CHC Payer Updates (July 2025)

July 2025

July Payer Processing Issues

Summary

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

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

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

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PAR Status Change for Multiple Payers

Effective immediately the PAR Status is changing for the following payers:

Payer Name: Medigold PPO
Product: Claims and Remittance
Industry ID: 13123
Exchange CPID(s): 5930, 7118
Current PAR Status: Transitional
New PAR Status: Non-Par

Payer Name: Medigold HMO
Product: Remittance
Industry ID: 95655
Exchange CPID(s): 1584, 4714
Current PAR Status: Par
New PAR Status: Non-Par

Payer Name: Cornerstone Hospice and Palliative Care, Inc.
Product: Claims
Industry ID: RP111
Exchange CPID(s): 3623, 1829
Current PAR Status: Gateway
New PAR Status: Transitional

Payer Name: Liberty Advantage Health Plan
Product: Claims
Industry ID: LIB01
Exchange CPID(s): 4056, 8796
Current PAR Status: Gateway
New PAR Status: Transitional

Payer Name: PodAmerica
Product: Claims
Industry ID: RP106
Exchange CPID(s): 1901, 1737
Current PAR Status: Gateway
New PAR Status: Transitional

Payer Name: Ultimate Health Plans
Product: Claims
Industry ID: 77022
Exchange CPID(s): 7646, 6868
Current PAR Status: Gateway
New PAR Status: Transitional

Payer Name: SECUR Health Plan
Product: Claims
Industry ID: SECUR
Exchange CPID(s): 8960, 3426
Current PAR Status: Non-Par
New PAR Status: Transitional

Action Required: Please be aware of the upcoming changes.

7/31/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on July 30, 2025 were not processed by the payer due to a 999 Batch Rejection. 

  • CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer on July 31, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09623770.

7/31/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on July 30, 2025 were not processed by the payer due to a 999 Batch Rejection. 

  • CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer on July 31, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09623342.

7/31/2025

New Electronic Medical Attachment Connections Available (Medicare)

Optum is excited to announce we are now able to accept attachments for Medicare/MACs starting with the following payers:

Payer Name: Florida Medicare
Professional CPID: 1448
Professional Payer-assigned Payer ID: 09102
Institutional CPID: 3518
Institutional Payer-assigned Payer ID: 09101
Accepted Attachment Type: Solicited
Payer Enrollment Required: No
Payer Location: Florida

Payer Name: Southern California Medicare
Professional CPID: 1444
Payer-assigned Payer ID: 01182
Accepted Attachment Type: Solicited
Payer Enrollment Required: No
Payer Location: California


Payer Name: Northern California Medicare
Professional CPID: 1436
Payer-assigned Payer ID: 01112
Accepted Attachment Type: Solicited
Payer Enrollment Required: No
Payer Location: California

Payer Name: Texas Medicare
Professional CPID: 1440
Professional Payer-assigned Payer ID: 04412
Institutional CPID: 5502
Institutional Payer-assigned Payer ID: 04411
Accepted Attachment Type: Solicited
Payer Enrollment Required: No
Payer Location: Texas

Payer Name: California Medicare
Institutional CPID: 3508
Payer-assigned Payer ID: 01111
Accepted Attachment Type: Solicited
Payer Enrollment Required: No
Payer Location: California

Payer Name: Kansas Medicare
Professional CPID: 2463
Professional Payer-assigned Payer ID: 05202
Institutional CPID: 5518
Institutional Payer-assigned Payer ID: 05201
Accepted Attachment Type: Solicited
Payer Enrollment Required: No
Payer Location: Kansas

Action Required:

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

Note: Medicare payers only accept solicited attachments for now and only accept PDF documents. 

API submitters please provide the following required fields:  

  • serviceLine.payerClaimControlNumber is required and should contain CMS Claim Number 
  • serviceLine.procedureOrRevenueDetails.procedureOrRevenueCode = "ZZ" 
  • serviceLine.procedureOrRevenueDetails.procedureOrRevenueValue = "1000"  
  • serviceLine.procedureOrRevenueDetails.revenueCode is required (esMD Case Number) 
  • serviceLine.procedureOrRevenueDetails.revenueCode length should not be longer than 32 characters (esMD Case Number)

SFTP submitters please provide the following required fields:  

  • 2000A TRN02 is required and should contain CMS Claim Number  
  • 2000A REF with REF01=ZZ is required 
  • 2000A REF*ZZ REF02 should be 1000 
  • 2000A REF*ZZ REF4-01 should be YJ 
  • 2000A REF*ZZ REF4-02 is required (esMD Case Number) 
  • 2000A REF*ZZ REF4-02 length should not be longer than 32 characters (esMD Case Number)

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

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

7/31/2025

Report Generation Delay for CPIDs 8923 and 4289 El Paso First Health Plans CHIP

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

Payer impacted: 

  • CPID 8923 El Paso First Health Plans CHIP
  • CPID 4289 El Paso First Health Plans CHIP

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 09622846.

7/31/2025

Report Generation Delay for CPIDs 3678 and 4279 El Paso Health-STAR

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

Payer impacted: 

  • CPID 3678 El Paso Health-STAR 
  • CPID 4279 El Paso Health-STAR

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 09623012.

7/31/2025

Report Generation Delay for CPIDs 6672 and 6733 Wellmark Blue Cross Blue Shield of Iowa Crossover

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

Payer impacted: 

  • CPID 6672 Wellmark Blue Cross Blue Shield of Iowa Crossover
  • CPID 6733 Wellmark Blue Cross Blue Shield of Iowa Crossover

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 09622776.

7/31/2025

Report Generation Delay for CPID 5838 Preferred Administrators

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

Payer impacted: 

  • CPID 5838 Preferred 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 09623103.

7/31/2025

Report Generation Delay for CPID 1733 Doctors Professional Services Consultants (DPSC)

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

Payer impacted: 

  • CPID 1733 Doctors Professional Services Consultants (DPSC)

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 09622751.

7/31/2025

Report Generation Delay for CPIDs 9406 and 7022 Ochsner Health Plan

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

Payer impacted: 

  • CPID 9406 Ochsner Health Plan
  • CPID 7022 Ochsner Health Plan

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 09622684.

7/31/2025

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: EyeQuest
CPIDs: 6776
Payer ID: 63740
Reason: Payer unavailable electronically

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

7/30/2025

Electronic Routing Change for CPIDs 1603 and 2831 Correctional Medical Services

Effective August 1, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Old Payer Name: Correctional Medical Services
New Payer Name: YesCare
Professional CPID: 2831
Institutional CPID: 1603
Payer-assigned Payer ID: 43160
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 are receiving.

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.

7/30/2025

Electronic Routing Change for CPIDs 1603 and 2831 Correctional Medical Services

Effective August 1, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Old Payer Name: Correctional Medical Services
New Payer Name: YesCare
Professional CPID: 2831
Current Edit Master: PE_T007
New Edit Master: PE_B800
Institutional CPID: 1603
Current Edit Master: HE9T007
New Edit Master: HE9B801
Payer-assigned Payer ID: 43160
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

7/30/2025

Report Generation Delay for CPID 8677 Quartz ASO

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

Payer impacted: 

  • CPID 8677 Quartz ASO

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 09620953.

7/30/2025

Report Generation Delay for CPID 5879 Erisa Administrative Services

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

Payer impacted: 

  • CPID 5879 Erisa Administrative Services

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09620843.

7/30/2025

Electronic Routing Change for CPIDs 9477 and 7076 WelbeHealth

Effective July 30, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: WelbeHealth
Professional CPID: 9477
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 7076
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: WBHCA
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 are receiving.  

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. 

7/30/2025

Report Generation Delay for CPID 2830 CarePlus Health Plans

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

Payer impacted: 

  • CPID 2830 CarePlus 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 09620722.

7/30/2025

Electronic Routing Change for CPIDs 7717 and 9658 QualCare IPA

Effective July 30, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: QualCare IPA
Professional CPID: 7717
Institutional CPID: 9658
Payer-assigned Payer ID: QCP01
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/30/2025

Electronic Routing Change for CPIDs 9477 and 7076 WelbeHealth

Effective July 30, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: WelbeHealth
Professional CPID: 9477
Institutional CPID: 7076
Payer-assigned Payer ID: WBHCA
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/30/2025

Electronic Routing Change for CPIDs 7717 and 9658 QualCare IPA

Effective July 30, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: QualCare IPA
Professional CPID: 7717
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 9658
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: QCP01
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 are receiving.  

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. 

7/30/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Business Administrators & Consultants
Institutional CPID: 9019
Professional CPID: 3496
Payer-assigned Payer ID: 49984
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Ohio
Claims Fee: N/A

Action Required: 

  • Add the payer 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. 

7/30/2025

Electronic Routing Change for CPIDs 5663, 6862 Peak Pace Solutions

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

Payer Name: Peak Pace Solutions
Professional CPID: 6862
Institutional CPID: 5663
Payer-assigned Payer ID: 27034
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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.

7/30/2025

Electronic Routing Change for CPIDs 5663, 6862 Peak Pace Solutions

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

Payer Name: Peak Pace Solutions
Professional CPID: 6862
Edit Master: PE_T007
Institutional CPID: 5663
Edit Master: HE9T007
Payer-assigned Payer ID: 27034
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 are receiving.

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.

7/30/2025

Update: Report Generation Delay for CPID 7493 Blue Cross Blue Shield of Vermont

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted June 30, 2025, July 11, 2025 and July 12, 2025.

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

Update sent July 23, 2025:
Update: A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since June 30, 2025.

