July 2026

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

VIEW ALL PAYER LISTS →

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Crumdale Claims Solution
Payer ID: 69933
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National
Par Status: Transitional

Payer Name: Health Texas Medical Group
Payer ID: HTHTX
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Texas
Par Status: Nonpar

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.

7/24/2026

Payer enrollment form change

The following payers have changed their enrollment form:

CPID 8467, 3065 / Payer ID KCMD1 KeyCare of Maryland
CPID 1205, 3554 / Payer ID LWA01 Lifeworks Advantage (ISNP Plan)
CPID 8468, 3066 / Payer ID PTX01 Procare Advantage of Texas

Platform: Exchange
Transaction Type: Remittance

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

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

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

7/24/2026

Electronic Routing Change for CPIDs 5181 and 3613 Santa Clara Family Health Plan

Optum is changing electronic remittance routing for the following payer, effective July 24, 2026:

Payer Name: Santa Clara Family Health Plan
Professional CPID: 5181
Institutional CPID: 3613
Industry Standard Payer ID: 24077
Line of Business Code (LOB): H2P
Payer Remittance Enrollment Required: Yes
Remittance Par Status: Transitional
Remittance Fee: N/A

Enrollment Requirements:

Remittance:

Payer enrollment for electronic remittance is required.
Providers currently receiving electronic remittance through Optum do not need to complete a new enrollment form.
New providers must complete a new enrollment form.

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

No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

7/24/2026

Update: Payer Change for CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island

Update: Claims sent to CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP), Payer ID 96240 are not being processed. Claims must be sent using CPIDs 2487 and 3645 Neighborhood Health Plan of Rhode Island, Payer ID 05047.

CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP) will be terminated effective July 30, 2026.

Original notification sent July 16, 2026:

Optum has received information from the payer indicating that all Neighborhood lines of business will share the same Payer ID effective Jan 1, 2.026. The Payer ID for all lines of business will be 05047.

Effective immediately, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: Neighborhood Health Plan of Rhode Island - Integrity (MMP)
Professional CPID: 7171
Professional Edit Master: PE_T007
Institutional CPID: 8612
Institutional Edit Master: HE9T007
Industry Standard Payer ID: 96240
Line of Business Code (LOB): J2L

Claims sent to CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP), Payer ID 96240 are not being processed. Claims must be sent using CPIDs 2487 and 3645 Neighborhood Health Plan of Rhode Island, Payer ID 05047.

CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP) will be terminated effective July 30, 2026.

Providers need to transition to the following payer for electronic claims and remittance:

Payer Name: Neighborhood Health Plan of Rhode Island
Professional CPID: 2487
Professional Edit Master: PE_T007
Institutional CPID: 3645
Institutional Edit Master: HE9T007
Industry Standard Payer ID: 05047
Line of Business Code (LOB): U1G
Claim Par Status: Par
Claim Fee: N/A
Remittance Par Status: Non Par
Remittance Fee: N/A

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum for CPIDs 2487, 3645 Neighborhood Health Plan of Rhode Island, do not need to complete a new enrollment form.
- Providers not receiving electronic remittance through Optum for CPIDs 2487, 3645 Neighborhood Health Plan of Rhode Island, must complete a new enrollment form.
- New providers must complete a new enrollment form.

Report Changes:

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

Action Required: Please make the following updates to accommodate these payer changes:

Modify any bridge routines based on edit masters.
Modify related Payer Alias names to the new CPIDs.
To access the new enrollment forms, please visit Enrollment Central.

7/24/2026

Enrollment Form Change

The following payers have changed their Claims and Remittance enrollment form:

CPID 5512 / Payer ID 06001/ Payer Name - WISCONSIN MEDICARE

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

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

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

7/24/2026

Electronic Routing Change for CPIDs 5181 and 3613 Santa Clara Family Health Plan

Optum is changing electronic remittance routing for the following payer, effective July 24, 2026:

Enrollment Requirements:
Remittance:

Payer enrollment for electronic remittance is required.
Providers currently receiving electronic remittance through Optum do not need to complete a new enrollment form.
New providers must complete a new enrollment form.

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

No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

7/24/2026

MVP Health Plan New Real Time Claim Status 276/ 277 Connection Available

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

Payer Name: MVP Health Plan
Industry Payer ID: 14165
IMN Real Time ID: 14165
Exchange Real Time ID: NYMVP
Optum IEDI Real Time ID: 14165
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Claim Status Inquiry subscriber

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

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

7/24/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: Edenbridge PACE of West Baltimore
Professional CPID: 3452
Institutional CPID: 9002
Industry Standard Payer ID: R3491
Line of Business (LOB) Code: E74
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Remittance Fee: N/A
Payer Location: Maryland

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.

7/24/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: Edenbridge PACE of West Baltimore
Professional CPID: 3452
Institutional CPID: 9002
Industry Standard Payer ID: R3491
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Remittance Fee: N/A
Payer Location: Maryland

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.

7/24/2026

Update: Temporary Payer Claims Processing Suspension for Payer IDs 12115, 12116, 84147, 84146, & 80214

Update: The payer has informed us that the outage has been extended, and they now anticipate resuming processing on the evening of July 25, 2026. We will continue to monitor the situation and provide updates as they become available.

Original notify sent July 21, 2026:
It has been reported to Optum that the following payers have upcoming system changes that will require them to temporarily suspend file processing beginning July 20, 2026. They anticipate completing the work by end of day Wednesday, July 22, 2026, although the outage could potentially extend into Thursday, July 23, 2026.

