 2026:

Payer Name: Gateway Health Plan - Medicaid Pennsylvania
Professional CPID: 8472
Institutional CPID: 4569
Payer-assigned Payer ID: 25169
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Payer Name: Gateway Health Plan - Medicare Assured Pennsylvania
Professional CPID: 2298
Institutional CPID: 2912
Payer-assigned Payer ID: 60550
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. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central. 

2/18/2026

---

Delay in Electronic Remittance Advice (ERA) for Michigan Medicaid

Due to a payer processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for the check date of Jan. 15, 2026.

• CPID 5935 Michigan Medicaid Long Term Care
• CPID 2908 Michigan Medicaid Long Term Care
• CPID 2480 Michigan Medicaid
• CPID 3512 Michigan Medicaid

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004105.

2/18/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: AIDS Healthcare Foundation - RW
Institutional CPID: 7059
Professional CPID: 9443
Payer-assigned Payer ID: 95433
Line of Business (LOB) Code: H4G
Payer Enrollment Required: Yes
Payer Location: National 

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. 

2/18/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: AIDS Healthcare Foundation - RW
Institutional CPID: 7059
Professional CPID: 9443
Payer-assigned Payer ID: 95433
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National 

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. 

2/18/2026

---

Resolved: Delay in Electronic Remittance Advice (ERA) for CPIDs 3506, 4423 Medical Mutual of Ohio

Resolved: This issue is now resolved for ERAs dated February 17, 2026 and after. Any missing remits will need to be posted manually.

Original Notification sent February 11, 2026:

Due to a payer intermediary processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates of September 9, 2025 through present:

• CPID 3506 Medical Mutual of Ohio
• CPID 4423 Medical Mutual of Ohio

Additional updates will be forwarded as more information becomes available. 

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004086. 

2/18/2026

---

Electronic Routing Change for CPIDs 8137 and 2005 Empower Healthcare Solutions

Optum is changing electronic remittance routing for the following payer, effective Feb. 18, 2026:

Payer Name: Empower Healthcare Solutions
Professional CPID: 8137
Institutional CPID: 2005
Payer-assigned Payer ID: 21956
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. 

2/18/2026

---

New Electronic Remittance Connections Available
Optum has new electronic remittance connections available:  

Payer Name: PSKW LLC
Institutional CPID: 6023
Professional CPID: 1239
Payer-assigned Payer ID: PSKW0
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National 

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. 

2/18/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: PSKW LLC
Institutional CPID: 6023
Professional CPID: 1239
Payer-assigned Payer ID: PSKW0
Line of Business (LOB) Code: H50
Payer Enrollment Required: Yes
Payer Location: National 

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. 

2/18/2026

---

Electronic Routing Change for CPIDs 8137 and 2005 Empower Healthcare Solutions

Optum is changing electronic remittance routing for the following payer, effective Feb. 18, 2026: 

Payer Name: Empower Healthcare Solutions
Professional CPID: 8137
Institutional CPID: 2005
Payer-assigned Payer ID: 12956
Line of Business Code (LOB): H7Z
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: 

• 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. 

2/18/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Upper Peninsula Health Group (TPA)
Institutional CPID: 2686
Professional CPID: 1792
Payer-assigned Payer ID: 37324
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Michigan

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.

2/17/2026

---

Report Generation Delay for CPIDs 7136 and 7681 Benefit and Risk Management Services

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 2, 2026.

Payer impacted:

• CPID 7136 Benefit and Risk Management Services
• CPID 7681 Benefit and Risk Management Services 

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 09893045.

2/17/2026

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available: 

Payer Name: Hinge Health
Payer ID: HINGE
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: National 

Action Required:

• Add the payers to your system to begin using the new payer connection. 
• When a payer requires claims enrollment, forms must be submitted and approved to begin submitting transactions. 
• Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum. 

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

2/17/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: AmeriHealth Caritas Next, A Product of AmeriHealth Caritas Louisiana
Payer ID: 75066
Payer Enrollment Required: Yes
Payer Location: Louisiana

Payer Name: AmeriHealth Caritas VIP Care - Louisiana HIDE SNP
Payer ID: 73575
Payer Enrollment Required: Yes
Payer Location: Louisiana

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.

2/17/2026

---

Par Status Change for Claim Payer EMI-KP Ambulance

The Payer Type changed for the following claim payer effective Feb. 1, 2026:

Payer Name: EMI-KP Ambulance
Payer ID: 59299
Old Payer Type: Gateway
New Payer Type: Transitional

Action Required: Please be aware of the change.

2/17/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Highmark Health Options Duals West Virginia
Institutional CPID: 9076
Professional CPID: 3849
Payer-assigned Payer ID: 88831
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: West Virginia
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.

2/17/2026

---

Restored Electronic Eligibility and Claim Status Connection

Optum is pleased to announce the restored Real-Time transactions for the payer specified below, effective February 6, 2026.

Eligibility Inquiry and Response 270/271 with updated Search Options

Real-time Claim Status Inquiry 276/277

Payer Name: Regence Blue Cross Blue Shield of Oregon

Industry Payer ID: 00851

IMN Real Time ID: SB850

Exchange Real Time ID: ORRBCS

CPID(s): 5516, 2404

Optum IEDi Real Time ID: ORBLS, 10045

Payer Enrollment Required: No

Connection Type:  X12 5010

Search Options:

Eligibility Subscriber

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

Eligibility Dependent

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

Claim Status Inquiry subscriber

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

Optional additional elements:

Payer Claim Number

Total Submitted Charges

Claim Status Inquiry Dependent

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

Optional additional elements:

Payer Claim Number

Total Submitted Charges

Action Required by customer:

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

2/17/2026

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PAR Status Change for Claim Payer

Effective Feb. 1, 2026, the PAR Status is changing for the following claim payer(s):

Payer Name: EMI-KP Ambulance
Industry ID: 59299
Exchange CPID(s): 8852
Old PAR Status: Gateway
New PAR Status: Transitional

Action Required: Please be aware of the upcoming change.

2/17/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Medcost Benefit Services
Institutional CPID: 8974
Professional CPID: 1880
Payer-assigned Payer ID: 56205
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: North Carolina, South Carolina

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.

2/16/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Medcost Benefit Services
Institutional CPID: 8974
Professional CPID: 1880
Payer-assigned Payer ID: 56205
Line of Business (LOB) Code: J61
Payer Enrollment Required: Yes
Payer Location: North Carolina, South Carolina

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.

2/16/2026

---

Follow up CSA for Claim Status Connection

Follow‑up to the previous CSA, Optum is pleased to announce the availability of Real‑time Claim Status Inquiry and Response (276/277) for the payer listed below, effective Feb. 6, 2026. Additionally, please note that, Tax ID is required in Information Receiver (NM1*41 segment) in the NM109 element and in the Service Provider (NM1*1P segment) in the NM109 element.  

Payer Name: Planned Administrators
Industry Payer ID: 37287
IMN Real Time ID: 37287
Exchange Real Time ID: PAIB
CPID(s): 3927 (I), 3883 (P)
IEDI Real Time ID: 37287
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Claim Status Inquiry subscriber

• Member ID, First name, Last name, date of birth, Gender

Optional additional elements:

• Payer claim number, Total submitted charges

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.

2/16/2026

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Electronic Routing Change for CPID 8771 Evolent Specialty Urology

Optum will be reactivating and changing electronic claims routing for the following payer, effective Feb. 17, 2026:

Payer Name: Evolent Specialty Urology
Professional CPID: 8771
Current Edit Master: PE_B800
New Edit Master: PE_T007
Payer-assigned Payer ID: NCHUR
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.

2/16/2026

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Payer Change for CPIDs 5074, 9121 Village Practice Management Company

Effective immediately, claims submitted to the payer listed below with Dates of Service on or after Nov. 1, 2025, will be rejected. The payer has also informed us that they will discontinue all claims and remittance activity effective May 1, 2026.

Payer Name: Village Practice Management Company
Professional CPID: 5074
Professional Edit Master: PE_T007
Institutional CPID: 9121
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: 36477
Line of Business Code (LOB): H65

Action Required: Be sure to follow the dates outlined above when submitting claims.

2/16/2026

---

Electronic Routing Change for CPID 8771 Evolent Specialty Urology

Optum will be reactivating and changing electronic claims routing for the following payer, effective Feb. 17, 2026:

Payer Name: Evolent Specialty Urology
Professional CPID: 8771
Payer-assigned Payer ID: NCHUR
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. 

2/16/2026

---

Payer Change for CPIDs 5074, 9121 Village Practice Management Company

Effective immediately, claims submitted to the payer listed below with Dates of Service on or after Nov. 1, 2025, will be rejected. The payer has also informed us that they will discontinue all claims and remittance activity effective May 1, 2026.

Payer Name: Village Practice Management Company
Professional CPID: 5074
Institutional CPID: 9121
Payer-assigned Payer ID: 36477

Action Required: Be sure to follow the dates outlined above when submitting claims.

2/16/2026

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

Deloitte is experiencing issues affecting Professional report generation for some claims submitted since Feb. 10, 2026.

Payer impacted:

• CPID 9435 OhioRISE - Aetna Better Health of Ohio

Optum is working diligently with Deloitte 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 09891677.

2/16/2026

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Report Generation Delay for CPID 3740 S & S Healthcare Strategies dba Reflect Health

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Jan. 26, 2026.

Payer impacted:

• CPID 3740 S & S Healthcare Strategies dba Reflect 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 09891638.