Original notify sent July 11, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 30, 2025.

Payer impacted: 

  • CPID 7493 Blue Cross Blue Shield of Vermont

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 09592449.

7/30/2025

Electronic Routing Change for CPIDs 1124 and 1572 All American Medical Group

Effective July 31, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: All American Medical Group
Professional CPID: 1124
Institutional CPID: 1572
Payer-assigned Payer ID: AAMG1
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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.

7/29/2025

Electronic Routing Change for CPIDs 1124 and 1572 All American Medical Group

Effective July 31, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: All American Medical Group
Professional CPID: 1124
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 1572
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: AAMG1
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 are receiving.

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.

7/29/2025

Report Generation Delay for CPID 9743 AdventHealth Transplant Institute

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

Payer impacted: 

  • CPID 9743 AdventHealth Transplant Institute

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 09619291.

7/29/2025

Report Generation Delay for CPID 2483 Texas Childrens Health Plan (STAR Medicaid)

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted July 16, 2025.

Payer impacted: 

  • CPID 2483 Texas Childrens Health Plan (STAR 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 09618941.

7/29/2025

VillageMD of Northern Indiana Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: VillageMD of Northern Indiana
Claims and Remittance CPIDs: 8249
Remittance LOB: H1V
Payer-assigned Payer ID: 75386
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

7/29/2025

VillageMD of Northern Indiana Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: VillageMD of Northern Indiana
Claim and Remittance CPIDs: 8249
Payer-assigned Payer ID: 75386
Reason: Payer no longer offers an electronic connection to which Optum can connect.

7/29/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Inspira Health Network Life
Professional CPID: 3497
Payer-assigned Payer ID: R3482
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. 

7/29/2025

Report Generation Delay for CPID 2490 Blue Cross Blue Shield of South Dakota

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

Payer impacted: 

  • CPID 2490 Blue Cross Blue Shield of South Dakota

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 09618813.

7/29/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Inspira Health Network Life
Professional CPID: 3497
Payer-assigned Payer ID: R3482
Line of Business (LOB) Code: H4U
Payer Enrollment Required: Yes
Payer Location: National 

Action Required: 

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

7/29/2025

Update: Report Generation Delay for multiple CPIDs

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted July 9, 2025 and July 10, 2025.

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

Original notify sent July 22, 2025:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted July 9, 2025 and July 10, 2025.

Payers impacted: 

  • CPID 1970 Ambetter from Absolute Total Care
  • CPID 1764 Ambetter from Absolute Total Care
  • CPID 6574 Ambetter from Nebraska Total Care
  • CPID 9431 Ambetter from Wellcare of Kentucky
  • CPID 9432 Ambetter from Wellcare of New Jersey
  • CPID 9775 Ambetter of Alabama
  • CPID 7051 Ambetter of Oklahoma
  • CPID 9433 Ambetter of Oklahoma

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 09607672.

7/29/2025

Update: Report Generation Delay for CPID 8920 Healthcare Management Administrators

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from June 26, 2025 through July 22, 2025.

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

Original notify sent July 11, 2025:

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

Payer impacted: 

  • CPID 8920 Healthcare Management Administrators

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09592516.

7/29/2025

Update: Report Generation Delay for CPID 2830 CarePlus Health Plans

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted June 24, 2025 and July 2, 2025.

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

Update sent July 16, 2025:
Update: A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 24, 2025 and July 2, 2025.

Original notify sent July 8, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 24, 2025.

Payer impacted: 

  • CPID 2830 CarePlus 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 09586501.

7/29/2025

999 Payer Batch Rejections CPID 5529 Massachusetts Medicaid

Institutional claims transmitted to the payer listed below from Optum July 25, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

  • CPID 5529 Massachusetts Medicaid

A resolution has been implemented, and the claims were retransmitted to the payer July 28, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09617382.

7/28/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Momentum TPA
Institutional CPID: 9016
Professional CPID: 3492
Payer-assigned Payer ID: MOMTM
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National
Claims Fee: N/A

Action Required: 

  • Add the payer 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. 

7/28/2025

Claims and Remittance Reactivation for CPIDs 6181, 4672 Children's Special Health Care Services (CSHCS)

Optum recently restored electronic claims and remittance connectivity for the following payer:

Payer Name: Children's Special Health Care Services (CSHCS)
Professional CPID: 6181
Institutional CPID: 4672
Payer-assigned Payer ID: 35600
Line of Business (LOB) Code: E30

Enrollment Requirements:

Claims:

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

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.

7/28/2025

Claims and Remittance Reactivation for CPIDs 6181, 4672 Children's Special Health Care Services (CSHCS)

Optum recently restored electronic claims and remittance connectivity for the following payer:

Payer Name: Children's Special Health Care Services (CSHCS)
Professional CPID: 6181
Institutional CPID: 4672
Payer-assigned Payer ID: 35600

Enrollment Requirements:

Claims:

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

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.

7/28/2025

Electronic Routing Change for CPIDs 4150 and 9663 Key Medical Group Medicare Advantage

Effective July 28, 2025, Optum is changing electronic claims routing for the following Professional payer: 

Payer Name: Key Medical Group Medicare Advantage
Professional CPID: 4150
Payer-assigned Payer ID: IP083
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: N/A 

Effective July 28, 2025, Optum will be reactivating and changing electronic claims routing for the following Institutional payer: 

Payer Name: Key Medical Group Medicare Advantage
Institutional CPID: 9663
Payer-assigned Payer ID: IP083
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: N/A 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/28/2025

Electronic Routing Change for CPIDs 4150 and 9663 Key Medical Group Medicare Advantage

Effective July 28, 2025, Optum is changing electronic claims routing for the following Professional payer: 

Payer Name: Key Medical Group Medicare Advantage
Professional CPID: 4150
Current Edit Master: PE_O007
New Edit Master: PE_T007
Payer-assigned Payer ID: IP083
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No 

Effective July 28, 2025, Optum is reactivating and changing electronic claims routing for the following Institutional payer: 

Payer Name: Key Medical Group Medicare Advantage
Institutional CPID: 9663
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: IP083
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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. 

7/28/2025

Electronic Routing Change for CPIDs 1295 and 6560 Imperial Health Holdings Medical Group

Effective July 28, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Imperial Health Holdings Medical Group
Professional CPID: 1295
Institutional CPID: 6560
Payer-assigned Payer ID: IHHMG
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/28/2025

Electronic Routing Change for CPIDs 1295 and 6560 Imperial Health Holdings Medical Group

Effective July 28, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Imperial Health Holdings Medical Group
Professional CPID: 1295
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 6560
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: IHHMG
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 are receiving. 

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. 

7/28/2025

Electronic Routing Change for CPID 3119 Community Health Center Network

Effective July 28, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Community Health Center Network
Professional CPID: 3119
Payer-assigned Payer ID: CHCN1
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 are receiving.  

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. 

7/28/2025

Electronic Routing Change for CPID 3119 Community Health Center Network

Effective July 28, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Community Health Center Network
Professional CPID: 3119
Current Edit Master :PE_O007
New Edit Master: PE_T007
Payer-assigned Payer ID: CHCN1
Payer Claim Enrollment Required: Yes
Secondary Claims Accepted: No 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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

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

7/28/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Health Choice Arizona
Institutional CPID: 2930
Professional CPID: 3232
Payer-assigned Payer ID: 62179
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Arizona 

Payer Name: Health Choice Pathway
Institutional CPID: 8985
Professional CPID: 4878
Payer-assigned Payer ID: 62180
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Arizona 

Action Required: 

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

7/28/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Health Choice Arizona
Institutional CPID: 2930
Professional CPID: 3232
Payer-assigned Payer ID: 62179
Line of Business (LOB) Code: H4L
Payer Enrollment Required: Yes
Payer Location: Arizona 

Payer Name: Health Choice Pathway
Institutional CPID: 8985
Professional CPID: 4878
Payer-assigned Payer ID: 62180
Line of Business (LOB) Code: U1D
Payer Enrollment Required: Yes
Payer Location: Arizona 

Action Required: 

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

7/28/2025

999 Payer Batch Rejections CPID 1782 North American Medical Management

Professional claims transmitted to the payer listed below from Optum July 28, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

  • CPID 1782 North American Medical Management (NAMM - N. CA)

A resolution has been implemented, and the claims were retransmitted to the payer July 28, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09614690.

7/28/2025

Upcoming changes for payer New Avenue, Inc.

Effective Oct. 1, 2025, the payer New Avenue, Inc. will be suspended at Optum for claim processing and removed from the payer list.

Payer Name: New Avenue, Inc.
Payer ID: 95998
CPID: 7714 (P), 9655 (I)

The payer has requested that claims received with a date of service after July 31, 2025 be rejected at Optum.

Reason: Payer will not offer an electronic connection after Sept. 30, 2025.

Action Required: Providers have until Sept. 30, 2025 to bill claims with dates of service July 31, 2025 or prior.

7/25/2025

999 Payer Batch Reject for CPID 1782 North American Medical

Professional claims transmitted to the payer listed below from Optum July 25, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

  • CPID 1782 North American Medical Management (NAMM - N. CA)

A resolution has been implemented, and the claims were retransmitted to the payer July 25, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09614690.