During this period, Optum will continue to submit files; however, the payer will not be returning 999 acknowledgments for submitted 837 claims. Once processing resumes, the VA expects a backlog of transactions that will need to be processed, which may result in additional delays for several days after the maintenance window has ended.

Payers affected are:

Payer ID 12115 Veterans Administration Fee Basis Programs
Payer ID 12116 Veterans Administration Fee Basis Programs
Payer ID 84147 Veteran Affairs Family Members Program Dental (VFMP)
Payer ID 84146 CHAMPVA-HAC
Payer ID 80214 CHAMPVA-HAC Medicare Crossover

The following transactions may be impacted:

837 Claims
277CA Claim Acknowledgments
835 Remittance Advice Files
File Acknowledgments (including 999s)

At this time, real-time eligibility transactions are not expected to be affected by these system changes.

Action Required: None. Please be aware of this payer issue. Further notification will be sent as it is received.

7/23/2026

Presbyterian Health Plan New Real Time Eligibility 270/271 Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective July 20, 2026:

Payer Name: Presbyterian Health Plan
Industry Payer ID: 05003
IMN Real Time ID: 05003
Exchange Real Time ID: PREHP
Optum IEDI Real Time ID: 10646
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

Eligibility Dependent

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

7/23/2026

Update: Payer Change for CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island

Update: Claims sent to CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP), Payer ID 96240 are not being processed. Claims must be sent using CPIDs 2487 and 3645 Neighborhood Health Plan of Rhode Island, Payer ID 05047.

CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP) will be terminated effective July 30, 2026.

Original notification sent July 16, 2026:
Optum has received information from the payer that all Neighborhood lines of business will now share the same Payer ID effective Jan. 1, 2026. The Payer ID for all lines of business will be 05047.

Effective immediately, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: Neighborhood Health Plan of Rhode Island - Integrity (MMP)
Professional CPID: 7171
Institutional CPID: 8612
Industry Standard Payer ID: 96240

Claims sent to CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP), Payer ID 96240 are not being processed. Claims must be resent using CPIDs 2487 and 3645 Neighborhood Health Plan of Rhode Island, Payer ID 05047.

CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP) will be terminated effective July 30, 2026.

Providers must transition to the following payer for electronic claims and remittance:

Payer Name: Neighborhood Health Plan of Rhode Island
Professional CPID: 2487
Institutional CPID: 3645
Industry Standard Payer ID: 05047
Claim Par Status: Par
Claim Fee: N/A
Remittance Par Status: Non Par
Remittance Fee: N/A

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum for CPIDs 2487, 3645 Neighborhood Health Plan of Rhode Island, do not need to complete a new enrollment form.
- Providers not receiving electronic remittance through Optum for CPIDs 2487, 3645 Neighborhood Health Plan of Rhode Island, must complete a new enrollment form.
- New providers must complete a new enrollment form.

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

Action Required:

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

7/23/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Meridian PACE Solutions
Payer ID: MPSAB
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Payer Location: National

Payer Name: Veterans Affairs Financial Services Center
Payer ID: VAFSC
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Payer Location: National

Payer Name: World Trade Center Health Program
Payer ID: 58605
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Payer Location: New York

Action Required:

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

7/23/2026

Electronic Claims Connection Suspended

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

Payer Name: Friday Health Plans
CPID(s): 6851, 7634
Industry Standard Payer ID: H0657
Reason: Payer unavailable electronically.

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

7/23/2026

Remit termination Thrivent Financial Lutheran Medicare

The payers listed below are no longer available at Optum for remittance processing, effective immediately.

Payer Name: Thrivent Financial Lutheran Brotherhood Medicare
Payer ID: 30166
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Payer Name: Thrivent Financial Aid Association for Lutheran Medicare
Payer ID: 30167
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: Please make any necessary system changes.

7/23/2026

Update: Temporary Payer Claims Processing Suspension for Payers Veterans Administration Fee Basis Programs, CHAMPVA-HAC

Update: The payer has informed us that the outage has been extended, and they now anticipate resuming processing on the evening of July 25, 2026. We will continue to monitor the situation and provide updates as they become available.

Original notification sent July 17, 2026:
It has been reported to Optum that the following payers have upcoming system changes that will require them to temporarily suspend file processing beginning July 20, 2026. They anticipate completing the work by end of day Wednesday, July 22, 2026, although the outage could potentially extend into Thursday, July 23, 2026.

Payers affected are:

CPID 1507 Veterans Administration Fee Basis Programs 12115
CPID 3887 Veterans Administration Fee Basis Programs 12115
CPID 1503 CHAMPVA-HAC 84146
CPID 3807 CHAMPVA-HAC 84146

The following transactions may be impacted:

837 Claims
277CA Claim Acknowledgments
835 Remittance Advice Files
File Acknowledgments (including 999s)

At this time, real-time eligibility transactions are not expected to be affected by these system changes.

Action Required: None. Please be aware of this payer issue. Further notification will be sent as it is received.

7/23/2026

Edit Master change for CPID 6274 Inland Health Organization

Optum is changing Edit Masters for the following payer, effective July 23, 2026:

Payer Name: Inland Health Organization
Professional CPID: 6274
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: IHORG

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

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

7/23/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: Meridian PACE Solutions
Institutional CPID: 8077
Professional CPID: 2867
Industry Standard Payer ID: MPSAB
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
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.