2/16/2026

---

Report Generation Delay for CPID 3740 S & S Healthcare Strategies dba Reflect Health

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 2, 2026 and Feb. 9, 2026.

Payer impacted:

• CPID 3740 S & S Healthcare Strategies dba Reflect 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 09891638.

2/16/2026

---

Report Generation Delay for CPIDs 1573 and 3802 AvMed

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Feb. 4, 2026.

Payer impacted: 

• CPID 1573 AvMed
• CPID 3802 AvMed

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 09891641.

2/16/2026

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Report Generation Delay for CPID 8714 Allstate

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 2, 2026.

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 09891557.

2/16/2026

---

Report Generation Delay for CPID 7692 Camp Lejeune Family Member Program

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Feb. 6, 2026.

Payer impacted: 

• CPID 7692 Camp Lejeune Family Member Program

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 09891477.

2/16/2026

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Follow up CSA for Claim Status Connection

Follow‑up to the previous CSA, Optum is pleased to announce the availability of Real‑time Claim Status Inquiry and Response (276/277) for the payer listed below, effective Feb. 6, 2026. Additionally, please note that this payer requires the Provider/Service Provider Tax Identification Number (Tax ID) to be used in the 276 transaction instead of the NPI.

Payer Name: Planned Administrators
Industry Payer ID: 37287
IMN Real Time ID: 37287
Exchange Real Time ID: PAIB
CPID(s): 3927 (I), 3883 (P)
IEDI Real Time ID: 37287
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Claim Status Inquiry subscribe

• Member ID, First name, Last name, date of birth, Gender

Optional additional elements:

• Payer claim number, Total submitted charges

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.

2/16/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: AmeriHealth Caritas Next, A Product of AmeriHealth Caritas Louisiana
Institutional CPID: 9006
Professional CPID: 3464
Payer-assigned Payer ID: 75066
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Louisiana

Payer Name: AmeriHealth Caritas VIP Care - Louisiana HIDE SNP
Institutional CPID: 9022
Professional CPID: 3499
Payer-assigned Payer ID: 73575
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Louisiana

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.

2/16/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: AmeriHealth Caritas Next, A Product of AmeriHealth Caritas Louisiana
Institutional CPID: 9006
Professional CPID: 3464
Payer-assigned Payer ID: 75066
Line of Business (LOB) Code: E32
Payer Enrollment Required: Yes
Payer Location: Louisiana

Payer Name: AmeriHealth Caritas VIP Care - Louisiana HIDE SNP
Institutional CPID: 9022
Professional CPID: 3499
Payer-assigned Payer ID: 73575
Line of Business (LOB) Code: E33
Payer Enrollment Required: Yes
Payer Location: Louisiana

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.

2/16/2026

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Resolved: Delay in Electronic Remittance Advice (ERA) for multiple CPIDs

Resolved: This issue is resolved. All impacted ERAs have been processed.

Original notice sent Feb. 9, 2026:
There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates since Jan. 30, 2026:

• CPID 6147 PacificSource Medicare
• CPID 4627 PacificSource Medicare
• CPID 6575 PacificSource Health 
• CPID 5441 PacificSource Health
• CPID 4972 PacificSource Community Health Solutions
• CPID 4794 PacificSource Community Health Solutions

Optum is working diligently with the payers 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 09883238.

2/16/2026

---

Electronic Routing Change for CPIDs 2489 and 7527 USAA

Effective immediately, Optum will be changing electronic remittance routing for the following payer:

Payer Name: USAA
Professional CPID: 2489
Institutional CPID: 7527
Payer-assigned Payer ID: 74147
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.

2/16/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: DCHP - Texas Medicaid
Institutional CPID: 7061
Professional CPID: 9444
Payer-assigned Payer ID: 38261
Line of Business (LOB) Code: J4l
Payer Enrollment Required: Yes
Payer Location: Texas 

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. 

2/16/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: DCHP - Texas Medicaid
Institutional CPID: 7061
Professional CPID: 9444
Payer-assigned Payer ID: 38261
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Texas 

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. 

2/16/2026

---

Resolved: 999 Error for Multiple Payer IDs

Resolved: Optum has resolved this issue with claims processing. All impacted files have been requeued

Original Notify sent January 29, 2026:

Due to a potential internal processing issue, professional claims for the payers listed below may have received the following error message:

• Claim rejected on 999 report, contact payer for additional information.

This issue began on January 22, 2026. Additional updates will be forwarded as more information becomes available.

Potential Payers Affected:

09824 Molina Healthcare of New Mexico

16146 Molina Healthcare of New York

20149 Molina Healthcare of Ohio

20554 Molina Healthcare of Texas

20934 Molina Healthcare of Illinois

33373 Molina Healthcare of California Encounters

38333 Molina Healthcare of California

38334 Molina Healthcare of Michigan

38336 Molina Healthcare of Washington

46299 Molina Healthcare of South Carolina

51062 Molina Healthcare of Florida

61325 Passport Health Plan by Molina Healthcare

61799 Molina Healthcare of Idaho

77010 Molina Healthcare of Mississippi

A6106 Molina Healthcare of Nevada

ABRI1 Molina Healthcare of Wisconsin

MCC01 Molina Complete Care of Arizona

MCC02 Molina Complete Care of Virginia

MLNIA Molina Healthcare of Iowa

MLNNE Molina Healthcare of Nebraska

MLNNV Molina Healthcare of Nevada

NM505 Molina Health Care Of New Mexico

SWHMA Senior Whole Health, LLC DBA Molina Healthcare

SWHNY Senior Whole Health New York

SX109 Molina Healthcare of Utah

Action Required: No customer action required.

2/16/2026

---

Electronic Routing Change for CPIDs 2489 and 7527 USAA

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

Payer Name: USAA
Professional CPID: 2489
Institutional CPID: 7527
Payer-assigned Payer ID: 74147
Line of Business Code (LOB): H8G
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:

• 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.

2/16/2026

---

Tricare For Life, East, and West Real-Time Eligibility and Claim Status Errors

We want to make you aware of a current issue affecting real-time 270/271 eligibility and 276/277 transactions submitted through Optum for Tricare for Life, East, and West.

Some transactions may return the message: "System Not Responding, please resubmit."

This response is due to a temporary system issue on the payer's side. Your transaction was received correctly, and there is no issue with your submission or your connection to Optum.

Payer Name: Tricare East
Payer ID: 99727
Transaction: Real Time Eligibility and Claim Status

Payer Name: Tricare West
Payer ID: 99726
Transaction: Real Time Eligibility and Claim Status

Payer Name: Tricare for Life
Payer ID: TRLIF
Transaction: Real Time Eligibility and Claim Status

What You Should Know:

• The issue is isolated to real-time eligibility and claim status transactions.
• It is being actively investigated and prioritized by the payer.
• There is no estimated time for resolution (ETA) at this moment.

What You Can Do:

• Please wait a few minutes and resubmit the transaction.
• If needed, consider using alternate eligibility verification methods until the issue is resolved.
• No action is needed on your part to correct or troubleshoot the issue.

We understand the importance of timely eligibility and claim status responses. We continue working closely with the payer to support resolution. We will share updates as they become available.

If you have any questions, please contact Customer Support and refer to Global Incident Number INC-000004096.

Thank you for your continued partnership and patience.

2/13/2026

---

National Medicare CMS (CMSEL) Eligibility And Benefits Error

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.

Payer Name: National Medicare CMS
Payer ID: CMSEL

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.

2/13/2026

---

Report Generation Delay for CPID 6237 Century PHO

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Jan. 31, 2026.

Payer impacted: 

• CPID 6237 Century PHO

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 09890130.

2/13/2026

---

Update: Report Generation Delay for CPID 7738 CountyCare Health Plan

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Jan. 13, 2026.

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

Original notice sent Jan. 27, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Jan. 13, 2026 and Jan. 14, 2026.

Payer impacted: 

• CPID 7738 CountyCare Health Plan

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 09842125.

2/13/2026

---

New Electronic Claims Connection Available

Optum has a new electronic claims connection available:  

Payer Name: Prism Univera
Institutional CPID: 9073
Payer-assigned Payer ID: 37315
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: New York
Claims Fee: N/A 

Action Required:

• Add the payers to your system to begin using the new payer connection. 
• When a payer requires claims 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. 

2/13/2026

---

New Electronic Claims Connection Available

Optum has a new electronic claims connection available:  

Payer Name: Prism Univera
Institutional CPID: 9073
Payer-assigned Payer ID: 37315
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: New York
Claims Fee: $0.10 

Action Required:

• Add the payers to your system to begin using the new payer connection. 
• When a payer requires claims 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. 

2/13/2026

---

Update: Report Generation Delay for CPIDs 8677 and 7264 Quartz ASO

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Jan. 5, 2026 through Feb. 3, 2026.

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

Original notice sent Jan. 20, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 5, 2026.

Payer impacted: 

• CPID 8677 Quartz ASO
• 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 09834797.

2/13/2026

---

New Electronic Eligibility & Claim Status Connection Available

Optum is pleased to announce the availability of Real-time Eligibility 270/271 & Claim Status Inquiry and Response 276/277 for the below payer, effective Feb 13, 2026:

Payer Name: March Vision Care
Industry Payer ID: 52461
IMN Real Time ID: 52461
Exchange Real Time ID: MRVSCR
CPID(s): 5246 (P), 9047 (I)
IEDI Real Time ID: 52461
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber

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

Claim Status Inquiry subscribe

• Member ID, First name, Last name, date of birth

Optional additional elements:

• Payer claim number, Total submitted charges

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.

