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

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

1/20/2026

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Update: Report Generation Delay for CPIDs 4093 and 8834 Commonwealth Care Alliance

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 20, 2025.

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

Original notice sent Jan. 8, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 20, 2025.

Payer impacted: 

• CPID 4093 Commonwealth Care Alliance
• CPID 8834 Commonwealth Care Alliance

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 09825004.

1/20/2026

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Update: Report Generation Delay for CPIDs 2513 and 1167 Blue Cross Medicare Advantage

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 20, 2025.

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

Original notice sent Jan. 8, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 20, 2025.

Payer impacted: 

• CPID 2513 Blue Cross Medicare Advantage
• CPID 1167 Blue Cross Medicare Advantage

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 09824912.

1/20/2026

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Update: Report Generation Delay for CPIDs 2936 and 3757 IMAGINE360 ADMINISTRATORS (GPA)

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 20, 2025.

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

Original notice sent Jan. 8, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 20, 2025.

Payer impacted: 

• CPID 2936 IMAGINE360 ADMINISTRATORS (GPA)
• CPID 3757 IMAGINE360 ADMINISTRATORS (GPA)

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 09825107.

1/20/2026

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Update: Report Generation Delay for CPIDs 5516 and 2404 Regence Blue Cross Blue Shield of Oregon

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 20, 2025.

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

Original notice sent Jan. 8, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 20, 2025.

Payer impacted: 

• CPID 5516 Regence Blue Cross Blue Shield of Oregon
• CPID 2404 Regence Blue Cross Blue Shield of Oregon

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 09824880.

1/20/2026

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Update: Report Generation Delay for CPIDs 3540 and 7426 Regence Blue Shield of Idaho

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 20, 2025.

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

Original notice sent Jan. 8, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 20, 2025.

Payer impacted: 

• CPID 3540 Regence Blue Shield of Idaho
• CPID 7426 Regence Blue Shield of Idaho

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 09824964.

1/20/2026

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Electronic Routing Change for CPIDs 8293 and 3044 Physicians Health Plan of Michigan

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

Payer Name: Physicians Health Plan of Michigan
Professional CPID: 8293
Institutional CPID: 3044
Payer-assigned Payer ID: 83276
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements

Claims:

• Payer enrollment for electronic claims is 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.

1/20/2026

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Update: 835 Delay for UMR, Payer ID 39026, CPIDs 5402 & 4590

Update: Some 835s for UMR are still delayed at the payer for payment date 01/09/26 for Payer ID 39026. The payer is aware of the issue and is diligently working on delivering the files. Efforts to resolve this issue continue. It is currently open and in progress.

Original notice sent January 15, 2026:

Some 835s for UMR payer ID 39026 are delayed at the payer for payment date Jan. 9, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs

• 5402
• 4590

Action Required: No submitter action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003957.

1/20/2026

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Report Generation Delay for CPIDs 7567 and 7499 Sentara Health Plans

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.

1/20/2026

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Electronic Routing Change for CPIDs 8293 and 3044 Physicians Health Plan of Michigan

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

Payer Name: Physicians Health Plan of Michigan
Professional CPID: 8293
Institutional CPID: 3044
Payer-assigned Payer ID: 83276
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is 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.

1/20/2026

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Electronic Routing Change for CPIDs 8293 and 3044 Physicians Health Plan of Michigan

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

Payer Name: Physicians Health Plan of Michigan
Professional CPID: 8293
Edit Master: PE_T007
Institutional CPID: 3044
Edit Master: HE9T007
Payer-assigned Payer ID: 83276
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.

1/20/2026

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Electronic Routing Change for CPIDs 2274 and 8993 Essence

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

Payer Name: Essence
Professional CPID: 2274
Institutional CPID: 8993
Payer-assigned Payer ID: 20818
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is 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.

1/20/2026

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Electronic Routing Change for CPIDs 2274 and 8993 Essence

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

Payer Name: Essence
Professional CPID: 2274
Edit Master: PE_T007
Institutional CPID: 8993
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 20818
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.

1/20/2026

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Update: 835 Delay for UMR payer ID 39026

Update: Some 835s for UMR are still delayed at the payer for payment date Jan. 9, 2026 for Payer ID 39026. The payer is aware of the issue and is diligently working on delivering the files. Efforts to resolve this issue continue. It is currently open and in progress.

Original notice sent January 15, 2026:
Some 835s for UMR payer ID 39026 are delayed at the payer for payment date Jan. 9, 2026. A ticket has been opened with the payer for further research.

Affected Payer ID:

• 39026

Action Required: No submitter action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003957.

1/20/2026

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Report Generation Delay for CPIDs 8677 and 7264 Quartz ASO

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.

1/20/2026

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Update: Report Generation Delay for CPID 8861 Aetna Better Health of Illinois

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 25, 2025.

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

Original notice sent Jan. 9, 2026:
A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Dec. 25, 2025.

Payer impacted:

• CPID 8861 Aetna Better Health 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 09826174.

1/20/2026

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Update: Report Generation Delay for CPID 7451 Regence Blue Shield of Washington

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 20, 2025.

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

Original notice sent Jan. 8, 2026:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 7451 Regence Blue Shield of Washington

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09824854.

1/20/2026

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Update: Report Generation Delay for CPIDs 1529 and 2412 Regence Blue Cross Blue Shield of Utah

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 20, 2025.

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

Original notice sent Jan. 8, 2026:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 1529 Regence Blue Cross Blue Shield of Utah
• CPID 2412 Regence Blue Cross Blue Shield of Utah

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 09824829.

1/20/2026

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Update: Report Generation Delay for CPIDs 9656 and 7715 Hopkins Health Advantage

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 20, 2025.

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

Original notice sent Jan. 8, 2026:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted:

• CPID 9656 Hopkins Health Advantage
• CPID 7715 Hopkins Health Advantage

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 09824669.

1/20/2026

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Update: Report Generation Delay for CPIDs 1592 and 5432 Johns Hopkins Healthcare/Priority Partners

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 20, 2025.

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

Original notice sent Jan. 6, 2026:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted:

• CPID 1592 Johns Hopkins Healthcare / Priority Partners
• CPID 5432 Johns Hopkins Healthcare / Priority Partners

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 09822160.

1/20/2026

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Electronic Claims Connection Suspended - Physicians of Southwest Washington

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

Payer Name: Physicians of Southwest Washington
Payer ID: 91171
Reason: Payer unavailable electronically.

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

1/20/2026

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Update: Report Generation Delay for CPIDs 8048 and 9766 Gold Kidney Health Plan

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 19, 2025 and Jan. 1, 2026.

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

Original notice sent Jan. 6, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 19, 2025.

Payer impacted: 

• CPID 8048 Gold Kidney Health Plan
• CPID 9766 Gold Kidney 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 09822035.

1/20/2026

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Update: Report Generation Delay for CPID 2842 Alexian PACE

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 17, 2025 and Dec. 20, 2025.

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

Original notice sent Jan. 6, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Dec. 17, 2025 and Dec. 20, 2025.

Payer impacted: 

• CPID 2842 Alexian PACE

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 09821734.

1/20/2026

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Dec. 17, 2025 through Dec. 19, 2025.

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

Original notice sent Jan. 6, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Dec. 17, 2025.

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 09821794.

1/20/2026

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Payer Fee Change

Please be aware of the following payer RT Eligibility fee changes Effective Date January 08, 2026.

Payer Name: OKLAHOMA MEDICAID
Industry Payer ID: SKOK0
IMN Real Time ID: SKOK0
Exchange Real Time ID: OKCAID
CPID(s): 2753, 3594
Optum IEDI Real Time ID: OKMCD, MC030
Payer Enrollment Required: No
Connection Type: X12
Pass Through Fee: $0.02

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.

1/20/2026

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Update: Report Generation Delay for CPIDs 8035 and 2859 Ascension Living Hope PACE

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Dec. 17, 2025 and Dec. 20, 2025.

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

Original notice sent Jan. 6, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Dec. 17, 2025 and Dec. 20, 2025.

Payer impacted: 

• CPID 8035 Ascension Living Hope PACE
• CPID 2859 Ascension Living Hope PACE

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 09821541.

1/20/2026

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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 from Dec. 16, 2025 through Jan. 6, 2026.

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

Original notice sent Jan. 6, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Dec. 16, 2025.

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 09821497.

1/20/2026

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Report Generation Delay for CPIDs 1496 and 1548 Colorado Medicaid

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

Payer impacted:

• CPID 1496 Colorado Medicaid
• CPID 1548 Colorado Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09834473.

1/20/2026

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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: Physicians of Southwest Washington
CPIDs: 1136, 8623
Payer ID: 91171
Reason: Payer unavailable electronically.

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

1/20/2026

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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 from Dec. 15, 2025 through Jan. 1, 2026.

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

Original notice sent Dec. 30, 2025:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Dec. 15, 2025.

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 09816609.

1/20/2026

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New Payer Edit for CPID 8579

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 Jan. 20, 2026: 

• INM10333DW: MISSING ATT PROV LAST NAME - The Attending Provider Name is required on all claims except when non-scheduled transportation is present. Exception: When the following conditions are present, this requirement does not apply. a. CPID is 5959; and b. Type of Bill is 32x or 34x; and c. HCPCS/CPT-4 Code T1019 is the only HCPCS/CPT-4 Code present. LOOP 2310A NM103

 Edit applies to:

• CPID 8579 CHRISTUS HEALTH MEDICARE ADVANTAGE

Action Required: Please be aware of updated edit requirements.

1/20/2026

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Claim Status Connection Available

Effective January 16, 2026 Optum is pleased to announce the availability of Real-time Claim Status 276/277 for the below payer:

Payer Name: Garden State Life Insurance Company
Industry Payer ID: 84030
IMN Real Time ID: 84030
Exchange Real Time ID: GASLI
CPID(s): N/A
Optum IEDi Real Time ID: 84030
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Claim Status Inquiry subscriber

• Member id, first name, last name, date of birth
• Optional additional elements: Payer claim number; Total submitted charges

1/16/2026

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New Electronic Eligibility Connection Available

Effective January 15th, 2026 Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer:

Payer Name: Benefit and Risk Management Services
Industry Payer ID: 99320
IMN Real Time ID: 99320
Exchange Real Time ID: BRMSE
CPID(s): 7681, 7136
Optum IEDi Real Time ID: 99320
Payer Enrollment Required: No
Connection Type: X12

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

1/16/2026

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Electronic Claims Connection Suspended - AvMed

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

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

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

1/16/2026

---

New Electronic Claims Connections Available - Chorus Community Health Plan
Optum has new electronic claims connections available:

Payer Name: Chorus Community Health Plan
Payer ID: 29123
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Wisconsin
Claims Fee: N/A

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.