7/23/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: World Trade Center Health Program
Institutional CPID: 6639
Professional CPID: 6741
Industry Standard Payer ID: 58605
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Remittance Fee: N/A
Payer Location: New York

Action Required:

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

7/23/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: Meridian PACE Solutions
Institutional CPID: 8077
Professional CPID: 2867
Industry Standard Payer ID: MPSAB
Line of Business (LOB) Code: N54
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
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.

7/23/2026

999 Payer Batch Rejections for CPID 6843 Northwood

Professional claims transmitted to the payer listed below from Optum July 17, 2026 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

CPID 6843 Northwood

A resolution has been implemented, and the claims were retransmitted to the payer July 23, 2026.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 10390145.

7/23/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: World Trade Center Health Program
Institutional CPID: 6639
Professional CPID: 6741
Industry Standard Payer ID: 58605
Line of Business (LOB) Code: U8D
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Remittance Fee: N/A
Payer Location: New York

Action Required:

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

7/23/2026

Remit termination Thrivent Financial Lutheran Medicare

The payers listed below are no longer available at Optum for remittance processing, effective immediately.

Payer Name: Thrivent Financial Lutheran Brotherhood Medicare
Remittance CPIDs: 2566, 1192
Industry Standard Payer ID: 30166
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Payer Name: Thrivent Financial Aid Association for Lutheran Medicare
Remittance CPIDs: 2565, 1191
Industry Standard Payer ID: 30167
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: Please make any necessary system changes.

7/23/2026

Remit termination Thrivent Financial Lutheran Medicare

The payers listed below are no longer available at Optum for remittance processing, effective immediately.

Payer Name: Thrivent Financial Lutheran Brotherhood Medicare
Remittance CPIDs: 2566, 1192
Line of Business (LOB) Code: J9I
Industry Standard Payer ID: 30166
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Payer Name: Thrivent Financial Aid Association for Lutheran Medicare
Remittance CPIDs: 2565, 1191
Line of Business (LOB) Code: J9I
Industry Standard Payer ID: 30167
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: Please make any necessary system changes.

7/23/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Veterans Affairs Financial Services Center
Institutional CPID: 6987
Industry Standard Payer ID: VAFSC
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
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.

7/23/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Veterans Affairs Financial Services Center
Institutional CPID: 6987
Industry Standard Payer ID: VAFSC
Line of Business (LOB) Code: E73
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
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.

7/23/2026

Edit Master changes for CPID 6430 Horizon Valley Medical Group and CPID 7112 Inland Faculty Medical Group Encounters

Effective July 22, 2026, Optum will be changing Edit Masters for the following payers:

Payer Name: Horizon Valley Medical Group
Professional CPID: 6430
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: HVMG1

Payer Name: Inland Faculty Medical Group Encounters
Professional CPID: 7112
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: MVMM2

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

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

7/22/2026

Report Generation Delay for CPID 2460 First Managed Care Options, Inc.

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted on July 9, 2026 and July 10, 2026.

Payer impacted:

• CPID 2460 First Managed Care Options, 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 10388435.

7/22/2026

Update: Payer Change for Payer ID 16120 Americas PPO

Update: Providers have been given an extra week to make the transition to the new Payer ID. Payer ID 16120 Americas PPO will be terminated effective July 28, 2026.

Original notification sent July 17, 2026:
Effective immediately, claims currently exchanged with the following payer must use different Payer ID.

Payer Name: Americas PPO
Payer ID: 16120

Providers should transition to the following payer immediately:
Payer Name: HealthEZ
Payer ID: 41178
Claim Par Status: Transitional

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/22/2026

Edit Master updates for CPIDs 8401 and 3051 Hoag

Optum will change Edit Masters for the following payer, effective July 22, 2026:

Payer Name: Hoag
Professional CPID: 8401
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 3051
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: HPPZZ

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

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

7/22/2026

Update: Payer Change for CPIDs 7424, 6986 Americas PPO

Update: Providers have been given an extra week to make the transition to the new CPIDs. CPIDs 7424 and 6986 Americas PPO will be terminated effective July 28, 2026.

Original notification sent July 17, 2026:
Effective immediately, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: Americas PPO
Professional CPID: 7424
Institutional CPID: 6986
Industry Standard Payer ID: 16120

CPIDs 7424 and 6986 Americas PPO will be terminated effective July 21, 2026.

Providers should transition to the following payer immediately:
Payer Name: HealthEZ
Professional CPID: 2143
Institutional CPID: 4905
Industry Standard Payer ID: 41178
Claim Par Status: Transitional
Claim Fee: N/A

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/22/2026

Original notification sent July 17, 2026:
Effective immediately, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: Americas PPO
Professional CPID: 7424
Professional Edit Master: PE_T007
Institutional CPID: 6986
Institutional Edit Master: HE9T007
Industry Standard Payer ID: 16120

CPIDs 7424 and 6986 Americas PPO will be terminated effective July 21, 2026.

Providers should transition to the following payer immediately:
Payer Name: HealthEZ
Professional CPID: 2143
Professional Edit Master: PE_T007
Institutional CPID: 4905
Institutional Edit Master: HE9T007
Industry Standard Payer ID: 41178
Claim Par Status: Transitional
Claim Fee: N/A

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required: Please make the following updates to accommodate these payer changes:

Modify related Payer Alias names to the new CPIDs.
To access the new enrollment forms, please visit Enrollment Central.