2/13/2026

---

New Electronic Remittance (ERA) Connections Available on RPA

ERA (Remittance) transactions have recently been added to the Revenue Performance Advisor system for the following payer:

Payer ID – Payer name

21583 – Next Generation MyCare Buckeye Community Health Plan
21586 – Next Generation MyCare Molina Healthcare of Ohio Inc.
21599 – Next Generation MyCare CareSource
22147 – Next Generation MyCare Anthem Blue Cross Blue Shield
29123 – Chorus Community Health Plan
36326 – Associates for Healthcare
51579 – Coastal Communities Physician Network
95721 – S USA Life Insurance
A6865 – Gold Kidney Health Plan
CSSD2 – Children's Specialists of San Diego
MLNCT – ConnectiCare Molina
PRESA – Presbyterian Salud
R3470 – Ascension Living HOPE PACE

ERA enrollment/set up is required for all ERA transactions on Revenue Performance Advisor. You can access the payer enrollment intake form on the Revenue Performance Advisor (RPA) restoration resources page in the User Community.

If you’re in Revenue Performance Advisor, you can also open the Revenue Performance Advisor Resource Center, click the Quick Reference Guides tab, and then click the Billing Provider Enrollment link to find the payer enrollment intake form.

2/13/2026

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Electronic Routing Change for CPIDs 6838 and 7617 Keenan and Associates

Effective February 12, 2026, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Keenan and Associates
Professional CPID: 6838
Institutional CPID: 7617
Payer-assigned Payer ID: 95279
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
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. 

2/12/2026

---

Electronic Routing Change for CPIDs 6838 and 7617 Keenan and Associates

Effective February 12, 2026, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Keenan and Associates
Professional CPID: 6838
Edit Master: PE_T007
Institutional CPID: 7617
Edit Master: HE9T007
Payer-assigned Payer ID: 95279
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. 

2/12/2026

---

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on Feb. 11, 2026 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 Feb. 12, 2026.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09888734.

2/12/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Van Lang IPA
Payer ID: 77036
Payer Enrollment Required: Yes
Payer Location: National

Payer Name: Christian Care Ministries
Payer ID: 59355
Payer Enrollment Required: Yes
Payer Location: National

Payer Name: WelbeHealth
Payer ID: WBHCA
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.

2/12/2026

---

Update: Report Generation Delay for multiple CPIDs

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Jan. 27, 2026.

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

Original notify sent Jan. 29, 2026:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 26, 2026.

Payers impacted: 

• CPID 2581 Lifewise Health Plan of Oregon
• CPID 2854 Lifewise Health Plan of Oregon
• CPID 5522 Premera Blue Cross Blue Shield of Washington and Alaska
• CPID 7445 Premera Blue Cross Blue Shield of Washington and Alaska

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 09844485.

2/12/2026

---

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum Feb. 11, 2026 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 Feb. 12, 2026.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09888663.

2/12/2026

---

New Electronic Eligibility & Claim Status Connection Available

Optum is pleased to announce the availability of Real-time Eligibility 270/271 & Claim Status Inquiry and Response 276/277 for the below payer, effective Feb 6, 2026.

Payer Name: Planned Administrators
Industry Payer ID: 37287
IMN Real Time ID: 37287
Exchange Real Time ID: PAIB
CPID(s): 3927 (I), 3883 (P)
IEDI Real Time ID: 37287
Payer Enrollment Required: No
Connection Type: X12

Search Options
Eligibility Subscriber

• Member ID, First Name, Last Name, Date of Birth
• Claim Status Inquiry subscribe
• Member ID, First name, Last name, date of birth
• Gender

Optional additional elements:

• Payer claim number, Total submitted charges

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.

2/12/2026

---

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 Feb. 11, 2026.

Payer Name: Country Life Insurance Company
IMN Real Time ID: CNTYF
Exchange Real Time ID: CTRYL
Optum IEDI Real Time ID: 10670
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.

2/12/2026

---

Payer Name Change

Please be aware of the following payer RT Eligibility & Claim Status name change effective Feb 6, 2026:

Payer Name: Anthem Blue Cross of California (Previously known as Anthem Blue Cross Blue Shield of California)
Industry Payer ID: 47198
IMN Real Time ID: 47198
Exchange Real Time ID: CABC
CPID(s): 3511, 4417
Optum IEDI Real Time ID: 00540
Payer Enrollment Required: No
Connection Type: X12

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.

2/12/2026

---

Delay in Electronic Remittance Advice (ERA) for CPIDs 3506, 4423 Medical Mutual of Ohio

Due to a payer intermediary processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates of Sept. 9, 2025-present:

• CPID 3506 Medical Mutual of Ohio
• CPID 4423 Medical Mutual of Ohio

Additional updates will be forwarded as more information becomes available. 

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004086. 

2/11/2026

---

Payer Processing Issue for CPID 4479 Alabama Medicaid

Due to a payer processing issue, some Professional claims transmitted to the payer listed below Feb. 6, 2026 were not processed by the payer.

Payer impacted:

• CPID 4479 Alabama Medicaid

A resolution has been implemented and the claims were retransmitted to the payer Feb. 11, 2026.

This delay affected claims released to Optum Feb. 5, 2026, 3:00 p.m.-Feb. 6, 2026, 3:00 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 09887149.

2/11/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Christian Care Ministries
Institutional CPID: 8638
Professional CPID: 7154
Payer-assigned Payer ID: 59355
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National

Payer Name: WelbeHealth
Institutional CPID: 7076
Professional CPID: 9477
Payer-assigned Payer ID: WBHCA
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.

2/11/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Christian Care Ministries
Institutional CPID: 8638
Professional CPID: 7154
Payer-assigned Payer ID: 59355
Line of Business (LOB) Code: E48
Payer Enrollment Required: Yes
Payer Location: National

Payer Name: WelbeHealth
Institutional CPID: 7076
Professional CPID: 9477
Payer-assigned Payer ID: WBHCA
Line of Business (LOB) Code: E49
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.

2/11/2026

---

Report Generation Delay for CPID 7736 Direct Care Administrators

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Jan. 28, 2026.

Payer impacted:

• CPID 7736 Direct Care 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 09886981.

2/11/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Van Lang IPA
Institutional CPID: 7016
Professional CPID: 9298
Payer-assigned Payer ID: 77036
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National

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.

2/11/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Van Lang IPA
Institutional CPID: 7016
Professional CPID: 9298
Payer-assigned Payer ID: 77036
Line of Business (LOB) Code: N53
Payer Enrollment Required: Yes
Payer Location: National

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.

2/11/2026

---

Reminder: Payer Change for CPID 4492 Massachusetts Medicaid Format 5

Reminder: Effective Feb. 11, 2026, providers must begin using CPID 4491 MassHealth for electronic claims and remittance. CPID 4492 Massachusetts Medicaid Format 5 will be terminated.

Reminder CSA sent 2/2/26:

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 February 11, 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 February 11, 2026.

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is required.
  • Providers currently submitting electronic claims through Optum to CPID 4492 Massachusetts Medicaid Format 5 do not need to complete a new enrollment form.
  • Providers who have not submitted claims to CPID 4492 since November 9, 2025, must complete a new enrollment form for CPID 4491 MassHealth.
  • 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.
    • Optum has migrated providers who have received remittance since November 9, 2025, by updating their clearinghouse routes to the applicable CPID 4491 MassHealth.
  • Providers who have not received remittance since November 9, 2025, were not migrated and 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.

2/10/2026

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Payer Consolidation - Immanuel Pathways

Effective immediately, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: Pace Nebraska
Payer ID: 35416
Claim Type: Professional, Institutional

Payer Name: Pace Southwest Iowa
Payer ID: 53534
Claim Type: Professional, Institutional

Payer IDs 35416 and 53534 will be terminated effective March 10, 2026.

Providers must begin using the following ID for electronic claims:
Payer Name: Immanuel Pathways
Payer ID: IMP01

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

 Action Required:

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

2/10/2026

---

New Electronic Remittance Connections Available - Gold Kidney Health Plan (A6865)

Optum has new electronic remittance connections available:  

Payer Name: Gold Kidney Health Plan
Payer ID: A6865
Payer Enrollment Required: Yes
Payer Location: Arizona  

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. 

2/10/2026

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Update: Assurance Reimbursement Management Performance Issue

Update: Optum is continuing to work to resolve this issue. We will notify you as soon as additional information becomes available.

Original notify sent Jan. 27, 2026:
Assurance Reimbursement Management is experiencing an issue with intermittent performance.

This may result in:

• Error: An error occurred while retrieving worklist data
• Slowness or Delay in viewing or validating claims

Optum is working to resolve this issue. We will notify you as soon as additional information becomes available.

We apologize for any inconvenience.

Action Required: None.

2/10/2026

---

Update: Invalid Error Message for CPIDs 5547/4426 Arizona Blue Cross Blue Shield

Update: This issue is still under review with the payer. Additional notifications will be sent as updates become available.