1/16/2026

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ERA Connection Available

Optum has electronic remittance connections available for Cinqcare:

Payer Name: Cinqcare
Institutional CPID: NA
Professional CPID: 2879
Payer-assigned Payer ID: CINQ1
Payer Remittance Enrollment Required: Yes

Action Required:

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

1/16/2026

---

Electronic Routing Change for CPIDs 8293 and 3044 Physicians Health Plan of Michigan

Effective January 16, 2026, Optum will be changing electronic remittance routing for the following payer:

Payer Name: Physicians Health Plan of Michigan
Professional CPID: 8293
Institutional CPID: 3044
Payer-assigned Payer ID: 83276
Line of Business Code (LOB): J5D
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:

• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

1/16/2026

---

Electronic Routing Change for CPIDs 8293 and 3044 Physicians Health Plan of Michigan

Effective January 16, 2026, Optum will be changing electronic remittance routing for the following payer:

Payer Name: Physicians Health Plan of Michigan
Professional CPID: 8293
Institutional CPID: 3044
Payer-assigned Payer ID: 83276
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.

1/16/2026

---

Report Generation Delay for multiple CPIDs

Deloitte is experiencing issues affecting Professional report generation for some claims submitted since Jan. 12, 2026.

Payers impacted: 

• CPID 9458 CareSource Ohio Medicaid
• CPID 9461 Anthem Ohio Medicaid
• CPID 9463 Humana Ohio Medicaid
• CPID 9462 Molina Ohio Medicaid
• CPID 9455 Molina Ohio Medicaid Vision
• 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 09832546.

1/16/2026

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New Real Time Claim Status Inquiry 276/277 Connection Available

Optum is pleased to announce the availability of Real-time Claim Status Inquiry 276/277 for the below payer, effective Dec. 17, 2025:

Payer Name: Washington Medicaid
Industry Payer ID: 77045
IMN Real Time ID: SKWA0
Exchange Real Time ID: WACAID
CPID(s): 5523, 1482
Optum IEDi Real Time ID: WAMCD
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Subscriber

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

Action Required by customer:
Washington Medicaid requires the provider to include the 9 Digit ProviderOne ID (7 digit domain ID with 2 zeros) in the 2100B NM1*09 Loop/Segment.

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.

1/16/2026

---

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

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

1/16/2026

---

New Electronic Remittance Connections Available - Kempton Group Administrators

Optum has new electronic remittance connections available:

Payer Name: Kempton Group Administrators
Payer ID: 73100
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Oklahoma

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.

1/15/2026

---

New Payer Name

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

Previous Payer Name:  Aetna Medicare FIDE
New Payer Name: Aetna Better Health of Illinois FIDE
Payer ID: 26337

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

1/15/2026

---

Error Message for CPID 1573, 3802 Payer Name AvMed

We would like to give you awareness of a payer processing issue that could potentially impact your business.

Due to a payer processing issue, Professional and Institutional claims for the payer listed below may have received the following error messages:

• R SERVICE DATE IS AFTER 12/31/2025. PLEASE RESUBMIT THIS CLAIM TO TRADING PARTNER USING EITHER PAYERID 59274 OR 59275.
• R AVMEDNTT DENY CLAIMS WITH DOS ON OR AFTER 1/1/2026

Payers affected:

• CPID 1573 AvMed
• CPID 3802 AvMed

Additional updates will be forwarded as more information becomes available. 

Action Required: Please be aware of the error message.

If you have any questions, feel free to contact your Customer Support Team.

1/15/2026

---

Payer Processing Issue for CPID 2907 Nevada Medicaid

Due to a payer intermediary processing issue, some Institutional claims transmitted to the payer listed below Jan. 14, 2026 were not processed by the payer.

Payer impacted:

• CPID 2907 Nevada Medicaid

A resolution has been implemented and the claims were retransmitted to the payer intermediary on Jan. 15, 2026.

This delay affected claims released to Optum between 6 p.m. CT on Jan. 13, 2026 and 11 a.m. CT on Jan. 14, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09832003.

1/15/2026

---

Delay in Electronic Remittance Advice (ERA) for CPIDs 7427, 5583 Idaho Medicaid

Due to an internal processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of December 11, 2025 through Present:

• CPID 7427 Idaho Medicaid
• CPID 5583 Idaho 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 file dates above.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003963.

1/15/2026

---

Edit Master for CPIDs 8946 and 3250 Butler Benefit

Effective immediately, Optum will be changing Edit Masters for the following payer:

Payer Name: Butler Benefit
Professional CPID: 3250
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Institutional CPID: 8946
Current Edit Master: HE9C054
New Edit Master: HE9T007
Payer-assigned Payer ID: 42150 

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(s) and CPID(s) are not changing. 

1/15/2026

---

Update: Electronic Claims Connection Suspended

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

Original notice sent January 2, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: EyeMed Vision Care
CPID: 5817
Payer ID: 31165
Reason: Payer unavailable electronically.

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

1/15/2026

---

Portal Payer Terminations

The eligibility portal payer connections below are no longer available at Optum, effective immediately:

Payer Name: HealthComp South
Real Time ID: GILSB1
CPID(s): 2557, 2802
Industry Payer ID: 07205
Connection Type: Portal

Payer Name: HealthComp North
Real Time ID: HLCMP1
CPID(s): 2984, 4287
Industry Payer ID: 36149
Connection Type: Portal

Payer Name: HealthComp West
Real Time ID: HLCMP1
CPID(s): 2934, 3206
Industry Payer ID: 85729
Connection Type: Portal

Action Required: None.

1/15/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Kempton Group Administrators
Institutional CPID: 4577
Professional CPID: 8435
Payer-assigned Payer ID: 73100
Line of Business (LOB) Code: J1L
Payer Enrollment Required: Yes
Payer Location: Oklahoma

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.

1/15/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Kempton Group Administrators
Institutional CPID: 4577
Professional CPID: 8435
Payer-assigned Payer ID: 73100
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Oklahoma

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.

1/15/2026

---

RESOLVED: Acknowledgment File Naming Issue

Resolved: The issue affecting the naming convention of certain acknowledgment files—including 999 and/or TA1 transactions—has been resolved. A deployment was completed the evening of January 13, 2026, which restored the original, expected naming convention for acknowledgment files.

Note:

The correction applies to acknowledgment files created after the deployment. Files generated during the impacted window (January 9, 2026 through January 13, 2026 prior to deployment) will not be retroactively renamed.

Original Notify Sent: January 13, 2026

Optum is aware of an issue that may be affecting the naming convention of certain acknowledgment files (including 999 and/or TA1 transactions). Some customers may see acknowledgment files delivered with unexpected or inconsistent file names.

Dates affected: 01/09/2026 to present

Our teams have identified the source of the issue and are actively working on a fix scheduled to be deployed this evening. This update will restore the previous file-naming convention moving forward.

We will provide a follow-up notice once the fix has been successfully deployed.

We appreciate your patience as we work to resolve this matter and prevent similar issues going forward.

Action Required:

No additional action is required.

1/15/2026

---

835 Delay for UMR, Payer ID 39026, CPIDs 5402 & 4590

Some 835s for UMR payer ID 39026 are delayed at the payer for payment date Jan. 9, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs

• 5402
• 4590

Action Required: No submitter action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners.

1/15/2026

---

South Florida Musculoskeletal Care Electronic Claims Connection No Longer Available

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

Payer Name: South Florida Musculoskeletal Care
Payer ID: 06294
Reason: Payer no longer offers an electronic connection.  

Action Required: None.

1/15/2026

---

New Payer Name

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

Previous Payer Name: Kentucky Health Administrators
New Payer Name: Advisory Health Administrators
Payer ID: 82357

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

1/15/2026

---

Report Generation Delay for CPIDs 7567 and 7499 Sentara Health Plans

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted from Dec. 8, 2025 through Dec. 31, 2025.

Payer impacted: 

• CPID 7567 Sentara Health Plans
• CPID 7499 Sentara Health Plans

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 09811190.

1/15/2026

---

835 Delay for UMR payer ID 39026

Some 835s for UMR payer ID 39026 are delayed at the payer for payment date Jan. 9, 2026. A ticket has been opened with the payer for further research.

Affected Payer ID:

• 39026

Action Required: No submitter action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners.

1/15/2026

---

Harvard Pilgrim Medicare Advantage Electronic Claims and Remittance Connections No Longer Available

The payer listed below will no longer be available at Optum for claims and remittance processing effective Feb. 1, 2026.

Payer Name: Harvard Pilgrim Medicare Advantage
Additional Plan Name: Harvard Community Health Plan
Payer ID: 04245
Reason: Payer no longer contracted with CMS and the runout period has ended.

Payer will no longer accept paper claims.

Claims must be submitted to Optum by Jan. 31, 2026, 1:30 p.m. CT to avoid claim rejections.

Action Required: Submit claims to Optum by January 31, 2026.

1/15/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: CapRock Health Plans
Payer ID: CAPHP
Payer Remittance Enrollment Required: Yes
Payer Location: Arizona, 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.

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

1/15/2026

---

Report Generation Delay for CPID 4270 Resurrection Physicians Provider Group

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

Payer impacted: 

• CPID 4270 Resurrection Physicians Provider Group

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 09831375.

1/15/2026

---

Resolved ERA Content Issue for UnitedHealthcare Payer ID 87726

We would like to give you awareness of a payer processing issue that could potentially impact your business.

Resolved: Some UnitedHealthcare 835s were generated with the tax ID only and without the NPI segment in the PE loop. This issue affected 835s intermittently, dated December of 2025 through January 9th, 2026. UnitedHealthcare identified the issue and deployed a fix on January 9th. The issue has been resolved and as of January 12th, the 835s will contain the NPI segment in the PE loop. 

Note: The fix applies to future remits only. The payer will not be sending corrected files.

Action Required: If the remit was delivered to a different vendor per the tax ID association, please submit a Customer Care Hub case to Enrollment, with an Enrollment request, Change of Vendor letter and request that impacted remits be reposted. If you do not wish to update the enrollment, please post all affected remits manually.

Original Notify Sent 01/12/2026

We would like to give you awareness of a payer processing issue that could potentially impact your business.

Optum is aware of an issue whereby some 835s were generated with the tax ID only and without the NPI segment in the PE loop. A ticket has been opened with the payer for further research.

Affected Payer ID:

• 87726 UnitedHealthcare

Action Required: No submitter action is currently required. An additional notice will be sent once a root cause has been identified.