7/25/2025

Electronic Routing Change for CPIDs 5828 and 2978 Southern California Physicians Managed Care Services

Effective July 29, 2025, Optum will be changing electronic claims routing for the following Professional payer:

Payer Name: Southern California Physicians Managed Care Services
Professional CPID: 5828
Current Edit Master: PE_O007
New Edit Master: PE_T007
Payer-assigned Payer ID: SCP01
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Effective July 29, 2025, Optum will be reactivating and changing electronic claims routing for the following Institutional payer:

Payer Name: Southern California Physicians Managed Care Services
Institutional CPID: 2978
Current Edit Master: HE9O007
New Edit Master: HE9t007
Payer-assigned Payer ID: SCP01
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 are receiving.

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.

7/25/2025

Electronic Routing Change for CPIDs 5828 and 2978 Southern California Physicians Managed Care Services

Effective July 29, 2025, Optum will be changing electronic claims routing for the following Professional payer:

Payer Name: Southern California Physicians Managed Care Services
Professional CPID: 5828
Payer-assigned Payer ID: SCP01
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Effective July 29, 2025, Optum will be reactivating and changing electronic claims routing for the following Institutional payer:

Payer Name: Southern California Physicians Managed Care Services
Institutional CPID: 2978
Payer-assigned Payer ID: SCP01
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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.

7/25/2025

New Electronic Claims Connections Available on Revenue Performance Advisor

Institutional claim transactions have recently been added to the Revenue Performance Advisor system for the following payers:

5477S – Pennsylvania Highmark BCBS Southeastern
73275 – Perlman Medical Group
91888 – CEHAS Plan Administrators
92170 – St. Lukes Health Plan
99914 – Healthy Mississippi
GMWP1 – West PACE
GNPMG – GREATER NEWPORT IPA
IEXAZ – Imperial Insurance Companies Exchange Arizona
IEXNV – Imperial Insurance Companies Exchange Nevada
MPM70 – Optum Care Network - Inland Faculty Medical Group
R3491 – Edenbridge PACE of West Baltimore
R3495 – ArchCare
SPPCA – St. Paul's PACE

Professional claim transactions have recently been added to the Revenue Performance Advisor system for the following payers:

73275 – Perlman Medical Group
77150 – Oregon Health Authority - HRSN
91888 – CEHAS Plan Administrators
92170 – St. Lukes Health Plan
99914 – Healthy Mississippi
GMWP1 – West PACE
GNPMG – GREATER NEWPORT IPA
IEXAZ – Imperial Insurance Companies Exchange Arizona
IEXNV – Imperial Insurance Companies Exchange Nevada
MPM70 – Optum Care Network - Inland Faculty Medical Group
R3491 – Edenbridge PACE of West Baltimore
R3495 – ArchCare
SPPCA – St. Paul's PACE

7/25/2025

Electronic Routing Change for CPIDs 6606 Optum Care Network - Monarch

Effective July 28, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Optum Care Network - Monarch
Institutional CPID: 6606
Edit Master: HE9T007
Payer-assigned Payer ID: IP095
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 are receiving.

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.

7/25/2025

Electronic Routing Change for CPID 6606 Optum Care Network - Monarch

Effective July 28, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Optum Care Network - Monarch
Institutional CPID: 6606
Payer-assigned Payer ID: IP095
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you are receiving.

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.

7/25/2025

Report Generation Delay for CPID 2481 Ohio Medicaid

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

Payer impacted:

  • CPID 2481 Ohio Medicaid

The payer has been unable to generate and deliver the reports for some claims submitted on July 22, 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 09614458.

7/25/2025

Monarch Electronic Remittance Connection No Longer Available

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

Payer Name: Optum Care Network - Monarch
Remittance CPIDs: 2475, 6606
Remittance LOB: K75
Payer-assigned Payer ID: IP095
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

7/24/2025

Electronic Routing Change for CPIDs 4775 and 3614 MedStar Family Choice, Inc (MD)

Effective July 24, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: MedStar Family Choice, Inc (MD)
Professional CPID: 4775
Edit Master: PE_T007
Institutional CPID: 3614
Edit Master: HE9T007
Payer-assigned Payer ID: RP063
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 are receiving.  

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. 

7/24/2025

Electronic Routing Change for CPIDs 4775 and 3614 MedStar Family Choice, Inc (MD)

Effective July 24, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: MedStar Family Choice, Inc (MD)
Professional CPID: 4775
Institutional CPID: 3614
Payer-assigned Payer ID: RP063
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements: 

Claims:

  • Payer enrollment for electronic claims is not required. 

Report Changes:

You may see some differences in the payer reports you are receiving.  

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. 

7/24/2025

Resolved: Delay in Electronic Remittance Advice (ERA) for CPIDs 2449, 4544 Humana
Resolved: This issue has been resolved. All impacted ERAs have been processed.

Original Notification sent July 22, 2025
Due to a payer intermediary processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates of July 1, 2025 through present:

  • CPID 2449 Humana
  • CPID 4544 Humana

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003055.

7/24/2025

Report Generation Delay for CPID 4248 Community Care BHO

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted July 16, 2025.

Payer impacted: 

  • CPID 4248 Community Care BHO

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09611138.

7/23/2025

Electronic Routing Change for CPIDs 3287 and 8684 Prospect Medical Systems

Effective July 23, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Prospect Medical Systems
Professional CPID: 3287
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 8684
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: PROSP
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 are receiving.

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.

7/23/2025

Electronic Routing Change for CPIDs 3287 and 8684 Prospect Medical Systems

Effective July 23, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Prospect Medical Systems
Professional CPID: 3287
Institutional CPID: 8684
Payer-assigned Payer ID: PROSP
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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.

7/23/2025

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

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted July 12, 2025.

Payer impacted: 

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

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 09610524.

7/23/2025

Report Generation Delay for CPID 2842 Alexian PACE

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted July 12, 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 09610447.

7/23/2025

Report Generation Delay for CPID 2234 Illinois Health Partners

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted July 11, 2025.

Payer impacted: 

  • CPID 2234 Illinois Health 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 09610301.

7/23/2025

Report Generation Delay for CPID 9747 Delaware First Health

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted July 10, 2025.

Payer impacted: 

  • CPID 9747 Delaware First Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09610216.

7/23/2025

Report Generation Delay for CPID 2254 Scott & White Health Plan

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since July 11, 2025.

Payer impacted: 

  • CPID 2254 Scott & White 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 09610367.

7/23/2025

ERA Delivery Delay PacificSource

An issue has been identified causing some ERAs to be delayed in processing for the following PacificSource payer IDs since July 10th.

Payer IDs: 93029, 20416, 20377, 95035

CPID(s):

5441/6575
6147/4627
4794/4972
4627/6147

Action Required: Please be aware of a delay in the delivery of some ERAs for files sent since July 10th.

7/23/2025

999 Payer Batch Rejections for CPID 1782 North American Medical


Professional claims transmitted to the payer listed below from Optum July 23, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

  • CPID 1782 North American Medical Management (NAMM - N. CA)

A resolution has been implemented, and the claims were retransmitted to the payer July 23, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09609671.

7/23/2025

Update: Report Generation Delay for CPID 3757 IMAGINE360 ADMINISTRATORS (GPA)

Update: A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since June 24, 2025.

Update sent July 15, 2025:
Update: A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 24, 2025 and July 1, 2025.

Original notify sent July 8, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 24, 2025.

Payer impacted: 

  • 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 09586555.

7/23/2025

Update: Report Generation Delay for CPIDs 1510 and 1404 Wellmark Blue Cross Blue Shield of Iowa

Update: A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since July 1, 2025.

Original notify sent July 14, 2025:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted July 1, 2025.

Payer impacted: 

  • CPID 1510 Wellmark Blue Cross Blue Shield of Iowa
  • CPID 1404 Wellmark Blue Cross Blue Shield of Iowa

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 09595363.

7/23/2025

Update: Report Generation Delay for CPID 7493 Blue Cross Blue Shield of Vermont     

Update: A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since June 30, 2025.

Original notify sent July 11, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 30, 2025.

Payer impacted: 

  • CPID 7493 Blue Cross Blue Shield of Vermont

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 09592449.

7/23/2025

Electronic Routing Change for CPIDs 8692 and 5870 Global Care Medical Group IPA

Effective July 25, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Global Care Medical Group IPA

Professional CPID: 5870

Institutional CPID: 8692

Payer-assigned Payer ID: MPM05

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 are receiving.

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.

7/23/2025

Electronic Routing Change for CPIDs 8692 and 5870 Global Care Medical Group IPA

Effective July 25, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Global Care Medical Group IPA

Professional CPID: 5870

Current Edit Master: PE_O007

New Edit Master: PE_T007

Institutional CPID: 8692

Current Edit Master: HE9O007

New Edit Master: HE9T007

Payer-assigned Payer ID: MPM05

Payer Claim Enrollment Required: No

Secondary Claims Accepted: No

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you are receiving.

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.

7/23/2025

Update: Report Generation Delay for CPID 7225 Sharp Community Medical Group

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on June 23, 2025.

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

Original notify sent July 8, 2025:

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

Payer impacted: 

  • CPID 7225 Sharp Community Medical 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 09587084.