Original notify sent on: March 27, 2025

Due to a payer processing issue, Professional and Institutional claims for the payer listed below may have received the following invalid error message on the Payer Claim Data Report (SR), Payer Claim Data Report (SE), Payer Report Data File (SF):

• Reject Code: 601
• Message: CLM: MISPLACED SEGMENT DTP (DATE - REPRICER RECEIVED DATE) AT 2-1350 WITHIN LOOP CLM (2300)(CLAIM INFORMATION) AT 2-1300, THIS SEGMENT, LOOP/GROUP MAY NOT BE IN THE CORRECT POSITION FOR LOOP/GROUP

This issue began November 2024 and is still ongoing. The payer is working to resolve the invalid error message in their system. Currently, the payer does not have an ETA on correcting the error, however any affected claims can be resubmitted.

Payers affected:

• 5547 Arizona Blue Cross Blue Shield
• 4426 Arizona Blue Cross Blue Shield

Action Required: Please be aware of the invalid error message.

2/10/2026

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Electronic Routing Change for Mercalis (56155)

Effective Feb. 9, 2026, Optum is changing electronic remittance routing for the following payer: 

Payer Name: Mercalis
Payer ID: 56155
Payer Remittance Enrollment Required: Yes
Par Status: Non-Par

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: 

• No Payer Alias changes are required. Payer name and payer ID are not changing. 
• When a payer requires enrollment, forms must be submitted and approved from IEDI. 

2/10/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Gold Kidney Health Plan
Institutional CPID: 8048
Professional CPID: 9766
Payer-assigned Payer ID: A6865
Line of Business (LOB) Code: E47
Payer Enrollment Required: Yes
Payer Location: Arizona  

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. 

2/10/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Gold Kidney Health Plan
Institutional CPID: 8048
Professional CPID: 9766
Payer-assigned Payer ID: A6865
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Arizona 

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. 

2/10/2026

---

Update: Report Generation Delay for CPIDs 4549 and 1232 Denver Health Medical Plan Inc. - Medicare Choice

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Jan. 22, 2026 and Jan. 23, 2026.

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

Original notice sent Feb. 2, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 19, 2026.

Payer impacted: 

• CPID 4549 Denver Health Medical Plan Inc. - Medicare Choice
• CPID 1232 Denver Health Medical Plan Inc. - Medicare Choice

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 09876517.

2/10/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: AdventHealth Transplant Institute
Payer ID: RP090
Payer Enrollment Required: Yes
Payer Location: Florida

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.

2/10/2026

---

New Payer Name

Effective immediately, please be aware of the following payer name change: 

Previous Payer Name: AmeriHealth Caritas Next A Product of AmeriHealth Caritas VIP Next, Inc.
New Payer Name: AmeriHealth Caritas Next A Product of AmeriHealth Caritas VIP Next, Inc. (Delaware)
Payer ID: 47073

Your existing Payer Alias entries will continue to work as they do currently; the new payer name is being provided for your reference. Be aware all future communications for this payer ID will reference the new payer name only. 

Action Required: None.

2/10/2026

---

Report Generation Delay for CPIDs 5927 and 4791 AultCare

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted Jan. 30, 2026.

Payer impacted: 

• CPID 5927 AultCare
• CPID 4791 AultCare

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 09885418.

2/10/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Valor Health Plan
Payer ID: 43259
Payer Enrollment Required: Yes
Payer Location: Ohio 

Payer Name: Children's Specialists of San Diego
Payer ID: CSSD2
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. 

2/10/2026

---

Report Generation Delay for CPID 9057 Sentara PACE

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Jan. 29, 2026.

Payer impacted: 

• CPID 9057 Sentara PACE

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 09885220.

2/10/2026

---

Report Generation Delay for CPID 1405 Blue Cross Blue Shield of Illinois

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Jan. 27, 2026.

Payer impacted: 

• CPID 1405 Blue Cross Blue Shield of Illinois

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 09885172.

2/10/2026

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:  

Payer Name: Hinge Health
Institutional CPID: 9074
Professional CPID: 3841
Payer-assigned Payer ID: HINGE
Line of Business (LOB) Code: H9C
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: National 

Action Required:

• Add the payers to your system to begin using the new payer connection. 
• When a payer requires claims enrollment, forms must be submitted and approved to begin submitting transactions. 
• Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum. 

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

2/10/2026

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available: 

Payer Name: Hinge Health
Institutional CPID: 9074
Professional CPID: 3841
Payer-assigned Payer ID: HINGE
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: National
Claims Fee: N/A
Remittance Fee: N/A 

Action Required:

• Add the payers to your system to begin using the new payer connection. 
• When a payer requires claims enrollment, forms must be submitted and approved to begin submitting transactions. 
• Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum. 

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

2/10/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: AdventHealth Transplant Institute
Institutional CPID: 8026
Professional CPID: 9743
Payer-assigned Payer ID: RP090
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Florida

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.

2/9/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: AdventHealth Transplant Institute
Institutional CPID: 8026
Professional CPID: 9743
Payer-assigned Payer ID: RP090
Line of Business (LOB) Code: H7T
Payer Enrollment Required: Yes
Payer Location: Florida

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.

2/9/2026

---

Edit Master for CPIDs 8944 and 5247 Fringe Benefit Coordinators (Medical and Accident)

Effective February 10, 2026, Optum will be changing Edit Masters for the following payer:

Payer Name: Fringe Benefit Coordinators (Medical and Accident)
Professional CPID: 5247
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Institutional CPID: 8944
Current Edit Master: HE9C054
New Edit Master:  HE9T007
Payer-assigned Payer ID: 59204 

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. 

2/9/2026

---

Electronic Routing Change for CPIDs 7821 and 9532 Mercalis

Effective Feb. 9, 2026, Optum is changing electronic remittance routing for the following payer: 

Payer Name: Mercalis
Professional CPID: 7821
Institutional CPID: 9532
Payer-assigned Payer ID: 56155
Line of Business Code (LOB): J9M
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: 

• 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. 

2/9/2026

---

Electronic Routing Change for CPIDs 7821 and 9532 Mercalis

Effective Feb. 9, 2026, Optum is changing electronic remittance routing for the following payer: 

Payer Name: Mercalis
Professional CPID: 7821
Institutional CPID: 9532
Payer-assigned Payer ID: 56155
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. 

2/9/2026

---

New Electronic Claims Connections Available on RPA

Institutional claim transactions have recently been added to the Revenue Performance Advisor (RPA) system for the following payer:

29123 – Chorus Community Health Plan

Professional claim transactions have recently been added to the Revenue Performance Advisor (RPA) system for the following payer:

29123 – Chorus Community Health Plan

2/9/2026

---

New Electronic Remittance (ERA) Connections Available on RPA

ERA (Remittance) transactions have recently been added to the Revenue Performance Advisor system for the following payer:

Payer ID – Payer name

95393 – High Desert Medical Group
CLFM1 – Camp Lejeune Family Member Program
DSCYF – Department of Services for Children
SKLA2 – Louisiana Medicaid Ambulance
SKLA4 – Louisiana Medicaid Rehab

ERA enrollment/set up is required for all ERA transactions on Revenue Performance Advisor. You can access the payer enrollment intake form on the Revenue Performance Advisor (RPA) restoration resources page in the User Community.

If you’re in Revenue Performance Advisor, you can also open the Revenue Performance Advisor Resource Center, click the Quick Reference Guides tab, and then click the Billing Provider Enrollment link to find the payer enrollment intake form.

2/9/2026

---

Delay in Electronic Remittance Advice (ERA) for multiple CPIDs

There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates since Jan. 30, 2026: 

• CPID 6147 PacificSource Medicare
• CPID 4627 PacificSource Medicare
• CPID 6575 PacificSource Health 
• CPID 5441 PacificSource Health
• CPID 4972 PacificSource Community Health Solutions
• CPID 4794 PacificSource Community Health Solutions

Optum is working diligently with the payers 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 09883238.

2/9/2026

---

New Real Time Connections Available on Revenue Performance Advisor

Eligibility transactions have recently been added to the Revenue Performance Advisor (RPA) system for the following payers:

10936 – Spectrum Health
10982 – State Mutual (Lincoln Novation)
14330 – Elips Life Insurance Company
16098 – Monitor Life Insurance Company of New York
26992 – NYCE
34186 – CSI Life Insurance
86304 – Insurers Administrative Corporation
PAMPR – Pan American Life Puerto Rico

Claim Status Inquiry transactions have recently been added to the Revenue Performance Advisor (RPA) system for the following payers:

26992 – NYCE
81040 – Allegiance Benefit Plan Management
86304 – Insurers Administrative Corporation

2/9/2026

---

Electronic Claims Connection Suspended - Leon Medical Center Health Plan

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

Payer Name: Leon Medical Center Health Plan
Payer ID: 37316
Reason: Payer unavailable electronically.

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

2/6/2026

---

New Electronic Claims Connections Available - JP Farley Corporation

Optum has new electronic claims connections available:

Payer Name: JP Farley Corporation
Payer ID: 34136
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Alabama, Alaska, Georgia, Ohio, Tennessee

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. 

2/6/2026

---

Electronic Claims Connection Suspended

Effective Feb. 3, 2026, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: AvMed
Payer ID: 59274
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 consider the following to allow transactions to process properly due to the above changes:

• Make any necessary system changes.

Original notice sent Jan. 16, 2026:

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

Payer Name: AvMed
Payer ID: 59274
Reason: Payer unavailable electronically.

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

2/6/2026

---

Electronic Claims Connection Suspended

Update: This payer has been reactivated. Providers may begin submitting claims after Feb. 6, 2026, 6:00 p.m. CT. Please note that this connection supports Encounter transactions only.