Please direct any questions to the Support Team at 1-866-OptumGo and reference incident #INC-000003899. Please do not reply to this email directly.

1/15/2026

---

ERA Content Issue for UnitedHealthcare Payer ID 87726, Multiple CPIDs

We would like to give you awareness of a payer processing issue that could potentially impact your business.

Resolved: Some UnitedHealthcare 835s were generated with the tax ID only and without the NPI segment in the PE loop. This issue affected 835’s intermittently, dated December of 2025 through January 9th, 2026. UnitedHealthcare identified the issue and deployed a fix on January 9th. The issue has been resolved and as of January 12th, the 835s will contain the NPI segment in the PE loop.

Note: The fix applies to future remits only. The payer will not be sending corrected files.

Action Required: If you are missing remittances dated between December 2025 and January 9, 2026, for CPIDs 3429, 3550, 6442, or 4523, please open a case through our Customer Care Hub. Be sure to include the following details: NPI, Tax ID, check number, check amount, and check date.

Original Notify Sent 01/12/2026

Optum is aware of an issue whereby some 835s were generated with the tax ID only and without the NPI segment in the PE loop. A ticket has been opened with the payer for further research.

Affected CPIDs:

• 3429
• 3550
• 6442
• 523

ACTION REQUIRED: No submitter action is currently required. An additional notice will be sent once a root cause has been identified.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003899.

1/15/2026

---

New Payer Name

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

Previous Payer Name: Aetna Medicare FIDE 
New Payer Name: Aetna Better Health of Illinois FIDE
Professional CPID: 4623
Institutional CPID: 6140 

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

1/14/2026

---

New Payer Name

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

Previous Payer Name: S & S Healthcare Strategies
New Payer Name: S&S Healthcare Strategies dba Reflect Health
Professional CPID: 3740
Institutional CPID: 2518 

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

1/14/2026

---

Edit Master for CPID 1830 Brokerage Concepts

Effective immediately, Optum will be changing Edit Masters for the following payer:

Payer Name: Brokerage Concepts
Professional CPID: 1830
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Payer-assigned Payer ID: 51037 

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 CPID are not changing.

1/14/2026

---

New Payer Name

Please be aware of the following payer name change, effective immediately:

Previous Payer Name: Aetna Medicare FIDE 
New Payer Name: Aetna Better Health of Illinois FIDE
Professional CPID: 6140
Professional Edit Master: PE_T007
Institutional CPID: 4623
Institutional Edit Master: HE9T007
Remit Line of Business (LOB) Code: J2Y 

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: 

• You may choose to update the Payer Alias in your system to accommodate the new payer name.

1/14/2026

---

New Payer Name

Please be aware of the following payer name change, effective immediately:

Previous Payer Name: S & S Healthcare Strategies
New Payer Name: S&S Healthcare Strategies dba Reflect Health
Professional CPID: 3740
Professional Edit Master: PE_N000
Institutional CPID: 2518
Institutional Edit Master: HE9N000
Remit Line of Business (LOB) Code: U2U 

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: 

• You may choose to update the Payer Alias in your system to accommodate the new payer name. 

1/14/2026

---

Harvard Pilgrim Medicare Advantage Electronic Claims and Remittance Connections No Longer Available

Effective February 1, 2026, the payer listed below will no longer be available at Optum for claims and remittance processing.

Payer Name: Harvard Pilgrim Medicare Advantage
Additional Plan Name: Harvard Community Health Plan
Claims and Remittance CPIDs: 7105, 7619
Remittance LOB: J87
Payer-assigned Payer ID: 04245
Reason: Payer no longer contracted with CMS and the runout period has ended.

Payer will no longer accept paper claims.

Claims must be submitted to Optum by 1:30 p.m. CT on January 31, 2026, to avoid claim rejections.

Action Required: Submit claims to Optum by January 31, 2026.

1/14/2026

---

Harvard Pilgrim Medicare Advantage Electronic Claims and Remittance Connections No Longer Available
The payer listed below will no longer be available at Optum for claims and remittance processing, effective Feb. 1, 2026.

Payer Name: Harvard Pilgrim Medicare Advantage
Additional Plan Name: Harvard Community Health Plan
Claim and Remittance CPIDs: 7105, 7619
Payer-assigned Payer ID: 04245
Reason: Payer no longer contracted with CMS and the runout period has ended.

Payer will no longer accept paper claims.

Claims must be submitted to Optum by January 31, 2026, 1:30 p.m. CT to avoid claim rejections.

Action Required: Submit claims to Optum Jan. 31, 2026.

1/14/2026

---

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 Jan. 12, 2026:

Payer Name: State Mutual Med Supp
Industry Payer ID: 10750
IMN Real Time ID: 10750
Exchange Real Time ID: STMMS
Optum IEDI Real Time ID: 10750
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.

1/14/2026

---

Update: Transmit Delay for Multiple CPIDs

Update: A resolution has been implemented and the affected claims were transmitted to the payers on Jan. 13, 2026.

This delay affected claims released to Optum between 7 a.m. CT on Jan. 12, 2026 and 11 a.m. CT on Jan. 13, 2026.

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

Original notify sent Jan. 13, 2026:

Due to a payer system issue, a delay occurred in some of the transmissions to the following payers since Jan. 12, 2026.

Payers impacted:

• CPID 1500 New York Medicaid
• CPID 1422 New York Medicaid
• CPID 1501 New York Medicaid Inpatient
• CPID 1502 New York Medicaid Outpatient
• CPID 2429 New York Medicaid
• CPID 2743 New York Medicaid
• CPID 2745 New York Medicaid
• CPID 6540 New York Medicaid

Optum is working diligently with the payers to resolve the issue.    

This delay affects claims released to Optum since 7 a.m. CT on Jan. 12, 2026.

Action Required: Be aware of the transmit delay above.

If you have any questions, please contact Customer Support and refer to Case Number 09828926.

1/14/2026

---

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 Jan. 7, 2026:

Payer Name: Universal American
Industry Payer ID: PN018
IMN Real Time ID: 11216
Exchange Real Time ID: UNAMR
Optum IEDI Real Time ID: 11216
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.

1/14/2026

---

South Florida Musculoskeletal Care Electronic Claims Connection No Longer Available

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

Payer Name: South Florida Musculoskeletal Care
Claim CPID: 1539
Payer-assigned Payer ID: 06294
Reason: Payer no longer offers an electronic connection.  

Action Required: None.

1/14/2026

---

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 Nov. 17, 2025 through Dec. 30, 2025.

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

Original notice sent Dec. 2, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Nov. 17, 2025.

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 09792788.

1/14/2026

---

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 Jan. 9, 2026:

Payer Name: Maryland Medicaid
Exchange Real Time ID: MDCAID
CPID(s): 1488, 5552
Payer Enrollment Required: No
Connection Type: X12

Search Options:
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 transaction. For assistance with submitting Real-Time transactions, please contact your Practice Management System Vendor or Optum Customer Care Hub ticket.

1/14/2026

---

Report Generation Delay for CPID 1497 Dean Health Plan by Medica

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted Dec. 22, 2025.

Payer impacted: 

• CPID 1497 Dean Health Plan by Medica 

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09829308.

1/13/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: CapRock Health Plans
Institutional CPID: 3654
Professional CPID: 5848
Payer-assigned Payer ID: CAPHP
Line of Business (LOB) Code: J48
Payer Remittance Enrollment Required: Yes
Payer Location: Arizona, 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.

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

1/13/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: CapRock Health Plans
Institutional CPID: 3654
Professional CPID: 5848
Payer-assigned Payer ID: CAPHP
Payer Remittance Enrollment Required: Yes
Payer Location: Arizona, Texas
Remittance Fee: N/A

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.

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

1/13/2026

---

Transmit Delay for CPIDs 7427 and 5583 Idaho Medicaid

Due to a payer system issue, a delay occurred in some of the transmissions to the following payer since Jan. 9, 2026.

Payer impacted: 

• CPID 7427 Idaho Medicaid
• CPID 5583 Idaho Medicaid

Optum is working diligently with the payer to resolve the issue.    

This delay affects claims released to Optum since Jan. 8, 2026, 3:00 p.m. CT.

Action Required: Be aware of the transmit delay above.

If you have any questions, please contact Customer Support and refer to Case Number 09829095.

1/13/2026

---

Update: New Payer Name

Update: Payer Name Restored to Prior Naming 

Previous Payer Name: Aetna Medicare HIDE
New Payer Name: Aetna Better Health of Michigan 

Original notice sent Jan. 5, 2026:
Effective immediately, please be aware of the following payer name change: 

Previous Payer Name: Aetna Better Health of Michigan
New Payer Name: Aetna Medicare HIDE
Payer ID: 128MI 

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

1/13/2026

---

PAR Status and Fee Change for Claims Payers Effective Feb. 1, 2026

Effective Feb. 1, 2026, the PAR Status is changing for the following claim payers and any Non Par fee changes will be noted if applicable for the payer:

Payer Name: Anchor Benefit Consulting
Industry ID: 53085
New Par Status: Non Par

Payer Name: Butler Benefit
Industry ID: 42150
New Par Status: Non Par

Payer Name: Carelon Behavioral Health
Industry ID: CHCBH
New Par Status: Non Par

Payer Name: Coastal Communities Physician Network
Industry ID: 51579
New Par Status: Non Par
New Fee: $0.10

Payer Name: Consolidated Associates Railroad
Industry ID: 75284
New Par Status: Non Par

Payer Name: Employee Benefit Administration & Management (EBA&M)
Industry ID: 95288
New Par Status: Non Par

Payer Name: Farm Family
Industry ID: 14140
New Par Status: Non Par

Payer Name: Fringe Benefit Coordinators (Medical and Accident)
Industry ID: 59204
New Par Status: Non Par

Payer Name: GlobalCare
Industry ID: 07689
New Par Status: Non Par

Payer Name: Health Services Preferred (HSP) Emerald Health
Industry ID: 34167
New Par Status: Non Par

Payer Name: Healthcare Solutions Group
Industry ID: 73147
New Par Status: Non Par

Payer Name: HealthSmart ACCEL Network
Industry ID: 75237
New Par Status: Non Par

Payer Name: HealthSmart Preferred Care
Industry ID: 75250
New Par Status: Non Par

Payer Name: Innovante Benefit Administrators
Industry ID: 31172
New Par Status: Non Par

Payer Name: MedCom
Industry ID: 59231
New Par Status: Non Par

Payer Name: NAMCI/Global Care
Industry ID: L0110
New Par Status: Non Par

Payer Name: Partners Health Plan
Industry ID: 14966
New Par Status: Non Par

Payer Name: UMWA Health and Retirement Funds
Industry ID: 52180
New Par Status: Non Par

Payer Name: US Benefits
Industry ID: 93092
New Par Status: Non Par

Payer Name: Veteran Affairs Community Care Network Region 1, 2, 3
Industry ID: VACCN
New Par Status: Non Par

Payer Name: William C Earhart
Industry ID: 93050
New Par Status: Non Par

Action Required: Please be aware of the upcoming PAR status changes for Feb. 1, 2026.