7/22/2026

AmeraPlan Electronic Claims and Remittance Connections No Longer Available

The payer listed below is no longer available at Optum for claims and remittance processing, effective July 22, 2026.

Payer Name: AmeraPlan
Payer ID: 38219
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: Please make any necessary system changes.

7/22/2026

Report Generation Delay for CPIDs 7052 and 9435 OhioRISE - Aetna Better Health of Ohio

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

Payer impacted:

CPID 7052 OhioRISE - Aetna Better Health of Ohio
CPID 9435 OhioRISE - Aetna Better Health of Ohio

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10388029.

7/22/2026

Payer Consolidation - Anthem Blue Cross Blue Shield of Colorado

Effective Aug 21, 2026, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: Anthem Blue Cross Blue Shield of Colorado
Payer ID: 00050, SB550
Claim Type: Professional
Payer ID: 15491
Claim Type: Institutional

Payer IDs 00050, SB550, 15491 will be terminated effective August 21, 2026.

Providers must begin using the following ID for electronic claims for Anthem Blue Cross Blue Shield of Colorado:

Institutional Payer ID: 12B03
Professional Payer ID: COBLS

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/21/2026

Payer Consolidation - Anthem Blue Cross Blue Shield of Maine

Effective Aug 21, 2026, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: Anthem Blue Cross Blue Shield of Maine
Payer ID: 00680, SB680
Claim Type: Professional

Payer IDs 00680, SB680 will be terminated effective August 21, 2026.

Providers must begin using the following ID for electronic claims for Anthem Blue Cross Blue Shield of Maine:

Professional Payer ID: MEBLS

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/21/2026

Edit Master for CPIDs 9757 and 8039 Healthcosmos Medical Group LLC

Effective July 21, 2026, Optum will be changing Edit Masters for the following payer:

Payer Name: Healthcosmos Medical Group LLC
Professional CPID: 9757
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 8039
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: COSAZ

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

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

7/21/2026

Report Generation Delay for CPID 3232 Health Choice Arizona

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

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 10386560.

7/21/2026

Temporary Payer Claims Processing Suspension for Payer IDs 12115, 12116, 84147, 84146, & 80214

It has been reported to Optum that the following payers have upcoming system changes that will require them to temporarily suspend file processing beginning July 20, 2026. They anticipate completing the work by end of day Wednesday, July 22, 2026, although the outage could potentially extend into Thursday, July 23, 2026.

Payers affected are:

Payer ID 12115 Veterans Administration Fee Basis Programs
Payer ID 12116 Veterans Administration Fee Basis Programs
Payer ID 84147 Veteran Affairs Family Members Program Dental (VFMP)
Payer ID 84146 CHAMPVA-HAC
Payer ID 80214 CHAMPVA-HAC Medicare Crossover

The following transactions may be impacted:

837 Claims
277CA Claim Acknowledgments
835 Remittance Advice Files
File Acknowledgments (including 999s)

At this time, real-time eligibility transactions are not expected to be affected by these system changes.

Action Required: None. Please be aware of this payer issue. Further notification will be sent as it is received.

7/21/2026

Payer Consolidation - Anthem Blue Cross Blue Shield of Connecticut

Claims currently exchanged with the following payer must use a different payer ID, effective Aug 21, 2026:

Payer Name: Anthem Blue Cross Blue Shield of Connecticut
Payer ID: 00060, SB560
Claim Type: Professional
Payer ID: 3534I
Claim Type: Institutional

Payer Name: Anthem Blue Cross Blue Shield of Connecticut Federal Employees Program

Payer ID: C2BLS
Claim Type: Professional

Payer IDs 00060, SB560, 3534I, C2BLS will be terminated effective August 21, 2026.

Providers must begin using the following ID for electronic claims for Anthem Blue Cross Blue Shield of Connecticut:

Institutional Payer ID: 12B04
Professional Payer ID: CTBLS

Providers must begin using the following ID for electronic claims for Anthem Blue Cross Blue Shield of Connecticut Federal Employees Program:

Professional Payer ID: SB563

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/21/2026

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Division of Substance Abuse and Mental Health (DSAMH)
Payer ID: DSAMH
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Delaware
Claim Par Status: Non Par

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.

7/21/2026

New electronic claims connections available

Optum has new electronic claims connections available:

Payer Name: Crumdale Claims Solution
Institutional CPID: 1924
Professional CPID: 2172
Industry Standard Payer ID: 69933
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National
Claims Fee: N/A
Par Status: Transitional

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.

7/21/2026

LIFEWISE HEALTH PLAN OF OREGON New RT CSI 276/ 277 Connection Available

Optum is pleased to announce the availability of Real-time Claim Status Inquiry and Response 276/277 for the below payer, effective July 21, 2026:

Payer Name: LIFEWISE HEALTH PLAN OF OREGON
Industry Payer ID: 93093
IMN Real Time ID: 93093
Exchange Real Time ID: WAPBC
Optum IEDI Real Time ID: 10651
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Claim Status Inquiry subscriber

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

7/21/2026

AmeraPlan Electronic Claims and Remittance Connections No Longer Available

The payer listed below will no longer be available at Optum for claims and remittance processing, effective July 22, 2026.

Payer Name: AmeraPlan
Claims and Remittance CPIDs: 4298, 4554
Line of Business (LOB) Code: H36
Industry Standard Payer ID: 38219
Reason: Payer no longer offers an electronic connection to which Optum can connect.