This connection is now a Non-Par payer.

Original notice sent Jan. 26, 2026:

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

Payer Name: Avmed (Encounters)

CPID(s): 3787, 9053
Payer ID: 59275
Reason: Payer unavailable electronically.

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

2/6/2026

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Electronic Routing Change for CPIDs 3198 and 1652 Preferred Benefit Administrators (Longwood, Florida)

Effective February 10, 2026, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Preferred Benefit Administrators (Longwood, Florida)
Professional CPID: 3198
Current Edit Master: PE_C054
New Edit Master: PE_T007
Institutional CPID: 1652
Current Edit Master: HE9C054
New Edit Master: HE9T007
Payer-assigned Payer ID: 53476
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:  

• 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. 

2/6/2026

---

Electronic Routing Change for CPIDs 3198 and 1652 Preferred Benefit Administrators (Longwood, Florida)

Effective February 10, 2026, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Preferred Benefit Administrators (Longwood, Florida)
Professional CPID: 3198
Institutional CPID: 1652
Payer-assigned Payer ID: 53476
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. 

2/6/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Ascension Living HOPE PACE
Institutional CPID: 8035
Professional CPID: 2859
Payer-assigned Payer ID: R3470
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Kansas

Payer Name: Coastal Communities Physician Network
Institutional CPID: 6625
Professional CPID: 6726
Payer-assigned Payer ID: 51579
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California

Payer Name: Presbyterian Salud
Institutional CPID: 1691
Professional CPID: 4252
Payer-assigned Payer ID: PRESA
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: New Mexico

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.

2/6/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Ascension Living HOPE PACE
Institutional CPID: 8035
Professional CPID: 2859
Payer-assigned Payer ID: R3470
Line of Business (LOB) Code: E45
Payer Enrollment Required: Yes

Payer Location: Kansas

Payer Name: Coastal Communities Physician Network
Institutional CPID: 6625
Professional CPID: 6726
Payer-assigned Payer ID: 51579
Line of Business (LOB) Code: E46
Payer Enrollment Required: Yes
Payer Location: California

Payer Name: Presbyterian Salud
Institutional CPID: 1691
Professional CPID: 4252
Payer-assigned Payer ID: PRESA
Line of Business (LOB) Code: E44
Payer Enrollment Required: Yes
Payer Location: New Mexico

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.

2/6/2026

---

Report Generation Delay for CPIDs 4972 and 4794 PacificSource Community Health Solutions

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 30, 2026.

Payer impacted:

• CPID 4794 PacificSource Community Health Solutions
• CPID 4972 PacificSource Community Health Solutions 

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 09883238.

2/6/2026

---

Report Generation Delay for CPID 2714 Blue Cross Blue Shield of Hawaii

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Jan. 29, 2026 and Feb. 3, 2026.

Payer impacted:

• CPID 2714 Blue Cross Blue Shield of Hawaii 

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 09824865.

2/6/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Next Generation MyCare Anthem Blue Cross Blue Shield
Payer ID: 22147
Payer Enrollment Required: Yes
Payer Location: Ohio 

Payer Name: Next Generation MyCare Buckeye Community Health Plan
Payer ID: 21583
Payer Enrollment Required: Yes
Payer Location: Ohio 

Payer Name: Next Generation MyCare CareSource
Payer ID: 21599
Payer Enrollment Required: Yes
Payer Location: Ohio 

Payer Name: Next Generation MyCare Molina Healthcare of Ohio Inc.
Payer ID: 21586
Payer Enrollment Required: Yes
Payer Location: Ohio 

Action Required: 

• Add the payers to your system to begin using the new payer connection. 
• Providers currently receiving electronic remittance through Optum for Ohio Medicaid do not need to complete a new enrollment form. 
• Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum. 

2/6/2026

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New Electronic Remittance Connections Available - S. USA Life Insurance Company

Optum has new electronic remittance connections available:

Payer Name: S. USA Life Insurance Company, Inc.
Payer ID: 95721
Payer Enrollment Required: Yes
Payer Location: National

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. 

2/6/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Leon Medical Center Health Plan
CPID(s): 2282, 2924
Payer ID: 37316
Reason: Payer unavailable electronically.

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

2/6/2026

---

Report Generation Delay for CPIDs 4792 and 5928 Ohio Bureau of Children with Medical Handicaps

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 26, 2026.

Payer impacted: 

• CPID 4792 Ohio Bureau of Children with Medical Handicaps 
• CPID 5928 Ohio Bureau of Children with Medical Handicaps

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 09877081.

2/6/22026

---

Report Generation Delay for multiple CPIDs

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 30, 2026.

Payers impacted:

• CPID 6147 PacificSource Medicare
• CPID 4627 PacificSource Medicare
• CPID 6575 PacificSource Health 
• CPID 5441 PacificSource 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 09883238.

2/6/2026

---

Update: Electronic Claims Connection Suspended

Update: This payer has been reactivated. Providers may begin submitting claims after Feb. 6, 2026, 6:00 p.m. CT. Please note that this connection supports Encounter transactions only.

Original notice sent Jan. 26, 2026:
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Avmed (Encounters)
CPID(s): 3787, 9053
Payer ID: 59275
Reason: Payer unavailable electronically.

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

2/6/2026

---

CareFirst Administrators/NCAS Electronic Remittance Connection No Longer Available

The payer listed below is no longer available at Optum for remittance processing, effective immediately.

Payer Name: CareFirst Administrators/NCAS
Remittance CPIDs: 2914, 1730
Remittance LOB: H29
Payer-assigned Payer ID: 75190
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

2/6/2026

---

CareFirst Administrators/NCAS Electronic Remittance Connection No Longer Available

The payer listed below is no longer available at Optum for remittance processing, effective immediately.

Payer Name: CareFirst Administrators/NCAS
Remittance CPIDs: 2914, 1730
Payer-assigned Payer ID: 75190
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

2/6/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Children's Specialists of San Diego
Professional CPID: 1197
Payer-assigned Payer ID: CSSD2
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.

2/6/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Children's Specialists of San Diego
Professional CPID: 1197
Payer-assigned Payer ID: CSSD2
Line of Business (LOB) Code: J2B
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.

2/6/2026

---

New Payer Edit for CPID 4295

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 Feb. 11, 2026:  

• PSBR0135FI: INVALID PAYER RESP SEQ NUM CODE- For an electronic claim, the Payer Indicator must be A. Exceptions: 1. When the CPID is other than 2712 and the Billing Provider State is MN, this requirement does not apply. 2. When the CPID is 2802 and the Other Payer Prior Paid Amount is zero, this requirement does not apply. LOOP 2000B SBR01

Edit applies to: 

• CPID 4295 Hillsborough County 

Action Required: Please be aware of updated edit requirements.

2/5/2026

---

Update: Report Generation Delay for CPIDs 2824 and 7551 The Health Plan of West Virginia

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Jan. 23, 2026-Jan. 28, 2026.

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

Original notify sent Feb. 2, 2026:
A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Jan. 23, 2026.

Payer impacted:

• CPID 2824 The Health Plan of West Virginia
• CPID 7551 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 09876388.

2/5/2026

---

Update 999 Error for Multiple Payer IDs

Update: Optum continues to work diligently to resolve the issue.

Original Notify sent January 29, 2026:

Due to a potential internal processing issue, professional claims for the payers listed below may have received the following error message:

• Claim rejected on 999 report, contact payer for additional information.

This issue began on January 22, 2026. Additional updates will be forwarded as more information becomes available.

Potential Payers Affected:

09824 Molina Healthcare of New Mexico

16146 Molina Healthcare of New York

20149 Molina Healthcare of Ohio

20554 Molina Healthcare of Texas

20934 Molina Healthcare of Illinois

33373 Molina Healthcare of California Encounters

38333 Molina Healthcare of California

38334 Molina Healthcare of Michigan

38336 Molina Healthcare of Washington

46299 Molina Healthcare of South Carolina

51062 Molina Healthcare of Florida

61325 Passport Health Plan by Molina Healthcare

61799 Molina Healthcare of Idaho

77010 Molina Healthcare of Mississippi

A6106 Molina Healthcare of Nevada

ABRI1 Molina Healthcare of Wisconsin

MCC01 Molina Complete Care of Arizona

MCC02 Molina Complete Care of Virginia

MLNIA Molina Healthcare of Iowa

MLNNE Molina Healthcare of Nebraska

MLNNV Molina Healthcare of Nevada

NM505 Molina Health Care Of New Mexico

SWHMA Senior Whole Health, LLC DBA Molina Healthcare

SWHNY Senior Whole Health New York

SX109 Molina Healthcare of Utah

Action Required: Please be aware of the given error message and note that Optum is working to determine root cause and resolution.

2/5/2026

---

Processing Issue for CPIDs 1573 and 3802 AvMed

Due to a processing issue, Institutional and Professional claims submitted to Optum on Feb. 3, 2026 were not processed by Optum.

Payer impacted: 

• CPID 1573 AvMed
• CPID 3802 AvMed

A resolution has been implemented, and the claims were processed and transmitted to the payer on Feb. 4, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09880437.

2/5/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Valor Health Plan
Institutional CPID: 2000
Professional CPID: 8132
Payer-assigned Payer ID: 43259
Line of Business (LOB) Code: J4H
Payer Enrollment Required: Yes
Payer Location: Ohio 

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. 