1/13/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Neighborhood Health Plan of Rhode Island - Integrity (MMP)/Neighborhood Health Plan of Rhode Island
Payer ID: 96240/05047
Reason: Payer unavailable electronically.

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

1/13/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Northwest Administrators
Payer ID: NWADM
Line of Business (LOB) Code: H1V
Payer Enrollment Required: Yes
Payer Location: California, Nevada, Oregon, Washington 

Payer Name: Island Home Insurance Company
Payer ID: 85502
Line of Business (LOB) Code: H1M
Payer Enrollment Required: Yes
Payer Location: Guam 

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. 

1/13/2026

---

Transmit Delay for Multiple CPIDs

Due to a payer system issue, a delay occurred in some of the transmissions to the following payers since Jan. 12, 2026.

Payers impacted: 

• CPID 1500 New York Medicaid
• CPID 1422 New York Medicaid
• CPID 1501 New York Medicaid Inpatient
• CPID 1502 New York Medicaid Outpatient
• CPID 2429 New York Medicaid
• CPID 2743 New York Medicaid
• CPID 2745 New York Medicaid
• CPID 6540 New York Medicaid

Optum is working diligently with the payers to resolve the issue.    

This delay affects claims released to Optum since Jan. 12, 2026, 7:00 a.m. CT.

Action Required: Be aware of the transmit delay above.

If you have any questions, please contact Customer Support and refer to Case Number 09828926.

1/13/2026

---

Report Generation Delay for CPID 9765 Central Valley Medical Providers

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 29, 2025.

Payer impacted: 

• CPID 9765 Central Valley Medical Providers

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 09828881.

1/13/2026

---

Report Generation Delay for CPIDs 2081 and 8226 Community Care IPA

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

Payer impacted:

• CPID 2081 Community Care IPA
• CPID 8226 Community Care IPA

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 09828883.

1/13/2026

---

Resolved: 835 Delay for UnitedHealthcare payer ID 87726

RESOLUTION: All missing 835s for payment date of Jan. 6, 2026 have been received and processed. Please allow up to 24 hours for posting to complete. 

Action Required: No additional action is needed.

Original notify sent Jan. 12, 2026:
Some 835s for UnitedHealthcare Payer ID 87726 are delayed at the payer for payment date Jan. 6, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs:

• 3429
• 3550
• 6442
• 4523

ACTION REQUIRED: No action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners. If the provider receives EFTs, copies of the 835s can be downloaded online at http://optum.com/optumpay.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003934.

1/13/2026

---

Resolved: 835 Delay for UnitedHealthcare payer ID 87726

RESOLUTION: All missing 835s for UnitedHealthcare Payer ID 87726 with a payment date of Jan. 6, 2026 have been received and processed. Please allow up to 24 hours for posting to complete. 

Original notification sent Jan. 9, 2026
Some 835s for UnitedHealthcare payer ID 87726 are delayed at the payer for payment date Jan. 6, 2026. A ticket has been opened with the payer for further research.

Affected Payer ID:

• 87726

SUBMITTER ACTION: No submitter action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners. If the provider receives EFTs, copies of the 835s can be downloaded online at http://optum.com/optumpay.

Please direct any questions to the Support Team at 1-866-OptumGo. Please do not reply to this email directly.

1/13/2026

---

Verity Medical Foundation Electronic Claims Connection No Longer Available

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

Payer Name: Verity Medical Foundation
Claim CPID: 9682
Payer-assigned Payer ID: VMF01
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

1/13/2026

---

Enrollment Form Change for Triple S Salud

The following payer has changed their Claims enrollment form: 

• Triple S Salud
• CPID 2756
• Payer ID SB980

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.

1/13/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Island Home Insurance Company
Institutional CPID: 2080
Professional CPID: 8225
Payer-assigned Payer ID: 85502
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Guam 

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. 

1/13/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Island Home Insurance Company
Institutional CPID: 2080
Professional CPID: 8225
Payer-assigned Payer ID: 85502
Line of Business (LOB) Code: H1M
Payer Enrollment Required: Yes
Payer Location: Guam 

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. 

1/13/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Northwest Administrators
Professional CPID: 6293
Payer-assigned Payer ID: NWADM
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California, Nevada, Oregon, Washington 

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. 

1/13/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Northwest Administrators
Professional CPID: 6293
Payer-assigned Payer ID: NWADM
Line of Business (LOB) Code: H1V
Payer Enrollment Required: Yes
Payer Location: California, Nevada, Oregon, Washington 

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. 

1/13/2026

---

Report Generation Delay for CPID 1209 Regence Group Administrators

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted 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.

1/13/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Neighborhood Health Plan of Rhode Island - Integrity (MMP) / Neighborhood Health Plan of Rhode Island
CPIDs: 8612, 7171 / 3645, 2487
Payer ID: 96240 / 05047
Reason: Payer unavailable electronically.

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

1/13/2026

---

New Payer Name

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

Previous Payer Name: Kentucky Health Administrators
New Payer Name: Advisory Health Administrators
Professional CPID: 9165
Institutional CPID: 6018

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

1/12/2026

---

New Payer Name

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

Previous Payer Name: Kentucky Health Administrators
New Payer Name: Advisory Health Administrators
Professional CPID: 9165
Professional Edit Master: PE_T007
Institutional CPID: 6018
Institutional Edit Master: HE9T007
Remit Line of Business (LOB) Code: K85

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:

• No Payer Alias changes are required.

1/12/2026

---

New Electronic Claims Connections Available - Chorus Community Health Plan

Optum has new electronic claims connections available:

Payer Name: Chorus Community Health Plan
Institutional CPID: 9059
Professional CPID: 3799
Payer-assigned Payer ID: 29123
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Wisconsin
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.

1/12/2026

---

ERA Delay for UnitedHealthcare Payer ID 87726, Multiple CPIDs

Some 835s for UnitedHealthcare Payer ID 87726 are delayed at the payer for payment date 01/06/26. A ticket has been opened with the payer for further research.

Affected CPIDs:

• 3429
• 3550
• 6442
• 4523

ACTION REQUIRED: No action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners. If the provider receives EFTs, copies of the 835s can be downloaded online at http://optum.com/optumpay.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003934.

1/12/2026

---

Report Generation Delay for CPID 9102 Meridian Medicare Medicaid Plan

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Dec. 27, 2025.

Payer impacted: 

• CPID 9102 Meridian Medicare Medicaid 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 09827498.

1/12/2026

---

ERA Content Issue for UnitedHealthcare Payer ID 87726, Mult CPIDs

Optum is aware of an issue whereby some 835s were generated with the tax ID only and without the NPI segment in the PE loop. A ticket has been opened with the payer for further research.

Affected CPIDs:

• 3429
• 3550
• 6442
• 4523

ACTION REQUIRED: No submitter action is currently required. An additional notice will be sent once a root cause has been identified.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003899.

1/12/2026

---

Optum San Diego Public Sector Behavioral Health Electronic Claims Connection No Longer Available

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

Payer Name: Optum San Diego Public Sector Behavioral Health
Claim CPID: 8038
Payer-assigned Payer ID: OSDPS

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

Action Required: None.

1/12/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Fox Everett
Institutional CPID: 6576
Professional CPID: 5433
Payer-assigned Payer ID: 64069
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Mississippi 

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. 

1/12/2026

---

Update: New Payer Name

Update: Payer Name Restored to Prior Naming 

Previous Payer Name: Aetna Medicare HIDE
New Payer Name: Aetna Better Health of Michigan  

Original notice sent Jan. 5, 2026:
Effective immediately, please be aware of the following payer name change: 

Previous Payer Name: Aetna Better Health of Michigan 
New Payer Name: Aetna Medicare HIDE 
Professional CPID: 7220
Institutional CPID: 8637 

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

1/12/2026

---

Update: New Payer Name

Update: Payer Name Restored to Prior Naming 

Previous Payer Name: Aetna Medicare HIDE
New Payer Name: Aetna Better Health of Michigan  

Original notice sent Jan. 5, 2026:
Effective immediately, please be aware of the following payer name changes: 

Previous Payer Name: Aetna Better Health of Michigan 
New Payer Name: Aetna Medicare HIDE 
Professional CPID: 7220
Professional Edit Master: PE_T007
Institutional CPID: 8637
Institutional Edit Master: HE9T007
Remit Line of Business (LOB) Code: J2V 

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: 

• You may choose to update the Payer Alias in your system to accommodate the new payer name. 

1/12/2026

---

Report Generation Delay for CPID 8714 Allstate

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 31, 2025.

Payer impacted: 

• CPID 8714 Allstate

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09827632.

1/12/2026

---

Report Generation Delay for CPID 6195 Superior Vision Services

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 31, 2025.

Payer impacted: 

• CPID 6195 Superior Vision Services

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 09827585.

1/12/2026

---

835 Content Issue for UnitedHealthcare payer ID 87726

Optum is aware of an issue whereby some 835s were generated with the tax ID only and without the NPI segment in the PE loop. A ticket has been opened with the payer for further research.

Affected Payer ID:

• 87726 UnitedHealthcare

Action Required: No submitter action is currently required. An additional notice will be sent once a root cause has been identified.

Please direct any questions to the Support Team at 1-866-OptumGo and reference incident #INC-000003899. Please do not reply to this email directly.

1/12/2026

---

Delay in Electronic Remittance Advice (ERA) for Payer ID 87726

Some 835s for UnitedHealthcare payer ID 87726 are delayed at the payer for payment date Jan. 6, 2026. A ticket has been opened with the payer for further research.

Affected Payer ID:

• 87726 UnitedHealthcare

Action Required: Please be aware of a delay in the delivery of ERA for check dates above. No action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners. If the provider receives EFTs, copies of the 835s can be downloaded online at http://optum.com/optumpay.

Please direct any questions to the Support Team at 1-866-OptumGo and reference incident #INC-000003934.