7/23/2025

Group Administrators LTD Update to Real Time 270/271 and 276/277 Inquiries

Effective July 22, 2025, Optum would like to announce Search Options for Real-time Eligibility Inquiry 270/271 and Claim Status Inquiry 276/277 have been updated for the below payer:

Payer Name: Group Administrators LTD
Industry Payer ID: 36338
IMN Real Time ID: 36338
Exchange Real Time ID: GRPAD
CPID(s): 8501/1770
Optum IEDi Real Time ID: 36338
Payer Enrollment Required: No
Connection Type: X12

Search Options: 

Eligibility Subscriber:

Member ID, First Name, Last Name, Date of Birth, Member Group ID
Eligibility Dependent:
Member ID, Dependent First Name, Dependent Last Name, Dependent Date of Birth, Member Group ID

Claim Status Inquiry Subscriber:

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

Optional additional elements:

        Payer claim number, Total submitted charges

Claim Status Inquiry Dependent:

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

Optional additional elements:

Payer claim number, Total submitted charges

Eligibility and Claim Status Inquiries are currently only accepted for members of the following Group IDs:

CCL
CHE24
DFF
DMOS
EIQC
EJEI
EXMP
GSTC
HSS
HUNT
HYVE
NSH
NWI
OPL
REC
RSNF
SYNC
TBG
TDC

Action Required by customer:

Please update your system to take advantage of this payer transaction. For assistance with submitting Real-Time transactions, please contact your Practice Management System Vendor or Optum Customer Care Hub ticket https://customercare.optum.com/public/home.html.

7/23/2025

Electronic Routing Change for CPID 3285 Desert Medical Group

Effective July 24, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Desert Medical Group
Professional CPID: 3285
Payer-assigned Payer ID: DESRT
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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.

7/22/2025

Electronic Routing Change for CPID 3285 Desert Medical Group

Effective July 24, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Desert Medical Group
Professional CPID: 3285
Current Edit Master: PE_O007
New Edit Master: PE_T007
Payer-assigned Payer ID: DESRT
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 are receiving.

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.

7/22/2025

Delay in Electronic Remittance Advice (ERA) for CPIDs 2449, 4544 Humana

Due to a payer intermediary processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates of July 1, 2025 through present:

  • CPID 2449 Humana
  • CPID 4544 Humana

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003055.

7/22/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on July 21, 2025 were not processed by the payer due to a 999 Batch Rejection. 

  • CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer on July 22, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09608426.

7/22/2025

Electronic Routing Change for CPIDs 1651 and 2295 Allegiance Benefit Plan Management

Effective July 22, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Allegiance Benefit Plan Management
Professional CPID: 2295
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 1651
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: 81040
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 are receiving.  

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. 

7/22/2025

999 Payer Batch Rejections for CPID 1407 Anthem Blue Cross Blue Shield of Georgia

Professional claims transmitted to the payer listed below from Optum on July 21, 2025 were not processed by the payer due to a 999 Batch Rejection.

  • CPID 1407 Anthem Blue Cross Blue Shield of Georgia

A resolution has been implemented and the claims were retransmitted to the payer on July 22, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09608362.

7/22/2025

Electronic Routing Change for CPIDs 1651 and 2295 Allegiance Benefit Plan Management

Effective July 22, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Allegiance Benefit Plan Management
Professional CPID: 2295
Institutional CPID: 1651
Payer-assigned Payer ID: 81040
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements: 

Claims:

  • Payer enrollment for electronic claims is not required. 

Report Changes:

You may see some differences in the payer reports you are receiving.  

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. 

7/22/2025

Payer Processing Issue for CPID 7110 Community Health Group

Due to a payer processing issue, some Professional claims transmitted to the payer listed below July 8, 2025-July 10, 2025 were not processed by the payer.

Payer impacted:

  • CPID 7110 Community Health Group

Optum is working with the payer to resolve this processing issue. We will notify you once this issue has been resolved.

This delay affected some claims released to Optum July 8, 2025, 5:00 p.m.-July 10, 2025, 5:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09586669.

7/22/2025

Report Generation Delay for CPID 2502 IU Health Plan Medicare Advantage

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 12, 2025.

Payer impacted: 

  • CPID 2502 IU Health Plan Medicare Advantage

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 09608052.

7/22/2025

Report Generation Delay for CPID 7595 StandardHealth with Health Choice (HCS)

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 8, 2025.

Payer impacted:

  • CPID 7595 StandardHealth with Health Choice (HCS)

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09607982.

7/22/2025

Report Generation Delay for CPID 3577 Regence Group Administrators

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 10, 2025 and July 14, 2025.

Payer impacted: 

  • CPID 3577 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 09607908.

7/22/2025

Report Generation Delay for CPIDs 4093 and 8834 Commonwealth Care Alliance DOS after 3/31/2023

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

Payer impacted: 

  • CPID 4093 Commonwealth Care Alliance DOS after 3/31/2023
  • CPID 8834 Commonwealth Care Alliance DOS after 3/31/2023

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 09607960.

7/22/2025

Report Generation Delay for CPID 2234 Illinois Health Partners

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

Payer impacted: 

  • CPID 2234 Illinois Health Partners

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 09607868.

7/22/2025

Report Generation Delay for CPID 7829 Passport Advantage

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted from July 10, 2025 through July 12, 2025.

Payer impacted: 

  • CPID 7829 Passport 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 09607814.

7/22/2025

Report Generation Delay for CPIDs 3532 and 2426 Blue Care Network of Michigan

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since July 9, 2025.

Payer impacted: 

  • CPID 3532 Blue Care Network of Michigan
  • CPID 2426 Blue Care Network of Michigan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09607748.

7/22/2025

Report Generation Delay for multiple CPIDs

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted July 9, 2025 and July 10, 2025.

Payers impacted: 

  • CPID 1970 Ambetter from Absolute Total Care
  • CPID 1764 Ambetter from Absolute Total Care
  • CPID 6574 Ambetter from Nebraska Total Care
  • CPID 9431 Ambetter from Wellcare of Kentucky
  • CPID 9432 Ambetter from Wellcare of New Jersey
  • CPID 9775 Ambetter of Alabama
  • CPID 7051 Ambetter of Oklahoma
  • CPID 9433 Ambetter of Oklahoma

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 09607672.

7/22/2025

Electronic Routing Change for CPIDs 1290 and 6548 Banner - University Family Care

Effective July 22, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Banner - University Family Care
Professional CPID: 1290
Institutional CPID: 6548
Payer-assigned Payer ID: 66901
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

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

Action Required: Please consider the following to allow transactions to be processed 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.

7/22/2025

Electronic Routing Change for CPIDs 1290 and 6548 Banner - University Family Care

Effective July 22, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Banner - University Family Care
Professional CPID: 1290
Edit Master: PE_T007
Institutional CPID: 6548
Edit Master: HE9T007
Payer-assigned Payer ID: 66901
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

7/22/2025

Update: Report Generation Delay for CPID 8121 Keystone First Community HealthChoices

Update: It has been determined that the report delay below was due to a payer claims processing issue. We have retransmitted the impacted claims to the payer intermediary on July 21, 2025. Reports will be delivered once the claims have successfully processed at the payer.

Action Required: Please be aware of delays and possible invalid duplicate rejections.

Original Notice Sent July 8, 2025:

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

Payer impacted:

  • CPID 8121 Keystone First Community HealthChoices

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 09587345.

7/22/2025

Eligibility Payer Termination

Effective July 07, 2025, the electronic Real Time eligibility 270/271 connection for the payer below will no longer be available. 

Payer Name: Federated Mutual Insurance Company
Optum iEDI Real Time ID: FEDMI

Action Required by customer:

For assistance with submitting Real-Time transactions, please contact your Practice Management System Vendor or Optum Customer Care Hub case.

7/21/2025

Payer Processing Issue for CPID 4480 SelectHealth

Due to a payer processing issue, some Professional claims transmitted to the payer listed below July 4, 2025 were not processed by the payer.

Payer impacted:

  • CPID 4480 SelectHealth

A resolution has been implemented and the claims were retransmitted to the payer July 21, 2025.

This delay affected claims released to Optum July 3, 2025, 7:00 p.m.-July 4, 2025, 7:00 p.m. CT.

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

If you have any questions, please contact Customer Support and refer to Case Number 09607013.

7/21/2025

Report Generation Delay for CPID 7715 Hopkins Health Advantage

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted July 12, 2025.

Payer impacted: 

  • CPID 3480 ArchCare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09606906.

7/21/2025

Report Generation Delay for CPID 3480 ArchCare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted July 12, 2025.

Payer impacted: 

  • CPID 3480 ArchCare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09606906.

7/21/2025

Report Generation Delay for CPID 8035 Ascension Living Hope PACE

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 12, 2025.

Payer impacted: 

  • CPID 8035 Ascension Living Hope PACE

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09606935.

7/21/2025

Electronic Routing Change for CPIDs 3809 and 8925 Community First Health Plan

Effective July 21, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Community First Health Plan
Professional CPID: 3809
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 8925
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: COMMF
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 are receiving. 

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. 

7/21/2025

Electronic Routing Change for CPIDs 3809 and 8925 Community First Health Plan

Effective July 21, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Community First Health Plan
Professional CPID: 3809
Institutional CPID: 8925
Payer-assigned Payer ID: COMMF
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/21/2025

Electronic Routing Change for CPIDs 8247 and 3000 Alphacare Medical Group

Effective July 21, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Alphacare Medical Group
Professional CPID: 8247
Institutional CPID: 3000
Payer-assigned Payer ID: NMM04
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/21/2025

Electronic Routing Change for CPIDs 8247 and 3000 Alphacare Medical Group


Effective July 21, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Alphacare Medical Group
Professional CPID: 8247
Edit Master: PE_T007
Institutional CPID: 3000
Edit Master: HE9T007
Payer-assigned Payer ID: NMM04
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 are receiving.  

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. 

7/21/2025

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

Effective July 21, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Gateway Health Plan Medicare Assured Pennsylvania
Professional CPID: 2298
Institutional CPID: 2912
Payer-assigned Payer ID: 60550
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/21/2025

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

Effective July 21, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Gateway Health Plan Medicare Assured Pennsylvania
Professional CPID: 2298
Edit Master: PE_T007
Institutional CPID: 2912
Edit Master: HE9T007
Payer-assigned Payer ID: 60550
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/21/2025

Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 9, 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 09606627.