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

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

7/21/2026

Payer Name: AmeraPlan
Claims and Remittance CPIDs: 4298, 4554
Industry Standard Payer ID: 38219
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: Please make any necessary system changes.

7/21/2026

Report Generation Delay for CPIDs 3813 and 9061 Next Generation MyCare Anthem Blue Cross Blue Shield

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

Payer impacted:

CPID 3813 Next Generation MyCare Anthem Blue Cross Blue Shield
CPID 9061 Next Generation MyCare Anthem Blue Cross Blue Shield

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 10386452.

7/21/2026

Report Generation Delay for CPIDs 2481 and 3509 Ohio Medicaid

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

Payer impacted:

CPID 2481 Ohio Medicaid
CPID 3509 Ohio 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 10386444.

7/21/2026

Update: Electronic Claims Connection Suspended

The following payer has been reactivated and now requires providers to submit a Claims enrollment form:

CPID 7485 HealthNow Blue Cross Blue Shield of New York

Providers already submitting transactions through Optum must complete an enrollment form.

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

Action Required: All providers should submit an enrollment form to obtain authorization for this payer.

Original sent July 17, 2026:
Effective immediately, the payer listed below has been suspended at Optum for claim processing.

Payer Name: HealthNow Blue Cross Blue Shield of New York
CPID: 7485
Industry Standard Payer ID: 55204
Reason: Payer unavailable electronically.

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

7/21/2026

Report Generation Delay for CPID 9057 Sentara PACE

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 8, 2026.

Payer impacted:

CPID 9057 Sentara PACE

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10386427.

7/21/2026

New Real Time Eligibility 270/271 Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271, for the below payer, effective July 21, 2026:

Key details to use where applicable are:

Payer Name: HIP of NY
Industry Payer ID: 10406
IMN Real Time ID: HIPNY
Exchange Real Time ID: HIPNY
Optum IEDI Real Time ID: 10406
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber:

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

Action Required by customer:

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

7/21/2026

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Division of Substance Abuse and Mental Health (DSAMH)
Institutional CPID: 1685
Professional CPID: 2144
Industry Standard Payer ID: DSAMH
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Delaware
Claim Par Status: Non Par
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.

7/21/2026

Report Generation Delay for CPIDs 9500 and 3803 Kern Health Systems

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted since July 7, 2026.

Payer impacted:

• CPID 9500 Kern Health Systems
• CPID 3803 Kern Health Systems

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 10385945.

7/21/2026

Report Generation Delay for CPID 8137 Empower Healthcare Solutions

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since July 7, 2026.

Payer impacted:

• CPID 8137 Empower Healthcare Solutions

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10385092.

7/20/2026

Edit Master for CPIDs 9195 and 6041 IN Physicians Associates IPA

Effective July 20, 2026, Optum will be changing Edit Masters for the following payer:

Payer Name: IN Physicians Associates IPA
Professional CPID: 9195
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 6041
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: INP12

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

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

7/20/2026

Delay in Electronic Remittance Advice (ERA) for Payer ID 58234 Alliant Health Plans

Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for dates of June 30, 2026-July 1, 2026.

Payer ID 58234 Alliant Health Plans

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number 10370206.

7/20/2026

Delay in Electronic Remittance Advice (ERA) for CPIDs 2589, 3793 Alliant Health Plans

Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for June 30, 2026-July 1, 2026:

CPID 2579 Alliant Health Plans
CPID 3793 Alliant Health Plans

Additional updates will be forwarded as more information becomes available.

Action Required:

Please be aware of a delay in the delivery of ERA for dates above.

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number 10370206.

7/20/2026

Payer Processing Issue for CPID 7472 Blue Medicare PPO/HMO of North Carolina

Due to a payer processing issue, some Professional claims transmitted to the payer listed below July 17, 2026 were not processed by the payer.

Payer impacted:

CPID 7472 Blue Medicare PPO/HMO of North Carolina

A resolution has been implemented and the claims were retransmitted to the payer July 20, 2026.

This delay affected claims released to Optum July 16, 2026, 2:00 p.m.-July 17, 2026, 2:00 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 10385658.

7/20/2026

Report Generation Delay for CPID 6555 Klais & Company

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 7, 2026 and July 8, 2026.

Payer impacted:

CPID 6555 Klais & Company

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 10385298.

7/20/2026

Edit Master Updates - multiple payers

Optum is changing Edit Masters for the following payers, effective July 20, 2026:

Payer Name: Hollywood Presbyterian Medical Center - St Vincent IPA
Professional CPID: 7802
Current Edit Master: HE9O007
New Edit Master: HE9T007
Institutional CPID: 8570
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: AMM19

Payer Name: IEHP Covered (Covered California)
Professional CPID: 1879
Current Edit Master: HE9O007
New Edit Master: HE9T007
Institutional CPID: 3950
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: IECCA

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

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

7/20/2026

Report Generation Delay for CPID 8676 CareSource of West Virginia

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted July 7, 2026.

Payer impacted:

CPID 8676 CareSource of West Virginia

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 10385063.

7/20/2026

Report Generation Delay for CPID 6778 Common Ground Healthcare

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

Payer impacted:

• CPID 6778 Common Ground Healthcare Cooperative

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 10384964.

7/20/2026

Temporary Payer Claims Processing Suspension for CPID's 1507/3387, 1503/3807, Payers Veterans Administration Fee Basis Programs, CHAMPVA-HAC

It has been reported to Optum that the following payers have upcoming system changes that will require them to temporarily suspend file processing beginning July 20, 2026. They anticipate completing the work by end of day Wednesday, July 22, 2026, although the outage could potentially extend into Thursday, July 23, 2026.