2/5/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Valor Health Plan
Institutional CPID: 2000
Professional CPID: 8132
Payer-assigned Payer ID: 43259
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Ohio 

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. 

2/5/2026

---

New Payer Name

Effective immediately, please be aware of the following payer name change: 

Previous Payer Name: AmeriHealth Caritas Next A Product of AmeriHealth Caritas VIP Next, Inc.
New Payer Name: AmeriHealth Caritas Next A Product of AmeriHealth Caritas VIP Next, Inc. (Delaware)
Professional CPID: 9426
Professional Edit Master: PE_T007
Institutional CPID: 7043
Institutional Edit Master: HE9T007
Remit Line of Business (LOB) Code: U1I 

Your existing Payer Alias entries will continue to work as they do currently; the new payer name is being provided for your reference. Be aware all future communications for these CPIDs will reference the new payer name only. 

Action Required: None 

2/5/2026

---

Processing Issue for CPIDs 1573 and 3802 AvMed

Due to a processing issue, Institutional and Professional claims submitted to Optum on Feb. 3, 2026 were not processed by Optum.

Payer impacted: 

• CPID 1573 AvMed
• CPID 3802 AvMed

A resolution has been implemented, and the claims were processed and transmitted to the payer on Feb. 4, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09880437.

2/5/2026

---

New Payer Name

Effective immediately, please be aware of the following payer name change: 

Previous Payer Name: AmeriHealth Caritas Next A Product of AmeriHealth Caritas VIP Next, Inc.
New Payer Name: AmeriHealth Caritas Next A Product of AmeriHealth Caritas VIP Next, Inc. (Delaware)
Professional CPID: 9426
Institutional CPID: 7043 

Action Required: Please make the appropriate changes to accommodate the name change. 

2/5/2026

---

Report Generation Delay for CPID 3706 Cenpatico

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Jan. 22, 2026.

Payer impacted: 

• CPID 3706 Cenpatico

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 09881566.

2/5/2026

---

Electronic Routing Change for Scripps Health Plans

Effective February 10, 2026, Optum will be changing electronic claims routing for the following payers:

Payer Name: Scripps Coastal Medical Group
Professional CPID: 7102
Institutional CPID: 6624
Payer-assigned Payer ID: SHPS1
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Payer Name: Scripps Health Plan MSO
Professional CPID: 1199
Institutional CPID: 2653
Current Payer-assigned Payer ID: SHPM1
New Payer-assigned Payer ID: 33099
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.

2/4/2026

---

Electronic Routing Change for Scripps Health Plans

Effective February 10, 2026, Optum will be changing electronic claims routing for the following payers:

Payer Name: Scripps Coastal Medical Group
Professional CPID: 7102
Edit Master: PE_T007
Institutional CPID: 6624
Edit Master: HE9T007
Payer-assigned Payer ID: SHPS1
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Payer Name: Scripps Health Plan MSO
Professional CPID: 1199
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 2653
Current Edit Master: HE9O007
New Edit Master: HE9T007
Current Payer-assigned Payer ID: SHPM1
New Payer-assigned Payer ID: 33099
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:

• 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 names and CPIDs are not changing.
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

2/4/2026

---

New Payer Name

Effective immediately, please be aware of the following payer name change: 

Previous Payer Name: Blue Cross of Michigan Complete
New Payer Name: Blue Cross Complete of Michigan
Payer ID: 32002

Action Required: Please make the appropriate changes to accommodate the name change. 

2/4/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: High Desert Medical Group
Payer ID: 95393
Payer Enrollment Required: Yes
Payer Location: California 

Payer Name: Associates for Healthcare
Payer ID: 36326
Payer Enrollment Required: Yes
Payer Location: Wisconsin 

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. 

2/4/2026

---

Payer Consolidation - St. Joseph Heritage Healthcare

Effective immediately, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: HDPC - Premier Healthcare
Payer ID: 90023
Claim Type: Professional

Payer Name: St. Joseph Heritage Healthcare
Payer ID: IP106, JOEHD
Claim Type: Professional

Payer IDs 90023, IP106, JOEHD will be terminated effective March 5, 2026.

Providers must begin using the following ID for electronic claims:

Payer Name: St. Joseph Heritage Healthcare
Payer ID: STJOE

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

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

2/4/2026

---

IMN PAR Status Change for Real Time Payers

The PAR Status is changing for the following payers, effective Feb. 1, 2026:

Payer Name: Absolute Total Care
IMN ID: 68069
New Par Status: Non Par
Transaction: Eligibility

Payer Name: ACS Benefit Services
IMN ID: 72467
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Ameriben Solutions
IMN ID: 75137
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Americo Financial Life & Annuity
IMN ID: AMRCO
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Asuris Northwest Regence
IMN ID: 93221
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Blue Cross Blue Shield of Texas Medicaid
IMN ID: 66001
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Blue Cross Blue Shield of Vermont
IMN ID: SB915
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Blue Cross Community Health Plans
IMN ID: MCDIL
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Blue Cross Medicare Advantage
IMN ID: 66006
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Bridgespan Regence
IMN ID: BRIDG
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Caprock Health Plans
IMN ID: CAPHP
New Par Status: Non Par
Transaction: Eligibility

Payer Name: CareFirst Administrators/NCAS
IMN ID: 75190
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Community Health Plan of Washington (CHPWA)
IMN ID: SB613
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: ConnectiCare
IMN ID: 06105
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Dean Health Plan by Medica
IMN ID: 39113
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Delta Care USA (CDCAP)
IMN ID: CDCAP
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Delta Dental of North Carolina
IMN ID: 56101
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Denver Health Medical Plan
IMN ID: 84135
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Employee Benefit Management Services (EBMS)
IMN ID: SX182
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Fidelis Care
IMN ID: 11315
New Par Status: Non Par
Transaction: Claim Status

Payer Name: FirstCarolinaCare
IMN ID: FCC01
New Par Status: Gateway
Transaction: Eligibility

Payer Name: Harvard Pilgrim Health Care
IMN ID: 04271
New Par Status: Gateway
Transaction: Eligibility

Payer Name: Health First Insurance
IMN ID: HFRST
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Health Net National
IMN ID: XHNNC
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Health Partners Plans of Pennsylvania
IMN ID: 80142
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Healthease
IMN ID: WCHEA
New Par Status: Non Par
Transaction: Claim Status

Payer Name: HealthEase Kids
IMN ID: WCHEK
New Par Status: Non Par
Transaction: Claim Status

Payer Name: HealthSpring
IMN ID: ELDER
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Horizon New Jersey Health
IMN ID: 22326
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Humana Dental
IMN ID: 73288
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Illinois Medicaid
IMN ID: SKIL0
New Par Status: Non Par
Transaction: Claim Status

Payer Name: Johns Hopkins Healthcare / Priority Partners
IMN ID: 52189
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Kaiser Foundation Health Plan of Colorado
IMN ID: 91617
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Kaiser Foundation Health Plan of Georgia
IMN ID: 21313
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Kaiser Foundation Health Plan of Northern California Region
IMN ID: 94135
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Kaiser Foundation Health Plan of the Mid-Atlantic States
IMN ID: 52095
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Kaiser Foundation Health Plan of the Northwest
IMN ID: 93079
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Kaiser Permanente Hawaii
IMN ID: 94123
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Lifewise Health Plan of Oregon
IMN ID: 93093
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Magellan Healthcare
IMN ID: 01260
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Mass General Brigham Health Plan
IMN ID: 04293
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Medico Insurance Company
IMN ID: 23160
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Complete Care of Arizona
IMN ID: MLNAZ
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Complete Care of Virginia
IMN ID: 26176
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of California
IMN ID: 38333
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Florida
IMN ID: 51062
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Idaho
IMN ID: 61799
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Illinois
IMN ID: 20934
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Michigan
IMN ID: 38334
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Mississippi
IMN ID: 77010
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Molina Healthcare of Nevada
IMN ID: MLNNV
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of New Mexico
IMN ID: 09824
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Ohio
IMN ID: MLNOH
New Par Status: Non Par
Transaction: Claim Status

Payer Name: Molina Healthcare of Texas
IMN ID: 20554
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Utah
IMN ID: SX109
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Washington
IMN ID: 38336
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Molina Healthcare of Wisconsin
IMN ID: ABRI1
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Ohana Health Plan
IMN ID: WCOHP
New Par Status: Non Par
Transaction: Claim Status

Payer Name: Passport Health Plan by Molina Healthcare
IMN ID: MLNKY
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Physicians Health Plan of Mid Michigan
IMN ID: 37330
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: Premera Blue Cross Blue Shield of Washington and Alaska
IMN ID: SB930
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Regence Blue Shield of Idaho
IMN ID: IDBCS
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Reserve National Insurance Company
IMN ID: 73066
New Par Status: Non Par
Transaction: Eligibility

Payer Name: Security Health Plan
IMN ID: 39045
New Par Status: Non Par
Transaction: Eligibility

Payer Name: StayWell
IMN ID: WCSWA
New Par Status: Non Par
Transaction: Claim Status

Payer Name: StayWell Kids
IMN ID: WCSWK
New Par Status: Non Par
Transaction: Claim Status

Payer Name: VNS Health
IMN ID: 77073
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Payer Name: WEBTPA
IMN ID: 75261
New Par Status: Non Par
Transaction: Eligibility, Claim Status

Action Required: Please be aware of the PAR Status changes.