7/21/2025

Report Generation Delay for CPID 1928 Medical Associates Health Plan

The payer listed below is experiencing issues affecting Institutional report generation for some claims submitted July 9, 2025.

Payer impacted: 

  • CPID 1928 Medical Associates Health Plan

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

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 09606548.

7/21/2025

Report Generation Delay for CPID 5072 MeridianComplete Michigan

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 9, 2025.

Payer impacted: 

  • CPID 5072 MeridianComplete Michigan

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 09606465.

7/21/2025

Report Generation Delay for CPID 4714 Medigold HMO

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since July 7, 2025.

Payer impacted: 

  • CPID 4714 Medigold HMO

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 09606318.

7/21/2025

Report Generation Delay for CPID 4258 VNS Health

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on July 7, 2025 and July 12, 2025.

Payer impacted: 

  • CPID 4258 VNS Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09606130.

7/21/2025

Payer Processing Issue for CPID 1782 North American Medical Management (NAMM - N. CA)

Professional claims transmitted to the payer listed below from Optum July 21, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

  • CPID 1782 North American Medical Management (NAMM - N. CA)

A resolution has been implemented and the claims were retransmitted to the payer July 21, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09605995.

7/21/2025

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted June 7, 2025-July 12, 2025.

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

Original notify sent June 23, 2025:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since June 7, 2025.

Payer impacted: 

  • CPID 1167 Blue Cross Medicare Advantage PPO/HMO
  • CPID 2513 Blue Cross Medicare Advantage PPO/HMO

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 09566081.

7/21/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plan

Professional claims transmitted to the payer listed below from Optum on July 16, 2025 were not processed by the payer due to a 999 Batch Rejection. 

  • CPID 1844 Wellcare Health Plan

A resolution has been implemented and the claims were retransmitted to the payer on July 17, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09602741.

7/17/2025

Electronic Routing Change for CPIDs 7235 and 8653 Alignment Health Care

Effective July 21, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Alignment Health Care
Professional CPID: 7235
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 8653
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: CCHPC
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.

7/17/2025

Electronic Routing Change for CPIDs 7235 and 8653 Alignment Health Care

Effective July 21, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Alignment Health Care
Professional CPID: 7235
Institutional CPID: 8653
Payer-assigned Payer ID: CCHPC
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

  • Make any necessary system changes.

7/17/2025

Electronic Routing Change for CPIDs 6100 and 4607 GEMCare - Kern County

Effective July 17, 2025, Optum will be changing electronic claims routing for the following payers:

Payer Name: GEMCare - Kern County
Professional CPID: 6100
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 4607
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: MCS03
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 are receiving.

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.

7/17/2025

Electronic Routing Change for CPIDs 6100 and 4607 GEMCare - Kern County

Effective July 17, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: GEMCare - Kern County 
Professional CPID: 6100
Institutional CPID: 4607
Payer-assigned Payer ID: MCS03
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you are receiving.

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.

7/17/2025

Electronic Routing Change for Multiple Payers

Effective July 21, 2025, Optum will be changing electronic claims routing for the following payers:

Payer Name: Downy Select IPA (AppleCare Medical Management)
Professional CPID: 4152
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 3071
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: APP01
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Payer Name: Bakersfield Family Medical Center
Professional CPID: 4241
Edit Master: PE_T007
Institutional CPID: 6614
Edit Master: HE9T007
Payer-assigned Payer ID: BKRFM
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Payer Name: Allcare IPA
Professional CPID: 7247
Current Edit Master: PE_O007
New Edit Master: PE_T007
Payer-assigned Payer ID: AC101
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 are receiving.

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

  • Revalidate unreleased claims to edit correctly under new edit masters.
  • Modify any bridge routines based on edit master changes.
  • 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.

7/17/2025

Electronic Routing Change for Multiple Payers

Effective July 21, 2025, Optum will be changing electronic claims routing for the following payers:

Payer Name: Downy Select IPA (AppleCare Medical Management)
Professional CPID: 4152
Institutional CPID: 3071
Payer-assigned Payer ID: APP01
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Payer Name: Bakersfield Family Medical Center
Professional CPID: 4241
Institutional CPID: 6614
Payer-assigned Payer ID: BKRFM
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Payer Name: Allcare IPA
Professional CPID: 7247
Payer-assigned Payer ID: AC101
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you are receiving.

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.

7/17/2025

Electronic Routing Change for CPID 4896 Facey Medical Foundation

Effective July 17, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Facey Medical Foundation
Professional CPID: 4896
Payer-assigned Payer ID: 95432
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

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

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. 

7/17/2025

Electronic Routing Change for CPID 4896 Facey Medical Foundation

Effective July 17, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Facey Medical Foundation
Professional CPID: 4896
Current Edit Master: PE_E049
New Edit Master: PE_T007
Payer-assigned Payer ID: 95432
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 are receiving 

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 master.  
  • 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. 

7/17/2025

Payer Processing Issue for CPID 1782 North American Medical Management (NAMM - N. CA)

Professional claims transmitted to the payer listed below from Optum July 17, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

  • CPID 1782 North American Medical Management (NAMM - N. CA)

A resolution has been implemented and the claims were retransmitted to the payer July 17, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09601730.

7/17/2025

Report Generation Delay for CPID 1780 MCA-Sedgwick WTCHP NPN

A payer is experiencing issues affecting Professional report generation for some claims submitted July 14, 2025.

Payer impacted:

  • CPID 1780 MCA-Sedgwick WTCHP NPN

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09601299.

7/17/2025

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: Innovative Payer 2
CPIDs: 4065, 8809
Payer ID: 23212
Reason: Payer unavailable electronically 

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

7/16/2025

Electronic Routing Change for CPIDs 5840 & 9676 Health Care LA IPA

Effective July 16, 2025, Optum is changing electronic claims routing for the following payer:

Payer Name: Health Care LA IPA
Professional CPID: 5840
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 9676
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: MPM06
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:
You may see some differences in the payer reports you are receiving

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.

7/16/2025

Electronic Routing Change for CPIDs 5840 & 9676 Health Care LA IPA

Effective July 16, 2025, Optum is changing electronic claims routing for the following payer:

Payer Name: Health Care LA IPA
Professional CPID: 5840
Institutional CPID: 9676
Payer-assigned Payer ID: MPM06
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 are receiving.

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.

7/16/2025

Update: Report Generation Delay for CPID 2830 CarePlus Health Plans

Update: A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on June 24, 2025 and July 2, 2025.

Original notify sent July 8, 2025:

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

Payer impacted: 

  • CPID 2830 CarePlus 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 09586501.

7/16/2025

Electronic Routing Change for CPIDs 8973 and 1825 Medsolutions

Effective July 18, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Medsolutions
Professional CPID: 1825
Institutional CPID: 8973
Payer-assigned Payer ID: 62160
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you are receiving.

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.

7/16/2025

Electronic Routing Change for CPIDs 8973 and 1825 Medsolutions

Effective July 18, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Medsolutions
Professional CPID: 1825
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 8973
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 62160
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 are receiving.

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.

7/16/2025

Electronic Routing Change for CPIDs 7613 and 6820 CenterLight Healthcare

Effective July 18, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: CenterLight Healthcare
Professional CPID: 6820
Institutional CPID: 7613
Payer-assigned Payer ID: 13360
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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.

7/16/2025

Electronic Routing Change for CPIDs 7613 and 6820 CenterLight Healthcare

Effective July 18, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: CenterLight Healthcare
Professional CPID: 6820
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 7613
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 13360
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 are receiving.

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.

7/16/2025

New Electronic Claims Auth Inquiry Connection Available

Optum is pleased to announce the availability of Real-time Auth Inquiry and Response 278/215 & 217 for the below payer, effective May 9, 2025:

Payer Name: ANTHEM BLUE CROSS BLUE SHIELD OF OHIO
IMN Real Time ID: SB338
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Claim Status Inquiry subscriber

  1. 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.

7/15/2025

New Electronic Claim Status Connection Available Platform

Optum is pleased to announce the availability of Real-time Claim Status Inquiry and Response 276/277 for the below payer, effective June 18, 2025:

Payer Name: Medi Share (CHRISTIAN CARE MINISTRIES)
Industry Payer ID: 59355
IMN Real Time ID: 59355
Exchange Real Time ID: CCMINS
CPID(s): 7154 / 8638
Optum iEDI Real Time ID: 59355
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Claim Status Inquiry subscriber

  • Member id, first name, last name, date of birth, Payer claim number

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.

7/15/2025

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective June 30, 2025:

Payer Name: TEXAS MEDICAID
Industry Payer ID: SKTX0
IMN Real Time ID: SKTX0
Exchange Real Time ID: TXCAID
CPID(s): 5500 / 1470
Optum iEDI Real Time ID: TXMCD
Payer Enrollment Required: No
Connection Type: X12
Current Fee: $0.08
New Fee: $0.075

Search Options:
Eligibility Subscriber:

  • Subscriber ID
  • Subscriber SSN, Date of Birth
  • First Name, Last Name, Date of Birth
  • First Name, Last Name, Subscriber SSN (Full 9-digit number)

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.

7/15/2025

Duplicate Electronic Remittance Advice Transmission for CPIDs 1775, 2560, 9930 WELLPOINT, ANTHEM ERA ONLY

Due to a payer processing issue, Institutional and Professional Electronic Remittance Advice (ERA) for the payer’s listed below may have been resent July 15, 2025, to customers who may have previously received the ERAs June 16, 2025-July 15, 2025. The check dates for the duplicate ERAs are June 13, 2025-June 18, 2025. Please disregard any duplicate ERA received.