Payers affected are:

CPID 1507 Veterans Administration Fee Basis Programs 12115
CPID 3887 Veterans Administration Fee Basis Programs 12115
CPID 1503 CHAMPVA-HAC 84146
CPID 3807 CHAMPVA-HAC 84146

The following transactions may be impacted:

837 Claims
277CA Claim Acknowledgments
835 Remittance Advice Files
File Acknowledgments (including 999s)

At this time, real-time eligibility transactions are not expected to be affected by these system changes.

Action Required: None. Please be aware of this payer issue. Further notification will be sent as it is received.

7/20/2026

Emanate Health IPA Electronic Remittance Connection No Longer Available

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

Payer Name: Emanate Health IPA
Remittance CPIDs: 8764, 4036
Industry Standard Payer ID: MPM62
Reason: Payer no longer contracted.

Action Required: Please make any necessary system changes.

7/20/2026

Emanate Health IPA Electronic Remittance Connection No Longer Available

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

Payer Name: Emanate Health IPA
Remittance CPIDs: 8764, 4036
Line of Business (LOB) Code: U2H
Industry Standard Payer ID: MPM62
Reason: Payer no longer contracted.

Action Required: Please make any necessary system changes

7/20/2026

Report Generation Delay for CPIDs 2525 and 1772 HAP CareSource

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

Payer impacted:

CPID 2525 HAP CareSource
CPID 1772 HAP CareSource

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 10384867.

7/20/2026

Report Generation Delay for CPIDs 1565 and 2786 Prime West

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted since July 7, 2026.

Payer impacted:

CPID 1565 Prime West
CPID 2786 Prime West

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 10383904.

7/20/2026

Electronic Claims Connection Suspended

The payer listed below is suspended at Optum for claim processing, effective immediately.

Payer Name: HealthNow Blue Cross Blue Shield of New York
CPID: 7485
Industry Standard Payer ID: 55204
Reason: Payer unavailable electronically.

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

7/17/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: VAFSC/ICE Health Service Corps
Payer ID: VAICE
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
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.

7/17/2026

Americas PPO - HealthEZ claims consolidation

Claims currently exchanged with the following payer must use a different Payer ID, effective immediately.

Payer Name: Americas PPO
Payer ID: 16120

Payer ID 16120 Americas PPO will be terminated effective July 30, 2026.

Providers should transition to the following payer immediately:
Payer Name: HealthEZ
Payer ID: 41178
Claim Par Status: Transitional

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/17/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: VAFSC/ICE Health Service Corps
Professional CPID: 1479
Institutional CPID: 1598
Industry Standard Payer ID: VAICE
Line of Business (LOB) Code: E72
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
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.

7/17/2026

New electronic remittance connections available

Optum has new electronic remittance connections available:

Payer Name: VAFSC/ICE Health Service Corps
Professional CPID: 1479
Institutional CPID: 1598
Industry Standard Payer ID: VAICE
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
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.

7/17/2026

Americas PPO - HealthEZ claims consolidation

Claims currently exchanged with the following payer must use different CPIDs, effective immediately.

Payer Name: Americas PPO
Professional CPID: 7424
Institutional CPID: 6986
Industry Standard Payer ID: 16120

CPIDs 7424 and 6986 Americas PPO will be terminated effective July 21, 2026.

Providers should transition to the following payer immediately:

Payer Name: HealthEZ
Professional CPID: 2143
Institutional CPID: 4905
Industry Standard Payer ID: 41178
Claim Par Status: Transitional
Claim Fee: N/A

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/17/2026

Americas PPO - HealthEZ claims consolidation

Claims currently exchanged with the following payer must use different CPIDs, effective immediately.

CPIDs 7424 and 6986 Americas PPO will be terminated effective July 21, 2026.

Providers should transition to the following payer immediately:

Payer Name: HealthEZ
Professional CPID: 2143
Professional Edit Master: PE_T007
Institutional CPID: 4905
Institutional Edit Master: HE9T007
Industry Standard Payer ID: 41178
Claim Par Status: Transitional
Claim Fee: N/A

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required: Please make the following updates to accommodate these payer changes:

Modify related Payer Alias names to the new CPIDs.
To access the new enrollment forms, please visit Enrollment Central.

7/17/2026

Payer Change for Payer ID 96240 Neighborhood Health Plan of Rhode Island - Integrity (MMP)

Optum has received information from the payer that all Neighborhood lines of business will now share the same Payer ID effective Jan. 1, 2026. The Payer ID for all lines of business is 05047.

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

Payer Name: Neighborhood Health Plan of Rhode Island - Integrity (MMP)
Payer ID: 96240

Claims sent to Neighborhood Health Plan of Rhode Island - Integrity (MMP), Payer ID 96240 are not being processed. Claims must be resent using Neighborhood Health Plan of Rhode Island, Payer ID 05047.

Payer ID 96240 Neighborhood Health Plan of Rhode Island - Integrity (MMP) will be terminated effective July 30, 2026.

Providers must transition to the following payer for electronic claims and remittance:

Payer Name: Neighborhood Health Plan of Rhode Island
Payer ID: 05047
Claim Par Status: Par
Remittance Par Status: Non Par

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum for Neighborhood Health Plan of Rhode Island, Payer ID 05047 do not need to complete a new enrollment form.
- Providers not receiving electronic remittance through Optum for Neighborhood Health Plan of Rhode Island, Payer ID 05047 must complete a new enrollment form.
- New providers must complete a new enrollment form.