1/12/2026

---

ERA Content Issue for UnitedHealthcare Payer ID 87726, Multiple CPIDs

Optum is aware of an issue whereby some 835s were generated with the tax ID only and without the NPI segment in the PE loop. A ticket has been opened with the payer for further research.

Affected CPIDs:

• 3429
• 3550
• 6442
• 4523

ACTION REQUIRED: No submitter action is currently required. An additional notice will be sent once a root cause has been identified.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003899.

1/12/2026

---

ERA Delay for UnitedHealthcare Payer ID 87726, Multiple CPIDs

Some 835s for UnitedHealthcare Payer ID 87726 are delayed at the payer for payment date Jan. 6, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs:

• 3429
• 3550
• 6442
• 4523

ACTION REQUIRED: No action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners. If the provider receives EFTs, copies of the 835s can be downloaded online at http://optum.com/optumpay.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003934.

1/12/2026

---

ERA Delay for UnitedHealthcare Payer ID 87726, Multiple CPIDs

Some 835s for UnitedHealthcare Payer ID 87726 are delayed at the payer for payment date Jan. 6, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs:

• 3429
• 3550
• 6442
• 4523

ACTION REQUIRED: No action is currently required. An additional notice will be sent once the 835s are received and posted out to trading partners. If the provider receives EFTs, copies of the 835s can be downloaded online at http://optum.com/optumpay.

If you have any questions, feel free to contact your Customer Support Team and refer to Incident Number INC-000003934.

1/12/2026

---

Resolved: IEDI Portal Claim File Upload Error for Print Image Claims

Resolved: Optum has identified and corrected root cause of this issue.

Action Required: Please reprocess your claim files.

Original notify sent Jan. 5, 2026
Optum is aware of an ongoing issue within our IEDI platform that began Dec. 19, causing claim file errors during the file upload process. This issue specifically impacts print image claim file upload submitters.

Our development team has prioritized this matter and is actively working to resolve it. At this time, we do not have an estimated date for the fix. We understand the inconvenience this may cause and appreciate your patience while we work toward a solution.

Please note: This is only affecting print image claim file upload submitters.

Action Required by customer: None at this time. An updated announcement will be sent when this issue is resolved.

If you have any questions, please contact Customer Support and refer to Global Incident Number INC-000003903.

Action Required: Please reprocess your claim files.

1/12/2026

---

Resolved: Claim Delay, Multiple Payers, Oct. 30, 2025-Nov. 4, 2025

Resolved: Optum has identified and resolved the root cause of this issue. The impacted files have been successfully resubmitted, and no further action is required on your part.

Action Required: None.

Original notify sent Jan. 8, 2026:
Due to an Optum processing issue, there has been a delay in Professional and Institutional claims for the following payers for file dates of Oct. 30, 2025-Nov. 4, 2025.

Payers affected are:

• 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

Optum is working to resolve this issue and resend any affected files. We will notify you as soon as additional information becomes available.

We apologize for any inconvenience.

1/12/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Fox Everett
Institutional CPID: 6576
Professional CPID: 5433
Payer-assigned Payer ID: 64069
Line of Business (LOB) Code: J3V
Payer Enrollment Required: Yes
Payer Location: Mississippi 

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. 

1/12/2026

---

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

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Jan. 1, 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 09826347.

1/9/2026

---

Aetna Better Health of Kansas, Electronic Claims Connection No Longer Available

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

Payer Name: Aetna Better Health of Kansas
Payer ID: 128KS
Reason: Payer no longer contracted. 

Payer will no longer accept paper claims. 

Action Required: None. 

1/9/2026

---

Electronic Routing Change Santa Clara County IPA HMO and Santa Clara County IPA PPO

Optum reactivated and changed electronic claims routing for the following payers, effective Jan. 5, 2026:

Payer Name: Santa Clara County IPA HMO
Payer ID: 10378
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: $0.10 

Payer Name: Santa Clara County IPA PPO
Payer ID: SCACO
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. 

1/9/2026

---

BARInet Electronic Claims Connection No Longer Available

The payer listed below is no longer available at Optum for claims processing, effective Jan. 1, 2026.

Payer Name: BARInet
Payer ID: CB369
Reason: Payer no longer offers an electronic connection.

Action Required: None.

1/9/2026

---

Electronic Routing Change for March Vision Care

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

Payer Name: March Vision Care
Payer ID: 52461
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A
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 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.

1/9/2026

---

New Electronic Remittance Connections Available on Revenue Performance Advisor

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

Payer ID – Payer name
26992 – NYCE
31481 – AmeriHealth Caritas VIP Care - North Carolina HIDE SNP
90689 – AmeriHealth Caritas VIP Care - Michigan HIDE SNP
FSHW1 – Franciscan Senior Health & Wellness
NVCS1 – Caresource Nevada Marketplace
NVCSM – CareSource Nevada Medicaid

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.

1/9/2026

---

Report Generation Delay for CPID 8861 Aetna Better Health of Illinois

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

Payer impacted: 

• CPID 8861 Aetna Better Health 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 09826174.

1/9/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Avmed (Encounters)
Payer ID: 59275
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Florida
Claims Fee: $0.10

Payer Name: Canopy
Payer ID: CNPY1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
Claims Fee: N/A 

Payer Name: Sentara PACE
Payer ID: SENT1
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Virginia
Claims Fee: N/A 

Payer Name: Harbor Health
Payer ID: HARBR
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Texas
Claims Fee: N/A

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.

1/9/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: PACE Southeast Michigan
Payer ID: R3460
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Michigan 

Payer Name: Dignity Health Sacramento Hospital
Payer ID: HOSH1
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. 

1/9/2026

---

Electronic Claims Connection Suspended

The payers listed below have been suspended at Optum for claim processing and removed from the payer list, effective immediately.

Payer Name: Yuzu Health
Payer ID: IHS15
Reason: Payer unavailable electronically.

Payer Name: PHCS Multiplan - Group Resources
Payer ID: 28680
Reason: Payer unavailable electronically.

Payer Name: PHCS Multiplan - Group Resources
Payer ID: 28680
Reason: Payer unavailable electronically.

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

1/9/2026

---

New Electronic Eligibility Connection Available - DCRSS

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective Jan. 5, 2026.

Payer Name: Clearwater
Industry Payer ID: DCRSS
IMN Real Time ID: DCRSS
Exchange Real Time ID: DCRSS
CPID(s): 7960, 2834
Optum IEDi Real Time ID: DCRSS
Payer Enrollment Required: No
Connection Type: X12 5010

Search Options:
Subscriber

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

Dependent

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

Action Required by customer:
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.

1/9/2026

---

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Nov. 18, 2025-Dec. 10, 2025.

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

Original notify sent Dec. 1, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Nov. 18, 2025.

Payer impacted:

• CPID 2824 The Health Plan of West Virginia

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

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

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

1/9/2026

---

Report Generation Delay for CPID 1419 Magellan Healthcare
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 20, 2025 and Dec. 21, 2025.

Payer impacted: 

• CPID 1419 Magellan Healthcare

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 09825730.

1/9/2026

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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: PHCS Multiplan - Group Resources
CPIDs: 2053, 8192
Payer ID: 28680
Reason: Payer unavailable electronically.

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

1/9/2026

---

Electronic Routing Change for CPID 5246 March Vision Care

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

Payer Name: March Vision Care
Professional CPID: 5246
Payer-assigned Payer ID: 52461
Line of Business Code (LOB): J4W
Payer Remittance Enrollment Required: Yes

Enrollment Requirements:

Remittance:

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

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

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

1/9/2026

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Electronic Routing Change for CPID 5246 March Vision Care

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

Payer Name: March Vision Care
Professional CPID: 5246
Payer-assigned Payer ID: 52461
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.

1/9/2026

---

Report Generation Delay for CPID 6671 HealthSun

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

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 09825783.

1/9/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Dignity Health Sacramento Hospital
Institutional CPID: 2084
Professional CPID: 8232
Payer-assigned Payer ID: HOSH1
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. 

1/9/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Dignity Health Sacramento Hospital
Institutional CPID: 2084
Professional CPID: 8232
Payer-assigned Payer ID: HOSH1
Line of Business (LOB) Code: H1T
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. 

1/9/2026

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Report Generation Delay for CPID 2419 CareFirst Blue Cross Blue Shield of Maryland

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Dec. 20, 2025 and Dec. 21, 2025.

Payer impacted: 

• CPID 2419 CareFirst Blue Cross Blue Shield of Maryland

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 09825717.

1/9/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: PACE Southeast Michigan
Institutional CPID: 8980
Professional CPID:7279
Payer-assigned Payer ID: R3460
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. 

1/9/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: PACE Southeast Michigan
Institutional CPID: 8980
Professional CPID: 7279
Payer-assigned Payer ID: R3460
Line of Business (LOB) Code: H6C
Payer Enrollment Required: Yes
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. 

1/9/2026

---

Report Generation Delay for CPID 2425 Carefirst Blue Cross Blue Shield of District of Columbia

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 20, 2025-Dec. 21, 2025.

Payer impacted: 

• CPID 2425 Carefirst Blue Cross Blue Shield of District of Columbia

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 09825707.

1/9/2026

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Claim Delay, Multiple Payers Oct. 30, 2025-Nov. 4, 2025

Due to an Optum processing issue, there has been a delay in Professional and Institutional claims for the following payers for file dates of Oct. 30, 2025-Nov. 4, 2025.

Payers affected are:

• 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

Optum is working to resolve this issue and resend any affected files. We will notify you as soon as additional information becomes available.

We apologize for any inconvenience.

1/8/2026

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Connection no longer available CPID 2053/8192

Professional and Institutional claims for the payer listed below are rejecting for:

• SDS IS NO LONGER PROCESSING CLAIMS FOR THE PAYER WITH ID = 28680

Optum no longer has a connection to this payer at this time.

Payers affected:

• CPID 2053 PHCS MULTIPLAN GROUP RESOURCES
• CPID 8192 PHCS MULTIPLAN GROUP RESOURCES

Action Required: Please be aware we do not have a connection at this time watch for future communications if one becomes available. We are also working to remove this payer ID from our connection list.

1/8/2026

---

Report Generation Delay for CPID 3807 CHAMPVA

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted Dec. 11, 2025 and Dec. 12, 2025.

Payer impacted:

• CPID 3807 CHAMPVA

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09825226.

1/8/2026

---

BARInet Electronic Claims Connection No Longer Available

The payer listed below is no longer available at Optum for claims processing, effective Jan. 1, 2026.

Payer Name: BARInet
Claim CPIDs: 8450, 3060
Payer-assigned Payer ID: CB369
Reason: Payer no longer offers an electronic connection.