2/4/2026

---

Payer Consolidation - HealthSmart Benefit Solutions

Effective immediately, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: Healthsmart Benefit Solutions Oklahoma City
Payer ID: 37256
Claim Type: Professional and Institutional

Payer Name: HealthSmart OKC
Payer ID: 73140
Claim Type: Professional and Institutional

Payer Name: HealthSmart
Payer ID: 37212, 37272, 87815
Claim Type: Professional and Institutional

Payer IDs 37212, 37256, 37272, 73140, 87815 will be terminated effective March 5, 2026.

Providers must begin using the following ID for electronic claims:
Payer Name: HealthSmart Benefit Solutions
Payer ID: 37283

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

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

2/4/2026

---

Report Generation Delay for CPID 8714 Allstate

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Jan. 22, 2026.

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 09879802.

2/4/2026

---

Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Jan. 22, 2026.

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 09879757.

2/4/2026

---

Eligibility and Claim Status No Longer Available on RPA for Payer ID 85468

Effective immediately, Real Time Eligibility 270/271 or Claim Status Inquiry 276/277 for the payer listed below will no longer be available on the Revenue Performance Advisor (RPA) system.

Payer Name: Clear Spring Health
Payer ID: 85468
Reason: Payer no longer offers an electronic connection.

Action Required: None

2/4/2026

---

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 January 29, 2026:

Payer Name: Community Health Group
Industry Payer ID: 66170
IMN Real Time ID: 66170
Exchange Real Time ID: COMHGR
CPID(s): 7668 (I), 7110 (P)
IEDI Real Time ID: 11087
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Claim Status Inquiry subscriber

• Member id, First name, Last name, Date of Birth
• Payer claim number

Optional additional elements:

• Total submitted charges

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.

2/3/2026

---

Update: Electronic Claims Connection Suspended and Routing Change for CPIDs 1573 and 3802 AvMed

Update:

Effective Feb. 3, 2026, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: AvMed
Professional CPID: 3802
Current Edit Master: PE_N000
New Edit Master: PE_B800
Institutional CPID: 1573
Current Edit Master: HE9N000
New Edit Master: HE9B801
Payer-assigned Payer ID: 59274
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:

• 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.

Original notice sent Jan. 16, 2026:

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

Payer Name: AvMed
CPIDs: 1573, 3802
Payer ID: 59274
Reason: Payer unavailable electronically.

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

2/3/2026

---

Update: Electronic Claims Connection Suspended and Routing Change for CPIDs 1573 and 3802 AvMed

Update:

Effective Feb. 3, 2026, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: AvMed
Professional CPID: 3802
Institutional CPID: 1573
Payer-assigned Payer ID: 59274
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.
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

Original notice sent Jan. 16, 2026:

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

Payer Name: AvMed
CPIDs: 1573, 3802
Payer ID: 59274
Reason: Payer unavailable electronically.

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

2/3/2026

---

New Payer Name
Effective immediately, please be aware of the following payer name change: 

Previous Payer Name: Blue Cross of Michigan Complete
New Payer Name: Blue Cross Complete of Michigan
Professional CPID: 7409
Professional Edit Master: PE_T007
Institutional CPID: 5096
Institutional Edit Master: HE9T007
Remit Line of Business (LOB) Code: X69 

Your existing Payer Alias entries will continue to work as they do currently; the new payer name is being provided for your reference. Be aware all future communications for these CPIDs will reference the new payer name only. 

Action Required: None

2/3/2026

---

Report Generation Delay for CPIDs 1532 and 4480 Select Health

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted Jan. 25, 2026.

Payer impacted:

• CPID 1532 Select Health
• CPID 4480 Select Health

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 09878976.

2/3/2026

---

New Payer Name

Effective immediately, please be aware of the following payer name change: 

Previous Payer Name: Blue Cross of Michigan Complete
New Payer Name: Blue Cross Complete of Michigan
Professional CPID: 7409
Institutional CPID: 5096  

Action Required: Please make the appropriate changes to accommodate the name change. 

2/3/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Next Generation MyCare Anthem Blue Cross Blue Shield Institutional CPID: 9061
Professional CPID: 3813
Payer-assigned Payer ID: 0022147
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Ohio 

Payer Name: Next Generation MyCare Buckeye Community Health Plan
Institutional CPID: 9062
Professional CPID: 3817
Payer-assigned Payer ID: 0021583
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Ohio 

Payer Name: Next Generation MyCare CareSource
Institutional CPID: 9063
Professional CPID: 3819
Payer-assigned Payer ID: 0021599
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Ohio 

Payer Name: Next Generation MyCare Molina Healthcare of Ohio Inc.
Institutional CPID: 9064
Professional CPID: 3821
Payer-assigned Payer ID: 0021586
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Ohio 

Action Required: 

• Add the payers to your system to begin using the new payer connection. 
• Providers currently receiving electronic remittance through Optum for Ohio Medicaid do not need to complete a new enrollment form. 
• Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum. 

2/3/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Next Generation MyCare Anthem Blue Cross Blue Shield
Institutional CPID: 9061
Professional CPID: 3813
Payer-assigned Payer ID: 0022147
Line of Business (LOB) Code: J5N
Payer Enrollment Required: Yes
Payer Location: Ohio 

Payer Name: Next Generation MyCare Buckeye Community Health Plan
Institutional CPID: 9062
Professional CPID: 3817
Payer-assigned Payer ID: 0021583
Line of Business (LOB) Code: J7C
Payer Enrollment Required: Yes
Payer Location: Ohio 

Payer Name: Next Generation MyCare CareSource
Institutional CPID: 9063
Professional CPID: 3819
Payer-assigned Payer ID: 0021599
Line of Business (LOB) Code: J95
Payer Enrollment Required: Yes
Payer Location: Ohio 

Payer Name: Next Generation MyCare Molina Healthcare of Ohio Inc.
Institutional CPID: 9064
Professional CPID: 3821
Payer-assigned Payer ID: 0021586
Line of Business (LOB) Code: J94
Payer Enrollment Required: Yes
Payer Location: Ohio 

Action Required: 

• Add the payers to your system to begin using the new payer connection. 
• Providers currently receiving electronic remittance through Optum for Ohio Medicaid do not need to complete a new enrollment form. 
• Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum. 

2/3/2026

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Report Generation Delay for CPID 5547 Blue Cross Blue Shield of Arizona

A payer is experiencing issues affecting Institutional report generation for some claims submitted on Jan. 28, 2026.

Payer impacted:

• CPID 5547 Blue Cross Blue Shield of Arizona

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 09878187.

2/3/2026

---

Upcoming Payer Edit Change for CPIDs 8293, 3044 Physicians Health Plan of Michigan

Optum has been informed that Physicians Health Plan of Michigan, Payer ID 83276 coverage has ended effective Dec. 31, 2025. Physicians Health Plan of Michigan is operating on a standard runout period for claims with 2025 dates of service. Optum will be implementing the following edits for date of service effective Febr. 3, 2026. 

• PDTP03C450: INVALID STATEMENT FROM DATE - This payer is not accepting claims with a Service Line From Date on or after 01/01/2026. LOOP 2400 DTP03
• IDTP038270: INVALID STATEMENT FROM DATE - This Payer is not accepting claims with Statement From Date on or after 01/01/2026. LOOP 2300 DTP03

The date of service edits will be applied for:

Payer Name: Physicians Health Plan of Michigan
Claim CPIDs: 8293, 3044
Payer-assigned Payer ID: 83276

Providers must be aware that claims with date of service on or after Jan. 1, 2026, will be rejected. 

For additional information, providers can go to payer’s website - www.phpmichigan.com.

Action Required: Providers should be aware of the date of service edit implementation.

2/2/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: JP Farley Corporation
Institutional CPID: 2578
Professional CPID: 3771
Payer-assigned Payer ID: 34136
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Alabama, Alaska, Georgia, Ohio, Tennessee
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. 

2/2/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: High Desert Medical Group
Institutional CPID: 9670
Professional CPID: 3290
Payer-assigned Payer ID: 95393
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. 

2/2/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Associates for Healthcare
Institutional CPID: 4592
Professional CPID: 6482
Payer-assigned Payer ID: 36326
Line of Business (LOB) Code: E42
Payer Enrollment Required: Yes
Payer Location: Wisconsin 

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. 

2/2/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Associates for Healthcare
Institutional CPID: 4592
Professional CPID: 6482
Payer-assigned Payer ID: 36326
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Wisconsin 

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. 

2/2/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: High Desert Medical Group
Institutional CPID: 9670
Professional CPID: 3290
Payer-assigned Payer ID: 95393
Line of Business (LOB) Code: E41
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. 

2/2/2026

---

Upcoming Payer Edit Change for CPIDs 8293, 3044 Physicians Health Plan of Michigan

Optum has been informed that Physicians Health Plan of Michigan, Payer ID 83276 coverage has ended effective Dec. 31, 2025. Physicians Health Plan of Michigan is operating on a standard runout period for claims with 2025 dates of service. Optum will be implementing the following edits for date of service effective Febr. 3, 2026. 

• PDTP03C450: INVALID STATEMENT FROM DATE - This payer is not accepting claims with a Service Line From Date on or after 01/01/2026. LOOP 2400 DTP03
• IDTP038270: INVALID STATEMENT FROM DATE - This Payer is not accepting claims with Statement From Date on or after 01/01/2026. LOOP 2300 DTP03

The date of service edits will be applied for:

Payer Name: Physicians Health Plan of Michigan
Claim CPIDs: 8293, 3044
Payer-assigned Payer ID: 83276

Providers must be aware that claims with date of service on or after Jan. 1, 2026, will be rejected. 