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

Action Required:

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

7/17/2026

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Blue Ridge Independence at Home PACE
Payer ID: R3464
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Virginia

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.

7/17/2026

Electronic Claims Connection Reactivated - U.S. Family Health Plan Northwest Region

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

Payer Name: U.S. Family Health Plan Northwest Region
Industry Standard Payer ID: 87347
Reason: Payer unavailable electronically.

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

White Memorial Medical Center Remittance Connection No Longer Available

The payer listed below is no longer available at Optum for remittance processing, effective July 15, 2026.

Payer Name: White Memorial Medical Center
Payer ID: NMM01
Reason: Payer no longer offers an electronic connection.

Action Required: Please make any necessary system changes.

7/17/2026

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective July 16, 2026:

Payer Name: UnitedHealthcare Community Plan of New Jersey Medicaid
IMN Real Time ID: 86047
Exchange Real Time ID: NJAMCH
CPID(s): 7510 (I), 2806 (P)
Optum IEDI Real Time ID: 86047
Payer Enrollment Required: NO
Connection Type: X12

Search Options:

Eligibility Subscriber

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

Eligibility Dependent

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

Action Required by customer:

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

7/17/2026

Electronic Claims Connection Reactivated- Choice Physicians Net First Choice

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

Payer Name: Choice Physicians Net First Choice
Payer ID: CPNFC
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claim Par Status: Non Par

Original notification sent July 8, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Industry Standard Payer ID: CPNFC
Reason: Payer unavailable electronically.

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

7/17/2026

Electronic Claims Connection Suspended

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

Payer Name: New York Life Long Term Care
Industry Standard Payer ID: NYL11
Reason: Payer unavailable electronically.

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

7/17/2026

Electronic Claims Connections No Longer Available

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

Payer Name: United Group Programs
Payer ID: UGP19
Reason: Payer no longer in business.

Payer no longer accepts paper claims.

Action Required: Please make any necessary system changes.

The payer listed below is no longer available at Optum for claims processing, effective July 17, 2026.

Payer Name: Emanate Health Med Center AltaMed
Payer ID: MPM45

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

Action Required: Please be aware this payer must now be submitted on paper. Please make needed changes to accommodate the payer no longer offering an electronic connection.

7/17/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Empire Healthcare IPA
Payer ID: EHI01
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Payer Location: California

Action Required:

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

7/17/2026

Emanate Health Med Center AltaMed Electronic Claims Connection No Longer Available

Effective July 16, 2026, the payer listed below will no longer be available at Optum for claims processing.

Payer Name: Emanate Health Med Center AltaMed
Claims CPIDs: 8181, 2043
Industry Standard Payer ID: MPM45
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: Please make any necessary system changes.

7/17/2026

United Group 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: United Group Programs
Claims CPIDs: 6849, 7632
Industry Standard Payer ID: UGP19
Reason: Payer no longer in business.

Payer will no longer accept paper claims.

Action Required: Please make any necessary system changes.

7//17/2026

Update: Delay in Electronic Remittance Advice (ERA) for CPID 3807 & 1503 CHAMPVA – HAC

Update: The affected date range has been expanded through July 10, 2026.

Several impacted ERAs with check dates June 25, 2026-July 10, 2026 have now been successfully processed. We are continuing to work with the payer to resolve the remaining impacted ERAs.

Additional updates will be provided as more information becomes available.

Original notification sent July 14, 2026
We would like to give you awareness of a payer processing issue that could potentially impact your business.

Due to a payer processing issue, there has been a delay affecting some Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for check dates June 25, 2026-July 1, 2026.

Payers affected:

CPID 3807 CHAMPVA – HAC
CPID 1503 CHAMPVA – HAC

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000005179.

7/17/2026

Delay in Electronic Remittance Advice (ERA) for CHAMPVA

Update: The affected date range has been expanded through July 10, 2026.

Several impacted ERAs with check dates June 25, 2026-July 10, 2026 have now been successfully processed. We are continuing to work with the payer to resolve the remaining impacted ERAs.

Additional updates will be provided as more information becomes available.

Original notification sent April 13, 2026
We would like to give you awareness of a payer processing issue that could potentially impact your business.

Payers affected:

CPID 3807 CHAMPVA – HAC
CPID 1503 CHAMPVA – HAC

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000005179.

7/16/2026

Delay in Electronic Remittance Advice (ERA) for CHAMPVA

Update: The affected date range has been expanded through July 10, 2026.

Several impacted ERAs with check dates June 25, 2026-July 10, 2026 have now been successfully processed. We are continuing to work with the payer to resolve the remaining impacted ERAs.

Additional updates will be provided as more information becomes available.

Original notification sent April 13, 2026
We would like to give you awareness of a payer processing issue that could potentially impact your business.

Payers affected:

Payer ID 84146 CHAMPVA – HAC
Payer ID 80214 CHAMPVA – HAC Medicare Crossover

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000005179.

7/16/2026

Emanate Health Med Center AltaMed Electronic Claims Connection No Longer Available

The payer listed below is no longer available at Optum for claims processing, effective July 16, 2026.

Payer Name: Emanate Health Med Center AltaMed
Claims CPIDs: 8181, 2043
Industry Standard Payer ID: MPM45
Reason: Payer no longer offers an electronic connection to which Optum can connect.