Payers impacted:

  • CPID 1775 WELLPOINT
  • CPID 2560 WELLPOINT
  • CPID 9930 ANTHEM ERA ONLY

Action Required: Please be aware of this processing error and disregard the duplicate ERAs received for the check dates above.

If you have any questions, please contact Customer Support and refer to Case # INC-000002887.

7/15/2025

Electronic Routing Change for CPIDs 4959 and 4750 Johns Hopkins - USFHP

Effective July 15, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Johns Hopkins - USFHP
Professional CPID: 4750
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 4959
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 52123
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 are receiving.  

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. 

7/15/2025

Electronic Routing Change for CPIDs 4959 and 4750 Johns Hopkins - USFHP

Effective July 15, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Johns Hopkins - USFHP
Professional CPID: 4750
Institutional CPID: 4959
Payer-assigned Payer ID: 52123
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10 

Enrollment Requirements: 

Claims:

  • Payer enrollment for electronic claims is not required. 

Report Changes:

You may see some differences in the payer reports you are receiving.  

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. 

7/15/2025

Report Generation Delay for CPID 2234 Illinois Health Partners

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on July 3, 2025.

Payer impacted: 

  • CPID 2234 Illinois Health 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 09597297.

7/15/2025

Report Generation Delay for CPID 1402 Blue Cross Blue Shield of Minnesota

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

Payer impacted: 

  • CPID 1402 Blue Cross Blue Shield of Minnesota

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 09597254.

7/15/2025

Electronic Routing Change for CPID 6767 VGM Homelink

Effective July 15, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: VGM Homelink
Professional CPID: 6767
Edit Master: PE_T007
Payer-assigned Payer ID: 50701
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 are receiving.

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

7/15/2025

Electronic Routing Change for CPID 6767 VGM Homelink

Effective July 15, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: VGM Homelink
Professional CPID: 6767
Payer-assigned Payer ID: 50701
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

You may see some differences in the payer reports you are receiving.

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.

7/15/2025

Report Generation Delay for CPIDs 3679 and 5882 Kane County IPA

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

Payer impacted: 

  • CPID 3679 Kane County IPA
  • CPID 5882 Kane County 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 09596980.

7/15/2025

Update: Report Generation Delay for CPID 3757 IMAGINE360 ADMINISTRATORS (GPA)

Update: A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 24, 2025 and July 1, 2025.

Original notify sent July 8, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 24, 2025.

Payer impacted: 

  • 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 09586555.

7/15/2025

Update: Report Generation Delay for CPID 8551 Wellcare Health Plans

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted June 26, 2025.

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

Original notify sent July 10, 2025:
A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted June 26, 2025.

Payer impacted: 

  • CPID 8551 Wellcare 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 09590169.

7/15/2025

Resolved: Payer Report Issue for CPIDs 7430, 5582 Idaho Blue Cross Boise

Resolved: This issue has been resolved. Reports generated July 11, 2025 are now populating the error messages.

Original notify sent June 24, 2025:
Assurance Reimbursement Management is experiencing a payer processing issue causing missing claim rejections. This may result in an error when viewing claims or reports.  

Errors: 

  • “Code 7350: No Message Returned” is being returned when viewing claims with no rejection details. 
  • “ERRORED|R – REJECTED” with no rejection details.

Affected payers:

  • CPID 5582 Blue Cross Idaho
  • CPID 7430 Blue Cross Idaho

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

We apologize for any inconvenience. 

Action Required: Contact Optum Support to receive claim rejection messages.

7/15/2025

Eligibility payer termination - VAFEE

Effective July 30, 2025, the electronic eligibility connection for the payer below will no longer be available. 

Payer Name: Veterans Administration Fee Basis Programs
Real Time ID: VAFEE
CPID(s): 1507, 3887
Industry Payer ID: 12115
Connection Type: X12

Providers should begin using the eligibility payer ID VETFBP instead.

Action Required: Please update your system immediately with the new real-time eligibility payer ID VETFBP for this payer.

7/15/2025

Report Generation Delay for CPIDs 1510 and 1404 Wellmark Blue Cross Blue Shield of Iowa

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on July 1, 2025.

Payer impacted: 

  • CPID 1510 Wellmark Blue Cross Blue Shield of Iowa
  • CPID 1404 Wellmark Blue Cross Blue Shield of Iowa

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 09595363.

7/14/2025

Payer Processing Issue for CPID 1782 North American Medical Management (NAMM - N. CA)

Professional claims transmitted to the payer listed below from Optum on July 11, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

  • CPID 1782 North American Medical Management (NAMM - N. CA)

A resolution has been implemented and the claims were retransmitted to the payer on July 14, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09593784.

7/14/2025

Electronic Routing Change for CPID 6405 Cigna Health Plans

Effective July 15, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Cigna Health Plans
Professional CPID: 6405
Payer-assigned Payer ID: 62308
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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.

7/14/2025

Electronic Routing Change for CPID 6405 Cigna Health Plans

Effective July 15, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Cigna Health Plans
Professional CPID: 6405
Edit Master: PE_T007
Payer-assigned Payer ID: 62308
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 are receiving.

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.

7/14/2025

Report Generation Delay for CPIDs 1510 and 1404 Wellmark Blue Cross Blue Shield of Iowa

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on July 1, 2025.

Payer impacted: 

  • CPID 1510 Wellmark Blue Cross Blue Shield of Iowa
  • CPID 1404 Wellmark Blue Cross Blue Shield of Iowa

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 09595363.

7/14/2025

New Payer Edit for CPID 1966

The payer below has informed Optum of a new edit requirement effective immediately. In order to meet the new requirement, we will add the following edit on July 17, 2025: 

  • ISBR03A011: MISSING/INVLD SUBSCRIBER GROUP- The Active Subscriber Policy or Group Number is required and must not be in the following list:
    • 0000  2222
    • 1111  9999
    • 1234  34171

7/14/2025

New Payer Edit for CPID 2299 FRONTPATH HEALTH COALITION

The payer below has informed Optum of a new edit requirement effective immediately. In order to meet the new requirement, we will add the following edit on July 17, 2025: 

  • PSBR03A011: MISSING/INVLD SUBSCRIBER GROUP- The Active Subscriber Policy or Group Number is required and must not be in the following list:
    • 0000  2222
    • 1111  9999
    • 1234  34171

7/14/2025

Electronic Routing Change for CPIDs 6623 and 3225 Preferred IPA

Effective July 16, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Preferred IPA
Professional CPID: 3225
Institutional CPID: 6623
Payer-assigned Payer ID: PFIPA
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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.

7/14/2025

Electronic Routing Change for CPIDs 6623 and 3225 Preferred IPA

Effective July 16, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Preferred IPA
Professional CPID: 3225
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 6623
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: PFIPA
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 are receiving.

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.

7/14/2025

Update: Report Generation Delay for CPID 3577 Regence Group Administrators

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted June 23, 2025-July 7, 2025.

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

Original notify sent June 30, 2025:
A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since June 16, 2025.

Payer impacted: 

  • CPID 3577 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 09576896.

7/14/2025

Report Generation Delay for CPID 2151 Children First Medical Group

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted on July 7, 2025.

Payer impacted: 

  • CPID 2151 Children First Medical Group

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09594966.

7/14/2025

Payer Processing Issue for CPIDs 1780 and 2588 MCA-Sedgwick WTCHP NPN

Due to a payer processing issue, Professional and Institutional claims transmitted to the payer listed below on July 9, 2025 were not processed by the payer.

Payer impacted:

  • CPID 1780 MCA-Sedgwick WTCHP NPN
  • CPID 2588 MCA-Sedgwick WTCHP NPN

A resolution has been implemented and the claims were retransmitted to the payer on July 14, 2025.

This delay affected claims released to Optum between 1 p.m. on July 8, 2025 and 1 p.m. CST on July 9, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09594820.

7/14/2025

Payer Processing Issue for CPID 1782 North American Medical Management (NAMM - N. CA)

Due to a processing issue, some Professional claims transmitted to the payer listed below on July 11, 2025 were not processed by the payer.

Payer impacted:

  • CPID 1782 North American Medical Management (NAMM - N. CA)

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

This delay affected claims released to Optum between 4 a.m. on July 10, 2025 and 4 a.m. CT on July 11, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09593784.

7/11/2025

West Virginia Highmark Health Options Electronic Remittance Connection No Longer Available

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

Payer Name: West Virginia Highmark Health Options
Remittance CPIDs: 3957, 1881
Remittance LOB: U96
Payer-assigned Payer ID: RP118
Reason: Payer no longer offers an electronic connection.

Action Required: None.

7/11/2025

West Virginia Highmark Health Options Electronic Remittance Connection No Longer Available

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

Payer Name: West Virginia Highmark Health Options
Remittance CPIDs: 3957, 1881
Payer-assigned Payer ID: RP118
Reason: Payer no longer offers an electronic connection.

Action Required: None.

7/11/2025

Blue Cross Blue Shield of Minnesota Health Care Programs Electronic Claims Connection No Longer Available

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

Payer Name: Blue Cross Blue Shield of Minnesota Health Care Programs
Claim CPID: 8116
Payer-assigned Payer ID: A5143
Reason: Payer ID no longer available.

Action Required: None.