Action Required: None.

1/8/2026

---

Report Generation Delay for CPID 7056 Shared Health Mississippi

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Dec. 22, 2025.

Payer impacted: 

• CPID 7056 Shared Health Mississippi

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 09825147.

1/8/2026

---

Report Generation Delay for CPIDs 2936 and 3757 IMAGINE360 ADMINISTRATORS (GPA)

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 2936 IMAGINE360 ADMINISTRATORS (GPA)
• CPID 3757 IMAGINE360 ADMINISTRATORS (GPA)

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 09825107.

1/8/2026

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Aetna Better Health of Kansas, Electronic Claims Connection No Longer Available

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

Payer Name: Aetna Better Health of Kansas
Claim CPIDs: 1084, 8111
Payer-assigned Payer ID: 128KS
Reason: Payer no longer contracted. 

Payer will no longer accept paper claims. 

Action Required: None. 

1/8/2026

---

Report Generation Delay for CPID 4258 VNS Health

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

Payer impacted: 

• CPID 4258 VNS Health

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 09825028.

1/8/2026

---

Report Generation Delay for CPIDs 4093 and 8834 Commonwealth Care Alliance

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 4093 Commonwealth Care Alliance
• CPID 8834 Commonwealth Care Alliance

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 09825004.

1/8/2026

---

Report Generation Delay for CPIDs 3540 and 7426 Regence Blue Shield of Idaho

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 3540 Regence Blue Shield of Idaho
• CPID 7426 Regence Blue Shield of Idaho

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 09824964.

1/8/2026

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Report Generation Delay for CPIDs 2513 and 1167 Blue Cross Medicare Advantage

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 2513 Blue Cross Medicare Advantage
• CPID 1167 Blue Cross Medicare Advantage

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 09824912.

1/8/2026

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Report Generation Delay for CPIDs 5516 and 2404 Regence Blue Cross Blue Shield of Oregon

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 5516 Regence Blue Cross Blue Shield of Oregon
• CPID 2404 Regence Blue Cross Blue Shield of Oregon

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 09824880.

1/8/2026

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Report Generation Delay for CPID 7451 Regence Blue Shield of Washington

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

Payer impacted: 

• CPID 7451 Regence Blue Shield of Washington

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09824854.

1/8/2026

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Report Generation Delay for CPIDs 1529 and 2412 Regence Blue Cross Blue Shield of Utah

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 1529 Regence Blue Cross Blue Shield of Utah
• CPID 2412 Regence Blue Cross Blue Shield of Utah

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 09824829.

1/8/2026

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Report Generation Delay for Regence Blue Cross Blue Shield of Utah Federal Employee Program

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 1530 Regence Blue Cross Blue Shield of Utah Federal Employee Program
• CPID 2788 Regence Blue Cross Blue Shield of Utah Federal Employee 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 09824782.

1/8/2026

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Report Generation Delay for CPIDs 5942 and 4881 Asuris Northwest Regence

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 5942 Asuris Northwest Regence
• CPID 4881 Asuris Northwest Regence

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 09824711.

1/8/2026

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Report Generation Delay for CPIDs 9656 and 7715 Hopkins Health Advantage

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 9656 Hopkins Health Advantage
• CPID 7715 Hopkins Health Advantage

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 09824669.

1/8/2026

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Report Generation Delay for CPID 5502 Texas Medicare

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

Payer impacted:

• CPID 5502 Texas Medicare

The payer intermediary has been unable to generate and deliver the reports for some claims submitted Jan. 6, 2026.

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

If you have any questions, please contact Customer Support and refer to Case Number 09824563.

1/8/2026

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Tricare Real Time Eligibility Error

We want to make you aware of a current issue affecting real-time 270 eligibility transactions submitted through Optum for Tricare East and Tricare 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

Payer Name: Tricare West
Payer ID: 99726
Transaction: Real Time Eligibility

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

What You Should Know:

• The issue is isolated to real-time eligibility 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 responses and are 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-000003438.

Thank you for your continued partnership and patience.

1/8/2026

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Update: Report Generation Delay for CPID 4270 Resurrection Physicians Provider Group

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Oct. 25, 2025-Dec. 31, 2025.

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

Original notice sent Oct. 27, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Oct. 15, 2025.

Payer impacted: 

• CPID 4270 Resurrection Physicians Provider Group

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 09747501.

1/8/2026

---

Update: Report Generation Delay for CPIDs 6619 and 6899 Ravenswood Physician Associates

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Nov. 3, 2025-Dec. 23, 2025.

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

Original notice sent Oct. 27, 2025:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Oct. 15, 2025.

Payer impacted: 

• CPID 6619 Ravenswood Physician Associates
• CPID 6899 Ravenswood Physician Associates

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 09747436.

1/8/2026

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Electronic Routing Change for AvMed (59274)

Effective January 7, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: AvMed
Payer ID: 59274
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A
Par Status: T (TRANS), effective 1/9/26

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. 

1/7/2026

---

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: Teamsters Medicare Trust for Retired Employees (TMT)
Payer ID: 43619

Payer Name: AmericasHealth Plan
Payer ID: AHP01

Payer Name: Sierra Medical Group
Payer ID: 30891

Reason: Payer(s) unavailable electronically.

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

1/7/2026

---

Update: Payer Change for CPID 4492 Massachusetts Medicaid Format 5

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

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

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

Claims and remittance must begin using the following on 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 sending electronic claims through Optum for CPID 4492 Massachusetts Medicaid Format 5 do not need to complete a new enrollment form.
  • New providers must complete a new enrollment form for CPID 4491 MassHealth.

Remittance:

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

Action Required:

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

1/7/2026

---

New Electronic Claims Connections Available - Harbor Health

Optum has new electronic claims connections available:

Payer Name: Harbor Health
Institutional CPID: 9058
Professional CPID: 3798
Payer-assigned Payer ID: HARBR
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Texas
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 

1/7/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Sierra Medical Group
CPIDs: 2041, 7138
Payer ID: 30891
Reason: Payer unavailable electronically.

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

1/7/2026

---

Electronic Claims Connection Suspended

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

Payer Name: AmericasHealth Plan
CPID(s): 7001, 9281    
Payer ID: AHP01
Reason: Payer unavailable electronically.

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

1/7/2026

---

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: Teamsters Medicare Trust for Retired Employees (TMT)
CPIDs: 1271, 6508
Payer ID: 43619
Reason: Payer unavailable electronically.

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

1/7/2026

---

Electronic Routing Change for AvMed (59274)

Effective January 7, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: AvMed
Payer ID: 59274
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A
Par Status: T (TRANS), effective 1/9/26

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. 

1/7/2026

---

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: Teamsters Medicare Trust for Retired Employees (TMT)
Payer ID: 43619

Payer Name: AmericasHealth Plan
Payer ID: AHP01

Payer Name: Sierra Medical Group
Payer ID: 30891

Reason: Payer(s) unavailable electronically.

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

1/7/2026

---

Update: Payer Change for CPID 4492 Massachusetts Medicaid Format 5

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

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

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

Claims and remittance must begin using the following on 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 sending electronic claims through Optum for CPID 4492 Massachusetts Medicaid Format 5 do not need to complete a new enrollment form.
  • New providers must complete a new enrollment form for CPID 4491 MassHealth.

Remittance:

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

Action Required:

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

1/7/2026

---

New Electronic Claims Connections Available - Harbor Health

Optum has new electronic claims connections available:

Payer Name: Harbor Health
Institutional CPID: 9058
Professional CPID: 3798
Payer-assigned Payer ID: HARBR
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Texas
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 

1/7/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Sierra Medical Group
CPIDs: 2041, 7138
Payer ID: 30891
Reason: Payer unavailable electronically.

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

1/7/2026

---

Electronic Claims Connection Suspended

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

Payer Name: AmericasHealth Plan
CPID(s): 7001, 9281    
Payer ID: AHP01
Reason: Payer unavailable electronically.

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

1/7/2026

---

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: Teamsters Medicare Trust for Retired Employees (TMT)
CPIDs: 1271, 6508
Payer ID: 43619
Reason: Payer unavailable electronically.

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

1/7/2026

---

Electronic Routing Change for CPIDs 3802 and 1573 AvMed

Effective January 7, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: AvMed
Professional CPID: 3802
Institutional CPID: 1573
Payer-assigned Payer ID: 59274
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. 

1/7/2026

---

Electronic Routing Change for CPIDs 3802 and 1573 AvMed

Effective January 7, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: AvMed
Professional CPID: 3802
Institutional CPID: 1573
Payer-assigned Payer ID: 59274
Line of Business Code (LOB): U64
Payer Remittance Enrollment Required: Yes 

Enrollment Requirements: 

Remittance:

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

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

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

1/7/2026

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Report Generation Delay for CPID 4951 Florida Medicare

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Dec. 26, 2025-Dec. 29, 2025.

Payer impacted: 

• CPID 4951 Florida Medicare

The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 26, 2025-Dec. 29, 2025.

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

If you have any questions, please contact Customer Support and refer to Case Number 09822887.

1/7/2026

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Electronic Claims Connection Suspended - Care N Care Insurance Company

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

Payer Name: Care N Care Insurance Company
Payer ID: 66010
Reason: Payer unavailable electronically.

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

1/7/2026

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Orange County Medical Clinic Electronic Claims Connection No Longer Available

The payer listed below is no longer available at Optum for claims processing, effective Jan. 5, 2026.

Payer Name: Orange County Medical Clinic
Payer ID: DB497
Reason: Payer no longer offers an electronic connection.

Optum received information from the payer that claims can be sent to Lucent Government Operations, Payer ID 17380.

Providers should verify the information on their Member ID card before sending claims to Lucent Government Operations, Payer ID 17380. 

1/7/2026

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New Payer Name

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

Previous Payer Name: Senior Whole Health of Massachusetts
New Payer Name: Senior Whole Health, LLC DBA Molina Healthcare.
Payer ID: SWHMA

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

1/7/2026

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Report Generation Delay for CPID 1592 and 5432 Johns Hopkins Healthcare/Priority Partners

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

• CPID 1592 Johns Hopkins Healthcare / Priority Partners
• CPID 5432 Johns Hopkins Healthcare / Priority Partners

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 09822160.

1/6/2026

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Report Generation Delay for CPIDs 8048 and 9766 Gold Kidney Health Plan

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 19, 2025.

Payer impacted: 

• CPID 8048 Gold Kidney Health Plan
• CPID 9766 Gold Kidney 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 09822035.

1/6/2026

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Report Generation Delay for CPIDs 3506 and 4423 Medical Mutual of Ohio

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 20, 2025.