For additional information, providers can go to payer’s website - www.phpmichigan.com.

Action Required: Providers should be aware of the date of service edit implementation.

2/2/2026

---

New Electronic Claims Connection Available

Optum has a new electronic claims connection available: 

Payer Name: Wellcare by Meridian Illinois 
Institutional CPID: 9066
Professional CPID: 3830
Payer-assigned Payer ID: 68069
Payer Enrollment Required: No 
Secondary Claims Accepted: Yes 

Action Required:

• Add the payer to your system to begin using the new payer connection. 
• When a payer requires claims 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. 

2/2/2026

---

New Electronic Claims Connection Available

Optum has a new electronic claims connection available:  

Payer Name: Wellcare by Meridian Illinois 
Institutional CPID: 9066
Professional CPID: 3830
Payer-assigned Payer ID: 68069
Payer Enrollment Required: No 
Secondary Claims Accepted: Yes 
Claims Fee: $0.10 

Action Required:

• Add the payers to your system to begin using the new payer connection. 
• When a payer requires claims 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. 

2/2/2026

---

Report Generation Delay for CPID 1405 Blue Cross Blue Shield of Illinois

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Jan. 20, 2026.

Payer impacted: 

• CPID 1405 Blue Cross Blue Shield of Illinois

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 09876720.

2/2/2026

---

Update: Report Generation Delay for CPIDs 7420 and 5579 Blue Cross Blue Shield of Rhode Island

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Jan. 13, 2026.

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

Original notice sent Jan. 20, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Jan. 13, 2026.

Payer impacted:

• CPID 7420 Blue Cross Blue Shield of Rhode Island
• CPID 5579 Blue Cross Blue Shield of Rhode Island

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 09835171.

2/2/2026

---

Resolved: Invalid Error Message for NGS Medicare

Resolved: The payer confirmed the fix was put in place February 1, 2026.

Action Required: Please resubmit any impacted claims.

Previous Notify sent January 29, 2026:

Update: The intermediary has advised their initial fix completed January 18, 2026 requires additional correction. The intermediary estimates the issue will be resolved February 1, 2026.

Action Required: Please be aware that some claims submitted after January 18, 2026 may receive this error. We will notify you as soon as the intermediary confirms the issue is resolved.

Original Notify sent January 22, 2026:

Due to an intermediary processing issue, Professional claims for the payers listed below may have received the following invalid payer error message:

• NGSEDIT SUBMITTED THERAPY PROCEDURE CODE IS MISSING REQUIRED MODIFIER GP, GO OR GN

This issue began on January 2, 2026 and was resolved by the intermediary on January 18, 2026. Providers will need to resubmit impacted claims.

CPIDs affected:

• CPID 1452 Connecticut Medicare
• CPID 2472 Maine Medicare
• CPID 2469 Massachusetts Medicare
• CPID 1435 Minnesota Medicare
• CPID 2470 New Hampshire
• CPID 2244, 4442 New York Medicare Empire
• CPID 2260, 7401 New York Medicare GHI
• CPID 1463 New York Medicare Upstate
• CPID 7419 Rhode Island Medicare
• CPID 2471 Vermont Medicare
• CPID 1434 Wisconsin Medicare

Action Required: Please resubmit any impacted claims.

2/2/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: S USA Life Insurance
Professional CPID: 3800
Payer-assigned Payer ID: 95721
Line of Business (LOB) Code: E38
Payer Enrollment Required: Yes
Payer Location: National

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. 

2/2/2026

---

PAR Status Change for Eligibility Payers

Effective Feb. 1, 2026, the PAR Status changed for the following Eligibility payer(s):

Payer Name: Ameritas Life Insurance Company
Industry ID: 00425
Exchange CPIDs: 9402
Exchange RT ID: AMRTAS
Old Par Status: Transitional
New Par Status: Par

Payer Name: First Ameritas of New York
Industry ID: 00426
Exchange RT ID: AMTSNY
Old Par Status: Transitional
New Par Status: Par

Payer Name: Kaiser Permanente Hawaii
Industry ID: 94123
Exchange CPIDs: 5925, 6772
Exchange RT ID: HIKAIS
Old Par Status: Gateway
New Par Status: Non Par

Payer Name: Reliance Standard Life
Industry ID: 00427
Exchange RT ID: RELSTD
Old Par Status: Transitional
New Par Status: Par

Payer Name: Standard Insurance
Industry ID: 00429
Exchange RT ID: STDINS
Old Par Status: Transitional
New Par Status: Par

Payer Name: Standard Insurance of New York
Industry ID: 00430
Exchange RT ID: STDINY

Action Required: Please be aware of the upcoming changes.

2/2/2026

---

Resolved: Assurance Reimbursement Management Edit Issue

Resolved: This issue was resolved with the updated edit package deployed Jan. 30, 2026.

Action Required: Any claims affected by invalid edits require revalidation. Turnkey clients must run and install the latest EPD package. Once installation is complete, all affected claims should be revalidated. For questions, please contact Support.

Original Notify Sent Jan. 30, 2026:
Assurance Reimbursement Management is experiencing an issue with intermittent performance.

This may result in:

• Invalid Edit

Optum is working to resolve this issue. We will notify you as soon as additional information becomes available. 

We apologize for any inconvenience.

Action Required: None.

2/2/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: S USA Life Insurance
Professional CPID: 3800
Payer-assigned Payer ID: 95721
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National

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.

2/2/2026

---

Resolved: Invalid Error Message for NGS Medicare

Resolved: The payer confirmed the fix was put in place Feb. 1, 2026.

Action Required: Please resubmit any impacted claims.

Previous Notify sent January 29, 2026:
Update: The intermediary has advised their initial fix completed Jan. 18, 2026 requires additional correction. The intermediary estimates the issue will be resolved Feb. 1, 2026.

Action Required: Please be aware that some claims submitted after Jan. 18, 2026 may receive this error. We will notify you as soon as the intermediary confirms the issue is resolved.

Original Notify sent January 22, 2026:
Due to an intermediary processing issue, Professional claims for the payers listed below may have received the following invalid payer error message: 

• NGSEDIT SUBMITTED THERAPY PROCEDURE CODE IS MISSING REQUIRED MODIFIER GP, GO OR GN

This issue began Jan. 2, 2026 and was resolved by the intermediary Jan. 18, 2026. Providers will need to resubmit impacted claims.

Payer IDs affected:

• CCTMCR Connecticut Medicare
• MEMCR Maine Medicare
• MAMCR Massachusetts Medicare          
• MNMCR Minnesota Medicare
• NHMCR New Hampshire
• NYMCR, SMNY0 New York Medicare Empire
• GHMCR, SMNY2 New York Medicare GHI
• NN1MCR New York Medicare Upstate
• RIMCR Rhode Island Medicare
• VTMCR Vermont Medicare
• WIMCR Wisconsin Medicare

Action Required: Please resubmit any impacted claims.

2/2/2026

---

Report Generation Delay for CPIDs 4549 and 1232 Denver Health Medical Plan Inc. - Medicare Choice

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 19, 2026.

Payer impacted: 

• CPID 4549 Denver Health Medical Plan Inc. - Medicare Choice
• CPID 1232 Denver Health Medical Plan Inc. - Medicare Choice

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 09876517.

2/2/2026

---

Reminder: Payer Change for CPID 4492 Massachusetts Medicaid Format 5

Reminder:

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 February 11, 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 February 11, 2026.

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is required.
  • Providers currently submitting electronic claims through Optum to CPID 4492 Massachusetts Medicaid Format 5 do not need to complete a new enrollment form.
  • Providers who have not submitted claims to CPID 4492 since November 9, 2025, must complete a new enrollment form for CPID 4491 MassHealth.
  • 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.
    • Optum has migrated providers who have received remittance since November 9, 2025, by updating their clearinghouse routes to the applicable CPID 4491 MassHealth.
  • Providers who have not received remittance since November 9, 2025, were not migrated and 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.

2/2/2026

---

Report Generation Delay for CPIDs 8980 and 7279 PACE Southeast Michigan

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Jan. 19, 2026.

Payer impacted: 

• CPID 8980 PACE Southeast Michigan
• CPID 7279 PACE Southeast Michigan

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 09876452.

2/2/2026

---

Update: Report Generation Delay for CPID 1209 Regence Group Administrators

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 31, 2025 and Jan. 1, 2026.

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

Original notice sent Jan. 13, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Dec. 31, 2025 and Jan. 1, 2026.

Payer impacted: 

• CPID 1209 Regence Group 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 09828528.

2/2/2026

---

Transmit Delay for CPID 2527 Immanuel Pathways

Due to a system issue, a delay occurred in some of the transmissions to the following payer on Jan. 29, 2026 and Jan. 30, 2026.

Payer impacted:

• CPID 2527 Immanuel Pathways

A resolution has been implemented and the affected claims were transmitted to the payer on Feb. 2, 2026.

This delay affected claims released to Optum between 1 a.m. CT on Jan. 28, 2026 and 1 a.m. CT on Jan. 30, 2026.

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 09847944.

2/2/2026

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Report Generation Delay for CPIDs 2824 and 7551 The Health Plan of West Virginia

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Jan. 23, 2026.

Payer impacted: 

• CPID 2824 The Health Plan of West Virginia
• CPID 7551 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 09876388.

2/2/2026