7/11/2025

Report Generation Delay for CPID 8920 Healthcare Management Administrators

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

Payer impacted: 

  • CPID 8920 Healthcare Management Administrators

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09592516.

7/11/2025

Report Generation Delay for CPID 7493 Blue Cross Blue Shield of Vermont

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on June 30, 2025.

Payer impacted: 

  • CPID 7493 Blue Cross Blue Shield of Vermont

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 09592449.

7/11/2025

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on July 9, 2025 were not processed by the payer due to a 999 Batch Rejection. 

  • CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer on July 10, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09591212.

7/10/2025

PAR Status Change for Claim Payers

Effective immediately, the PAR Status for following claim payers will change from Non Par to Par:

Payer Name: National General
Industry ID: ASHC1
Exchange CPID(s): 4574, 1245

Intergroup Services Corporation
Industry ID: 23287
Exchange CPID(s): 2961, 5485

MDsave
Industry ID: MDSV
Exchange CPID(s): 3046, 8295

Village Practice Management Company
Industry ID: 36477
Exchange CPID(s): 5074, 9121

Healthgram
Industry ID: 56144
Exchange CPID(s): 6595, 1757

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

6/23/2025

Remittance Reactivation for CPIDs 5479, 2502 IU Health Plan Medicare Advantage

Optum recently restored electronic remittance connectivity for the following payer: 

Payer Name: IU Health Plan Medicare Advantage
Professional CPID: 5479
Institutional CPID: 2502
Payer-assigned Payer ID: 95444 

Remittance Enrollment Requirements:

  • Payer enrollment for electronic remittance is required: 
  • Providers currently receiving electronic remittance for this payer do not need to complete a new enrollment form. 
  • Providers who moved their enrollment to another clearinghouse or have not received remittance will need to re-enroll to receive remittance for this payer from Optum (Change Healthcare). 
  • 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. 

7/10/2025

Report Generation Delay for CPID 1261 Surgery One IPA, Inc.

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

Payer impacted: 

  • CPID 1261 Surgery One IPA, Inc.

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09590319.

7/10/2025

Remittance Reactivation for CPIDs 5479, 2502 IU Health Plan Medicare Advantage

Optum recently restored electronic remittance connectivity for the following payer: 

Payer Name: IU Health Plan Medicare Advantage
Professional CPID: 5479
Institutional CPID: 2502
Payer-assigned Payer ID: 95444
Line of Business (LOB) Code: H80 

Remittance Enrollment Requirements:

  • Payer enrollment for electronic remittance is required: 
  • Providers currently receiving electronic remittance for this payer do not need to complete a new enrollment form. 
  • Providers who moved their enrollment to another clearinghouse or have not received remittance will need to re-enroll to receive remittance for this payer from Optum (Change Healthcare). 
  • 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. 

7/10/2025

Report Generation Delay for CPID 1410 Blue Cross Blue Shield of Minnesota Comprehensive Care Services

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

Payer impacted: 

  • CPID 1410 Blue Cross Blue Shield of Minnesota Comprehensive Care 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 09590365.

7/10/2025

Report Generation Delay for CPID 8677 Quartz ASO

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on July 1, 2025.

Payer impacted: 

  • CPID 8677 Quartz ASO

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 09590277.

7/10/2025

Northeast Georgia Health Services Electronic Claims and Remittance Connection No Longer Available

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

Payer Name: Northeast Georgia Health Services
Claim and Remittance CPIDs: 9689, 7708
Payer-assigned Payer ID: 58169
Reason: Payer no longer offers an electronic connection.

Action Required: None.

7/10/2025

Report Generation Delay for CPID 8551 Wellcare Health Plans

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

Payer impacted: 

  • CPID 8551 Wellcare 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 09590169.

7/10/2025

Report Generation Delay for CPID 7045 AmeriHealth Caritas Ohio

A payer is experiencing issues affecting Institutional report generation for some claims submitted on July 7, 2025.

Payer impacted:

  • CPID 7045 AmeriHealth Caritas Ohio

The payer has been unable to generate and deliver the reports for some claims submitted on July 7, 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 09590167.

7/10/2025

ChampVA - HAC Delay in 835 Deliveries

The VA payer has identified a delivery of 835 issue that started with files from July 4. This is specific for payer IDs 84146, 84147, and 80214. 

The payer is aware of this issue and is working to resolve the issue. They are expecting to resume processing in the next day or two and files will be sent to Optum in the order of creation until they are fully caught up.

7/10/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: Optum San Diego Public Sector County
Professional CPID: 3491
Payer-assigned Payer ID: CNTY1
Payer Enrollment Required: No
Secondary Claims Accepted: No
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. 

7/9/2025

Payer Transmit issue for CPID 4480, 1532 SelectHealth

Due to processing issues, Professional and Institutional claims for the payer listed below were resubmitted to the payer on July 9, 2025.

Payer impacted:

  • CPID 4480 SelectHealth
  • CPID 1532 SelectHealth

This issue affected claims released to Optum between June 26, 2025 and July 1, 2025.

Action Required: Please be aware of possible invalid duplicate rejections.

If you have any questions, please contact Customer Support and refer to Case Number 09588361.

7/9/2025

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: Northwestern Medicine Physicians Network
CPIDs: 1918, 3229
Payer ID: 23550
Reason: Payer unavailable electronically

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

7/9/2025

Update: Report Generation Delay for CPIDs 2502 and 5479 IU Health Plan Medicare Advantage

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from June 21, 2025 through July 2, 2025.

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

Original notify sent June 30, 2025:

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

Payer impacted: 

  • CPID 2502 IU Health Plan Medicare Advantage
  • CPID 5479 IU Health Plan 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 09577457.

7/9/2025

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 from June 24, 2025 through July 3, 2025.

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

Original notify sent July 1, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since June 16, 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 09578442.

7/9/2025

Update: Report Generation Delay for CPID 2234 Illinois Health Partners

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on June 16, 2025 and June 17, 2025.

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

Original notify sent June 30, 2025:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on June 16, 2025 and June 17, 2025.

Payer impacted: 

  • CPID 2234 Illinois Health 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 09577332.

7/9/2025

Payer Processing Issue for CPID 1500 New York Medicaid

Due to a payer processing issue, some Institutional claims transmitted to the payer listed below on July 7, 2025 were not processed by the payer.

Payer impacted:

  • CPID 1500 New York Medicaid

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

This delay affected claims released to Optum between 11 a.m. and 2 p.m. CT on July 7, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09588195.

7/9/2025

Update: Report Generation Delay for CPIDs 5959 and 4258 VNS Health

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from June 23, 2025 through July 2, 2025.

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

Original notify sent June 30, 2025:

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

Payer impacted: 

  • CPID 5959 VNS Health
  • CPID 4258 VNS Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09577280.

7/9/2025

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 from June 23, 2025 through July 2, 2025.

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

Original notify sent June 30, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since June 16, 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 09576821.

7/9/2025

Update: Report Generation Delay for CPID 8551 Wellcare Health Plans

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on June 12, 2025.

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

Original notify sent June 25, 2025:

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on June 12, 2025.

Payer impacted: 

  • CPID 8551 Wellcare 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 09569054.

7/9/2025

Update: Report Generation Delay for CPID 8834 Commonwealth Care Alliance DOS after 3/31/2023

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from June 7, 2025 through June 26, 2025.

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

Original notify sent June 18, 2025:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since June 7, 2025.

Payer impacted: 

  • CPID 8834 Commonwealth Care Alliance DOS after 3/31/2023

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 09559453.

7/9/2025

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: Companion Life
CPIDs: 3273, 3989
Payer ID: 37322
Reason: Payer unavailable electronically

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

7/9/2025

Payer Processing Issue for CPIDs 1584 and 4714 Medigold HMO

Due to a processing issue, some Institutional and Professional claims transmitted to the payer listed below on July 1, 2025 were not processed by the payer.

Payer impacted: 

  • CPID 1584 Medigold HMO
  • CPID 4714 Medigold HMO

A resolution has been implemented and the claims were retransmitted to the payer on July 8, 2025.

This delay affected claims released to Optum between 4 a.m. CT on June 30, 2025 and 4 a.m. CT on July 1, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09587454.

7/8/2025

Report Generation Delay for CPID 8121 Keystone First Community

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

Payer impacted:

  • CPID 8121 Keystone First Community HealthChoices

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 09587345.

7/8/2025

Multiple Payers Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: Commonwealth Care Alliance DOS before 4/1/2023
Claims and Remittance CPIDs: 3437, 1604
Remittance LOB: H6O
Payer-assigned Payer ID: 14315
Reason: Payer no longer offers an electronic connection.

Payer Name: Commonwealth Care Alliance - Medicare Advantage
Claims CPIDs: 9220, 6065
Payer-assigned Payer ID: 14316
Reason: Payer no longer offers an electronic connection.
Payers will no longer accept paper claims.

Action Required: None.

7/8/2025

Multiple Payers Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: Commonwealth Care Alliance DOS before 4/1/2023
Claim and Remittance CPIDs: 3437, 1604
Payer-assigned Payer ID: 14315
Reason: Payer no longer offers an electronic connection.

Payer Name: Commonwealth Care Alliance - Medicare Advantage
Claims CPIDs: 9220, 6065
Payer-assigned Payer ID: 14316
Reason: Payer no longer offers an electronic connection.

Payers will no longer accept paper claims.

Action Required: None.

7/8/2025

Multiple Payers Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: Commonwealth Care Alliance DOS before 4/1/2023
Claim and Remittance CPIDs: 3437, 1604
Payer-assigned Payer ID: 14315
Reason: Payer no longer offers an electronic connection.