Payer impacted: 

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

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 09822115.

1/6/2026

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Report Generation Delay for CPID 1510 Wellmark Blue Cross Blue Shield of Iowa

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Dec. 19, 2025.

Payer impacted: 

• CPID 1510 Wellmark Blue Cross Blue Shield of Iowa

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 09821903.

1/6/2026

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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 Dec. 17, 2025.

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 09821794.

1/6/2026

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Report Generation Delay for CPID 2842 Alexian PACE

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 17, 2025 and Dec. 20, 2025.

Payer impacted: 

• CPID 2842 Alexian PACE

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 09821734.

1/6/2026

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Report Generation Delay for CPID 1258 Global Healthcare Alliance

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 17, 2025.

Payer impacted: 

• CPID 1258 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 09821590.

1/6/2026

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New Payer Name

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

Previous Payer Name: Senior Whole Health of Massachusetts
New Payer Name: Senior Whole Health, LLC DBA Molina Healthcare.
Professional CPID: 9246
Professional Edit Master: PE_C051
Institutional CPID: 6085
Institutional Edit Master: HE9C051
Remit Line of Business (LOB) Code: U21 

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: 

• You may choose to update the Payer Alias in your system to accommodate the new payer name. 

1/6/2026

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Report Generation Delay for CPIDs 8035 and 2859 Ascension Living Hope PACE

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 17, 2025 and Dec. 20, 2025.

Payer impacted: 

• CPID 8035 Ascension Living Hope PACE
• CPID 2859 Ascension Living Hope PACE

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 09821541.

1/6/2026

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New Payer Name

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

Previous Payer Name: Senior Whole Health of Massachusetts
New Payer Name: Senior Whole Health, LLC DBA Molina Healthcare.
Professional CPID: 9246
Institutional CPID: 6085 

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

1/6/2026

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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 Dec. 16, 2025.

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 09821497.

1/6/2026

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Electronic Claims Connection Suspended

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

Payer Name: Care N Care Insurance Company
CPIDs: 2013, 8146
Payer ID: 66010
Reason: Payer unavailable electronically.

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

1/6/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Avmed (Encounters)
Institutional CPID: 9053
Institutional Edit Master: HE9B801
Payer-assigned Payer ID: 59275
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Florida

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.

1/6/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Avmed (Encounters)
Institutional CPID: 9053
Payer-assigned Payer ID: 59275
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Florida
Claims Fee: $0.10

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.

1/6/2026

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New Payer Name

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

Previous Payer Name: Aetna Better Health of Illinois - MMAI
New Payer Name: Aetna Medicare FIDE
Payer ID: 26337

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

1/5/2026

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Meridian PACE Solutions Electronic Remittance Connection No Longer Available

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

Payer Name: Meridian PACE Solutions
Payer ID: MPSAB
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

1/5/2026

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Electronic Claims Connection Suspended - EyeMed Vision Care (31165)

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

Payer Name: EyeMed Vision Care
Payer ID: 31165
Reason: Payer unavailable electronically.

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

1/5/2026

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South Central Preferred Electronic Claims and Remittance Connections No Longer Available

Effective Dec. 25, 2025, the payer listed below is no longer available at Optum for claims and remittance processing. 

Payer Name: South Central Preferred
Payer ID: 23266
Reason: Payer no longer in business. 

Action Required: None. 

1/5/2026

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New Payer Name

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

Previous Payer Name: Aetna Better Health of Illinois - MMAI
New Payer Name: Aetna Medicare FIDE
Professional CPID: 6140
Professional Edit Master: PE_T007
Institutional CPID: 4623
Institutional Edit Master: HE9T007
Remit Line of Business (LOB) Code: J2Y 

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: 

• You may choose to update the Payer Alias in your system to accommodate the new payer name. 

1/5/2026

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New Payer Name

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

Previous Payer Name: Aetna Better Health of Illinois - MMAI
New Payer Name: Aetna Medicare FIDE
Professional CPID: 4623
Institutional CPID: 6140 

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

1/5/2026

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New Payer Name

Effective immediately, please be aware of the following payer name changes for both claims and ERAs: 

Previous Payer Name: Aetna Better Health of Michigan
New Payer Name: Aetna Medicare HIDE
Payer ID: 128MI 

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

1/5/2026

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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.

1/5/2026

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Report Generation Delay for CPID 2872 and 5979 TRICARE East Region

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Dec. 15, 2026 and Dec. 16, 2025.

Payer(s) impacted: 

• CPID 2872 TRICARE East Region
• CPID 5979 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 09820441.

1/6/2026

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Report Generation Delay for CPID 2708 StandardHealth with Health Choice

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Dec. 22, 2025.

Payer impacted: 

• CPID 2708 StandardHealth with Health Choice (HCS)

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09820384.

1/6/2026

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Orange County Medical Clinic Electronic Claims Connection No Longer Available

The payer listed below will no longer be available at Optum for claims processing, effective Jan. 5, 2026.

Payer Name: Orange County Medical Clinic
Claim CPIDs: 9486, 7083
Payer-assigned Payer ID: DB497
Reason: Payer no longer offers an electronic connection.

Optum received information from the payer that claims can be sent to Lucent Government Operations, Payer ID 17380. CPIDs 7021, 9405.

Providers should verify the information on their Member ID card before sending claims to Lucent Government Operations, Payer ID 17380.

Action Required: None.

1/6/2026

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New Payer Name

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

Previous Payer Name: Aetna Better Health of Michigan
New Payer Name: Aetna Medicare HIDE
Professional CPID: 7220
Professional Edit Master: PE_T007
Institutional CPID: 8637
Institutional Edit Master: HE9T007
Remit Line of Business (LOB) Code: J2V 

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: 

• You may choose to update the Payer Alias in your system to accommodate the new payer name. 

1/5/2026

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New Payer Name

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

Previous Payer Name: Aetna Better Health of Michigan
New Payer Name: Aetna Medicare HIDE
Professional CPID: 7220
Institutional CPID: 8637 

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

1/5/2026

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Update: Electronic Claims Connection Suspended - PACE of Southwest Michigan (45114)

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

Original notice sent Dec. 22, 2025:
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list. 

Payer Name: PACE of Southwest Michigan
Payer ID: 45114
Reason: Payer unavailable electronically. 

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

1/5/2026

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Meridian PACE Solutions Electronic Remittance Connection No Longer Available

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

Payer Name: Meridian PACE Solutions
Remittance CPIDs: 8077, 2867
Remittance LOB: N51
Payer-assigned Payer ID: MPSAB
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

1/5/2026

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Meridian PACE Solutions Electronic Remittance Connection No Longer Available

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

Payer Name: Meridian PACE Solutions
Remittance CPIDs: 8077, 2867
Payer-assigned Payer ID: MPSAB
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

1/5/2026

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Update: Electronic Claims Connection Suspended
Update: This payer has been reactivated. Providers may submit claims to this payer.  

Original notice sent Dec. 22, 2025:
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list. 

Payer Name: PACE of Southwest Michigan
CPID(s): 1150, 1586
Payer ID: 45114
Reason: Payer unavailable electronically. 

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

1/2/2026

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Electronic Claims Connection Suspended

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

Payer Name: EyeMed Vision Care
CPID: 5817
Payer ID: 31165
Reason: Payer unavailable electronically.

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

1/2/2026

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Update: Error Message for Payer ID 11328, HealthCare Partners IPA
Update: The trading partner confirmed this error was caused by an issue with their membership files which has now been corrected. Please resubmit any affected claims.

Original notify sent on December 24, 2025
Due to a potential trading partner processing issue, Professional and Institutional claims for the payer listed below may have received the following error message:

• MEMBER ID NOT FOUND

The trading partner is diligently reviewing this issue for a resolution.

Payer affected:

• Payer ID 11328, HealthCare Partners IPA

Action Required: None at this time. Please be aware of this issue. Further notification will be sent as it is received from the trading partner.

1/2/2026

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Report Generation Delay for CPID 1440 Texas Medicare

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

Payer impacted:

• CPID 1440 Texas Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09818800.

1/2/2026

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Report Generation Delay for CPID 5503 New Jersey Medicare

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since Dec. 23, 2025.

Payer impacted:

• CPID 5503 New Jersey Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09818793.

1/2/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: Canopy
Institutional CPID: 9056
Professional CPID: 3790
Payer-assigned Payer ID: CNPY1
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. 

1/2/2026

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Report Generation Delay for CPID 2208 Texas Medicare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Dec. 23, 2025.

Payer impacted:

• CPID 2208 Texas Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09818797.

1/2/2026

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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 Nov. 10, 2025-Nov. 26, 2025.

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

Original notice sent Nov. 24, 2025:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Nov. 10, 2025.

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 09788010.

1/2/2026

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Update: Report Generation Delay for CPIDs 2593 and 5428 QualChoice of Arkansas

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Nov. 10, 2025-Dec. 24, 2025.

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

Original notice sent Nov. 24, 2025:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Nov. 10, 2025.

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 09787921.

1/2/2026

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Report Generation Delay for CPID 2795 Cigna HealthSpring Tennessee/Alabama

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

Payer impacted:

• CPID 2795 Cigna HealthSpring Tennessee/Alabama

The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 20, 2025.

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

If you have any questions, please contact Customer Support and refer to Case Number 09818742.

1/2/2026

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Report Generation Delay for CPID 1748 MVP Health Plan

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

Payer impacted: 

• CPID 1748 MVP Health Plan

The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 20, 2025.

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

If you have any questions, please contact Customer Support and refer to Case Number 09818749.

1/2/2026

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South Central Preferred Electronic Claims and Remittance Connections No Longer Available

Effective Dec. 25, 2025, the payer listed below is no longer available at Optum for claims and remittance processing. 

Payer Name: South Central Preferred
Claim and Remittance CPIDs: 3888, 2926
Payer-assigned Payer ID: 23266
Reason: Payer no longer in business. 

Action Required: None. 

1/2/2026

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South Central Preferred Electronic Claims and Remittance Connections No Longer Available

Effective Dec. 25, 2025, the payer listed below is no longer available at Optum for claims and remittance processing. 

Payer Name: South Central Preferred
Claim and Remittance CPIDs: 3888, 2926
Remittance LOB: H7B
Payer-assigned Payer ID: 23626
Reason: Payer no longer in business.

Action Required: None. 

1/2/2026

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New Electronic Remittance Connections Available - Associated Administrators, LLC
Optum has new electronic remittance connections available:

Payer Name: Associated Administrators, LLC.
Payer ID: 13788
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.

1/2/2026

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New Electronic Claims Connections Available

Effective January 1, 2026, Optum will have new electronic claims connections available:

Payer Name: AmeriHealth Caritas Next, A Product of AmeriHealth Caritas Louisiana

Payer ID: 75066

Payer Claim Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: Louisiana

Claims Fee: N/A

 

Payer Name: AmeriHealth Caritas VIP Care - Louisiana HIDE SNP

Payer ID: 73575

Payer Claim Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: Louisiana

Claims Fee: N/A

Note:  Electronic Remittance will be made available for these payers at a future date. Please monitor upcoming communications for further details.

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.

1/2/2026

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Multicare Connected Care Electronic Remittance Connection No Longer Available

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

Payer Name: Multicare Connected Care

Payer ID: RP036

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

Action Required: None.

1/2/2026

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Electronic Claims Connection Suspended - Emanate Health IPA 

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

Payer Name:  Emanate Health IPA

Payer ID:  MPM62

Reason: Payer unavailable electronically. 

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

1/2/2026

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Amerigroup Payers Consolidating

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

Payer Name: Americaid Community Care (Houston)

Payer ID: 27515

Claim Type: Professional and Institutional

 

Payer Name: Americaid Community Care (New Jersey)

Payer ID: 27516

Claim Type: Professional and Institutional

 

Payer Name: Americaid Community Care (Maryland)

Payer ID: 27517

Claim Type: Professional and Institutional

 

Payer Name: Amerigroup

Payer ID: 27519

Claim Type: Professional

 

Payer Name: Amerigroup of Illinois

Payer ID: 28804

Claim Type: Professional and Institutional

 

Payer Name: Amerigroup / Americaid - Houston

Payer ID: 28805

Claim Type: Professional

 

Payer Name: Amerigroup New Jersey

Payer ID: 28806

Claim Type: Professional

 

Payer Name: Amerigroup of Maryland and District of Columbia

Payer ID: 28807

Claim Type: Professional

 

Payer Name: Amerigroup of Florida

Payer ID: 28809

Claim Type: Professional

Payer IDs 27515, 27516, 27517, 27519, 28804, 28805, 28806, 28807, 28809 will be terminated effective January 16, 2026.

Providers must begin using the following ID for electronic claims:

Payer ID: 26375

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.

1/2/2026

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Payer Unavailable Jan. 1 - Physician of Southwest Washington Payer ID 91171

Effective Jan. 1, 2026, Physician of Southwest Washington Payer id 91171 is not available at Optum for claims processing. 

Payer Name: Physician of Southwest Washington

Inst CPID: 8623

Prof CPID: 1136

Payer-assigned Payer ID: 91171 

Starting Jan. 6, claims will reject with the error "This Payer is not accepting claims with Statement From Date on or after 01/01/2026."

Reason: Runout for payer id 91171 ended Dec. 31, 2025. 

Action to be taken: If necessary, submit claims directly to health plan. 

1/2/2026

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PAR Status and Fee Change for Claims Payers Effective Feb. 1, 2026

Effective 2/01/2026, the PAR Status is changing for the following claim payer(s) and any Non Par fee changes will be noted if applicable for the payer:

Payer Name: Anchor Benefit Consulting

Industry ID: 53085

Exchange CPIDs: 8948,4269

New Par Status: Non Par

 

Payer Name: Butler Benefit

Industry ID: 42150

Exchange CPIDs: 8946,3250

New Par Status: Non Par

 

Payer Name: Carelon Behavioral Health

Industry ID: CHCBH

Exchange CPIDs: 5909, 4743

New Par Status: Non Par

 

Payer Name: Coastal Communities Physician Network

Industry ID: 51579

Exchange CPIDs: 6726

New Par Status: Non Par

New Fee: $0.10

 

Payer Name: Consolidated Associates Railroad

Industry ID: 75284

Exchange CPIDs: 7967,2233

New Par Status: Non Par

 

Payer Name: Employee Benefit Administration & Management (EBA&M)

Industry ID: 95288

Exchange CPIDs: 5205

New Par Status: Non Par

 

Payer Name: Farm Family

Industry ID: 14140

Exchange CPIDs: 8945,5876

New Par Status: Non Par

 

Payer Name: Fringe Benefit Coordinators (Medical and Accident)

Industry ID: 59204

Exchange CPIDs: 8944,5247

New Par Status: Non Par

 

Payer Name: GlobalCare

Industry ID: 07689

Exchange CPIDs: 4006,8728

New Par Status: Non Par

 

Payer Name: Health Services Preferred (HSP) Emerald Health

Industry ID: 34167

Exchange CPIDs: 6664,6788

New Par Status: Non Par

 

Payer Name: Healthcare Solutions Group

Industry ID: 73147

Exchange CPIDs: 3965,4267

New Par Status: Non Par

 

Payer Name: HealthSmart ACCEL Network

Industry ID: 75237

Exchange CPIDs: 9584,5280

New Par Status: Non Par

 

Payer Name: HealthSmart Preferred Care

Industry ID: 75250

Exchange CPIDs: 1517,2724

New Par Status: Non Par

 

Payer Name: Innovante Benefit Administrators

Industry ID: 31172

Exchange CPIDs: 5685,6134

New Par Status: Non Par

 

Payer Name: MedCom

Industry ID: 59231

Exchange CPIDs: 4939,3271

New Par Status: Non Par

 

Payer Name: NAMCI/Global Care

Industry ID: L0110

Exchange CPIDs: 2076,8221

New Par Status: Non Par

 

Payer Name: Partners Health Plan

Industry ID: 14966

Exchange CPIDs: 9521,1111

New Par Status: Non Par

 

Payer Name: UMWA Health and Retirement Funds

Industry ID: 52180

Exchange CPIDs: 2991,1758

New Par Status: Non Par

 

Payer Name: US Benefits

Industry ID: 93092

Exchange CPIDs: 4970,2241

New Par Status: Non Par

 

Payer Name: Veteran Affairs Community Care Network Region 1, 2, 3

Industry ID: VACCN

Exchange CPIDs: 3009,8257

New Par Status: Non Par

Payer Name: William C Earhart

Industry ID: 93050

Exchange CPIDs: 3919,3465

New Par Status: Non Par

Action Required: Please be aware of the upcoming PAR status changes for 2/1/26, including the fee change for the following payer:

Coastal Communities Physician Network

Industry ID: 51579

Exchange CPIDs: 6726

New Par Status: Non Par

New Fee: $0.10

1/2/2026

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PAR Status Change for Claims Payers Effective Jan. 1, 2026

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

Payer Name: East Boston Neighborhood Pace

Industry ID: 25849

Exchange CPIDs: 5507,1260

New Par Status: Transitional

Payer Name: GlobalHealth OKC

Industry ID: GHOKC

Exchange CPIDs: 5814

New Par Status: Gateway

Payer Name: Group Administrators LTD

Industry ID: 36338

Exchange CPIDs: 1770

New Par Status: Gateway

Payer Name: Health Plan of San Mateo

Industry ID: HPSM1

Exchange CPIDs: 5678,4292

New Par Status: Par

Payer Name: Hollywood Presby Medical Center

Industry ID: MPM29

Exchange CPIDs: 2032,8169

New Par Status: Par

Payer Name: InnovAge

Industry ID: 31182

Exchange CPIDs: 4770

New Par Status: Par

Payer Name: Integra Group - CHA

Industry ID: 31129

Exchange CPIDs: 7917,3860

New Par Status: Par

Payer Name: Integra Group - Home

Industry ID: 31128

Exchange CPIDs: 8543,2790

New Par Status: Par

Payer Name: Kopp Billing Agency

Industry ID: RP091

Exchange CPIDs: 8044,9763

New Par Status: Gateway

Payer Name: Loma Linda University Adventist

Industry ID: 37267

Exchange CPIDs: 3971,5124

New Par Status: Gateway

Payer Name: Mashantucket Pequot Tribal Nation

Industry ID: 37121

Exchange CPIDs: 8976,2818

New Par Status: Gateway

Payer Name: McLaren Advantage SNP

Industry ID: 3833R

Exchange CPIDs: 6637

New Par Status: Gateway

Payer Name: McLaren Health Plan Medicaid

Industry ID: 3833C

Exchange CPIDs: 6631,6732

New Par Status: Gateway

Payer Name: MDwise Health Indiana Plan

Industry ID: 3135M

Exchange CPIDs: 1086,8113

New Par Status: Gateway

Payer Name: MDwise Hoosier Healthwise

Industry ID: 3519M

Exchange CPIDs: 1085,8112

New Par Status: Gateway

Payer Name: MedCost Virginia

Industry ID: 54138

Exchange CPIDs: 7939,6186

New Par Status: Par

Payer Name: National Telecom Association

Industry ID: 52120

Exchange CPIDs: 2733

New Par Status: Par

Payer Name: New York State Dept of Health Uncompensated Care Program

Industry ID: 14142

Exchange CPIDs: 5863

New Par Status: Gateway

Payer Name: Olympus Managed Health Care

Industry ID: 65074

Exchange CPIDs: 6988,6812

New Par Status: Gateway

Payer Name: Priority Health of Michigan

Industry ID: PRIORITY

Exchange CPIDs: 7459

New Par Status: Transitional

Payer Name: Providence Health Plan

Industry ID: SX133

Exchange CPIDs: 1540,4498

New Par Status: Par

Payer Name: Select Benefit Administrators Iowa

Industry ID: 42137

Exchange CPIDs: 2536,1890

New Par Status: Gateway

Payer Name: TakeCare Insurance Company

Industry ID: 98022

Exchange CPIDs: 4085,8827

New Par Status: Par

Payer Name: Tall Tree Administrators

Industry ID: 88067

Exchange CPIDs: 4465

New Par Status: Par

Payer Name: Unified Health Services

Industry ID: 62170

Exchange CPIDs: 5420

New Par Status: Par

Payer Name: United Health Care Ohio Medicaid Vision

Industry ID: 8357V

Exchange CPIDs: 7093,9706

New Par Status: Gateway

Payer Name: Upper Peninsula Health Plan

Industry ID: 38337

Exchange CPIDs: 2532,3741

New Par Status: Gateway

Payer Name: Valor Health Plan

Industry ID: 43259

Exchange CPIDs: 8132

New Par Status: Par

Payer Name: Western Growers/Pinnacle

Industry ID: 24735

Exchange CPIDs: 1735

New Par Status: Par

Payer Name: Western Health Advantage

Industry ID: 68039

Exchange CPIDs: 5634

New Par Status: Par

Action Required: Please be aware of the upcoming changes.

1/2/2026