Payer Name: Commonwealth Care Alliance - Medicare Advantage
Claims CPIDs: 9220, 6065
Payer-assigned Payer ID: 14316
Reason: Payer no longer offers an electronic connection.

Payers will no longer accept paper claims.

Action Required: None.

7/8/2025

Report Generation Delay for CPIDs 4589 and 8473 Unicare

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on June 23, 2025.

Payer impacted: 

  • CPID 4589 Unicare
  • CPID 8473 Unicare

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 09587131.

7/8/2025

Report Generation Delay for CPID 7225 Sharp Community Medical Group

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

Payer impacted: 

  • CPID 7225 Sharp Community Medical 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 09587084.

7/8/2025

Report Generation Delay for CPID 3232 Health Choice Arizona

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

Payer impacted:

  • CPID 3232 Health Choice Arizona

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 09586741.

7/8/2025

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: Masters, Mates and Pilots
CPIDs: 3476, 4936
Payer ID: MMPHB
Reason: Payer unavailable electronically 

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

7/8/2025

Update: Report Generation Delay for CPID 5882 Kane County IPA

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from May 29, 2025 through June 26, 2025.

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

Original notify sent June 10, 2025:

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

Payer impacted: 

  • CPID 5882 Kane County 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 09546779.

7/8/2025

Report Generation Delay for CPID 2830 CarePlus Health Plans

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

Payer impacted: 

  • CPID 2830 CarePlus 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 09586501.

7/8/2025

Report Generation Delay for CPID 9743 AdventHealth Transplant Institute

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on June 30, 2025.

Payer impacted: 

  • CPID 9743 AdventHealth Transplant Institute

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 09586427.

7/8/2025

Report Generation Delay for CPID 3757 IMAGINE360 ADMINISTRATORS (GPA) Platform

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

Payer impacted: 

  • 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 09586555.

7/8/2025

Update: Report Generation Delay for CPID 3757 IMAGINE360 ADMINISTRATORS (GPA)

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on June 6, 2025.

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

Original notify sent June 17, 2025:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on June 6, 2025.

Payer impacted: 

  • 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 09557366.

7/7/2025

Resolved: Error Message for CPID 6286 Tricare West Region

Resolved: This issue has been resolved. All impacted claims were resubmitted on July 3, 2025.

Original Notice Sent July 2, 2025:

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

  • A3:26:40 ACK,RETURND AS UNPRCESSBLE CLM- CLM,ENCNTER BEEN REJECTD AND NOT ENTERD INTO ADJUDICATION SYS.:ENTITY NOT FOUND.:RECEIVER
  • H NPR044 INVALID PAYER ID SUBMITTED ON CLAIM

This issue began on June 25, 2025. Optum is working to resolve this issue. We will notify you as soon as additional information becomes available.

Payers affected:

  • CPID 6286 TRICARE WEST REGION

Action Required: Please be aware of the error message. 

7/7/2025

Update: Electronic Claims Connection Suspended – Industry Buying Group (IBG) Electronic Claims No Longer Available

Update:

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

Payer Name: Industry Buying Group (IBG)
Claims CPIDs: 2069, 8214
Payer-assigned Payer ID: 81810
Reason: Payer is no longer in business as of June 29, 2025.

Payer will no longer accept paper claims.

Action Required: None.

Original sent 6/27/25:

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

Payer Name: Industry Buying Group (IBG)
CPIDs: 2069, 8214
Payer ID: 81810
Reason: Payer unavailable electronically 

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

7/3/2025

Real Time Eligibility 270/271 Connection No Longer Available

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

Payer Name: Better Health Inc.
Optum IEDi Real Time ID: BHPLS
Connection Type: X12

Reason: Payer no longer offers a real time electronic connection

Action Required: None

7/3/2025

Real Time Eligibility 270/271 No longer Available

Payer Name: TEXAS CHILDREN'S HEALTH PLAN (MEDICAID) CHIP
Industry Payer ID: 76048
IMN Real Time ID: 76048
Optum IEDi Real Time ID: 76048
Connection Type: X12

Reason: Payer no longer offers an real time electronic connection

Action Required: None

7/3/2025

New Real Time Connections Available on Revenue Performance Advisor

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

00551 – Healthy Blue Dual Advantage Louisiana
54398 – Allina Health and Aetna Ins Co
59355 – Christian Care Ministries
95340 – Adventist Health System
99727 – TRICARE East Region
CALOP – CalOptima Direct
HMA01 – Healthcare Management Administrators
NEBTC – Nebraska Total Care

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

45564 – Centivo
53275 – Martin's Point Health Care
99727 – TRICARE East Region

7/3/2025

Payer Processing Issue for CPID 7427 Idaho Medicaid

Due to a payer processing issue, some Professional claims transmitted to the payer listed below June 30, 2025 were not processed by the payer.

Payer impacted:

  • CPID 7427 Idaho Medicaid

A resolution has been implemented and the claims were retransmitted to the payer July 3, 2025.

This delay affected claims released to Optum June 27, 2025, 3:00 p.m.-June 30, 2025, 3:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09582756.

7/3/2025

Update: Report Generation Delay for CPID 1404 Wellmark Blue Cross Blue Shield of Iowa

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

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

Original notify sent June 16, 2025:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on June 3, 2025.

Payer impacted:

  • CPID 1404 Wellmark Blue Cross Blue Shield of Iowa

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 09555547.

7/3/2025

Report Generation Delay for CPID 1402 Blue Cross Blue Shield of Minnesota

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

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

Original notify sent June 17, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 4, 2025 and June 6, 2025.

Payer impacted:

  • CPID 1402 Blue Cross Blue Shield of Minnesota

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 09557255.

7/3/2025

Error Message for CPID 6286 Tricare West Region

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

  • A3:26:40 ACK,RETURND AS UNPRCESSBLE CLM- CLM,ENCNTER BEEN REJECTD AND NOT ENTERD INTO ADJUDICATION SYS.:ENTITY NOT FOUND.:RECEIVER
  • H NPR044 INVALID PAYER ID SUBMITTED ON CLAIM

This issue began on June 25, 2025. Optum is working to resolve this issue. We will notify you as soon as additional information becomes available.

Payers affected:

  • CPID 6286 TRICARE WEST REGION

Action Required: Please be aware of the error message. 

7/2/2025

Electronic Connection No Longer Available

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

Payer Name: SCHALLER ANDERSON INTEGRAL QUALITY CARE FLORIDA
Optum IEDi Real Time ID: ICQFL
Connection Type: X12

Reason: Payer no longer offers an electronic connection

Action Required: None

7/2/2025

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 June 2, 2025 through June 18, 2025.

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

Original notify sent June 17, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since June 2, 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 09557227.

7/2/2025

Real Time Eligibility No Longer Available

Effective immediately, real time eligibility for the payer listed below will no longer be available at Optum.

Payer Name: QUALCARE
Optum IEDi Real Time ID: 10637
Connection Type: X12

Reason: Payer no longer offers an electronic connection

Action Required: None

7/2/2025

Electronic Routing Change for CPIDs 1584 and 4714 Medigold HMO

Effective July 7, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Medigold HMO
Professional CPID: 4714
Institutional CPID: 1584
Payer-assigned Payer ID: 95655
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: $0.10

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

7/2/2025

Report Generation Delay for CPIDs 4061 and 8805 Invicta Health Solutions

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted June 26, 2025.

Payer impacted:

  • CPID 4061 Invicta Health Solutions
  • CPID 8805 Invicta Health Solutions

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09581712.

7/2/2025

Payer Processing Issue for CPIDs 6695 and 6802 Center for Elders Independence

Due to a payer processing issue, some Professional and Institutional claims transmitted to the payer listed below since June 17, 2025 were not processed by the payer.

Payer(s) impacted:

  • CPID 6695 Center for Elders Independence
  • CPID 6802 Center for Elders Independence

Optum is working with the payer to resolve this processing issue. We will notify you once this issue has been resolved.

This delay affected claims released to Optum since 17, 2025, 5:00 a.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09581525.

7/2/2025

Report Generation Delay for CPID 9406 Ochsner Health Plan

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

Payer impacted: 

  • CPID 9406 Ochsner Health Plan

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 09581518.

7/2/2025

New Payer Edit for CPID 3526

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

  • ISV202855T: INVALID HCPCS/CPT-4 CODE - When the associated Revenue Code is 022, the HCPCS/CPT-4 Code is required and must be a valid Skilled Nursing Facility HIPPS or PDPM Code depending on the Date of Service.

Edit applies to: 

  • CPID 3526 NEW YORK BLUE CROSS UTICA/WATERTOWN

Action Required: Please be aware of updated edit requirements

7/2/2025

Report Generation Delay for CPIDs 2481 and 3509 Ohio Medicaid

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted June 27, 2025.

Payer impacted:

  • CPID 2481 Ohio Medicaid
  • CPID 3509 Ohio Medicaid

The payer has been unable to generate and deliver the reports for some claims submitted June 27, 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 09580710.

7/2/2025

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

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

Payer impacted:

  • CPID 2824 The Health Plan of West Virginia, Inc
  • CPID 7551 The Health Plan of West Virginia, Inc

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09578480.

7/1/2025

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

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since June 16, 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 09578442.

7/1/2025

Report Generation Delay for CPIDs 1491 and 5509 Pennsylvania Medicaid

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since June 26, 2025.

Payer impacted:

  • CPID 1491 Pennsylvania Medicaid
  • CPID 5509 Pennsylvania 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 09578418.

7/1/2025

Older Payer Updates

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

GET OLDER UPDATES
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