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

7/16/2026

Electronic Routing Change for CPID 6800 HealthTexas Medical Group

Effective July 20, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: HealthTexas Medical Group
Professional CPID: 6800
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: HTHTX
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

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

Electronic Routing Change for CPID 6800 HealthTexas Medical Group

Effective July 20, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: HealthTexas Medical Group
Professional CPID: 6800
Industry Standard Payer ID: HTHTX
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:
Payer enrollment for electronic claims is not required.

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

Report Generation Delay for CPID 3509 Ohio Medicaid

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on July 14, 2026.

Payer impacted:

CPID 3509 Ohio Medicaid

The payer intermediary has been unable to generate and deliver the reports for some claims submitted on July 14, 2026.

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

If you have any questions, please contact Customer Support and refer to Case Number 10381225.

7/16/2026

Update: Electronic Claims Connection Suspended

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

Payer Name: Choice Physicians Net First Choice
Professional CPID: 1794
Institutional CPID: 8661
Payer-assigned Payer ID: CPNFC
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claim Par Status: Non Par
Claims Fee: $0.10

Original notification sent July 8, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Choice Physicians Net First Choice
CPIDs: 1794, 8661
Industry Standard Payer ID: CPNFC
Reason: Payer unavailable electronically.

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

7/16/2026

Update: Electronic Claims Connection Suspended

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

Payer Name: Choice Physicians Net First Choice
Professional CPID: 1794
Current Edit Master: PE_T007
New Edit Master: PE_B800
Institutional CPID: 8661
Current Edit Master: HE9T007
New Edit Master: HE9B801
Payer-assigned Payer ID: CPNFC
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claim Par Status: Non Par

Original notification sent July 8, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

CPIDs: 1794, 8661
Industry Standard Payer ID: CPNFC
Reason: Payer unavailable electronically.

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

7/16/2026

Routing Change Provider Partners Health Plan of Maryland

Optum is changing electronic claims routing for the following payer, effective July 20, 2026:

Payer Name: Provider Partners Health Plan of Maryland
Professional CPID: 1845
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 4505
Current Edit Master: HE9E049
New Edit Master: HE9T007
Industry Standard Payer ID: 31118
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claim Par Status: Transitional

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/16/2026

Routing Change Provider Partners Health Plan of Maryland

Optum is changing electronic claims routing for the following payer, effective July 20, 2026:

Payer Name: Provider Partners Health Plan of Maryland
Professional CPID: 1845
Institutional CPID: 4505
Industry Standard Payer ID: 31118
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claim Par Status: Transitional
Claim Fee: N/A

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/16/2026

Edit Masters HealthTexas Medical Group

Optum is changing Edit Masters for the following payer, effective July 20, 2026:

Payer Name: HealthTexas Medical Group
Institutional CPID: 2699
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: HTHTX

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

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

7/16/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Empire Healthcare IPA
Institutional CPID: 8075
Professional CPID: 2864
Industry Standard Payer ID: EHI01
Line of Business (LOB) Code: U70
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Remittance Fee: N/A
Payer Location: California

Action Required:

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

7/16/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Empire Healthcare IPA
Institutional CPID: 8075
Professional CPID: 2864
Industry Standard Payer ID: EHI01
Payer Enrollment Required: Yes
Remittance Par Status: Non Par
Remittance Fee: N/A
Payer Location: California

Action Required:

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

7/16/2026

Payer Change for CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island
Optum has received information from the payer indicating that all Neighborhood lines of business will share the same Payer ID effective Jan. 1, 2026. The Payer ID for all lines of business will be 05047.

Effective immediately, claims currently exchanged with the following payer must use different CPIDs.

CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP) will be terminated effective July 30, 2026.

Providers need to transition to the following payer for electronic claims and remittance:

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum for CPIDs 2487, 3645 Neighborhood Health Plan of Rhode Island, do not need to complete a new enrollment form.
- Providers not receiving electronic remittance through Optum for CPIDs 2487, 3645 Neighborhood Health Plan of Rhode Island, must complete a new enrollment form.
- New providers must complete a new enrollment form.

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

Action Required: Please make the following updates to accommodate these payer changes:

Modify any bridge routines based on edit masters.
Modify related Payer Alias names to the new CPIDs.
To access the new enrollment forms, please visit Enrollment Central.

7/16/2026

Metropolitan Health Plan New Real Time Eligibility 270/271 Connection Available

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

Payer Name: Metropolitan Health Plan
Industry Payer ID: 10135
IMN Real Time ID: MHPRT
Exchange Real Time ID: MTPHP
Optum IEDI Real Time ID: 10135
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

7/16/2026

Payer Change for CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island

Optum has received information from the payer that all Neighborhood lines of business will now share the same Payer ID effective Jan. 1, 2026. The Payer ID for all lines of business will be 05047.

Effective immediately, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: Neighborhood Health Plan of Rhode Island - Integrity (MMP)
Professional CPID: 7171
Institutional CPID: 8612
Industry Standard Payer ID: 96240

CPIDs 7171 and 8612 Neighborhood Health Plan of Rhode Island - Integrity (MMP) will be terminated effective July 30, 2026.

Providers must transition to the following payer for electronic claims and remittance:

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Remittance:

Payer enrollment for electronic remittance is required.
- Providers currently receiving electronic remittance through Optum for CPIDs 2487, 3645 Neighborhood Health Plan of Rhode Island, do not need to complete a new enrollment form.
- Providers not receiving electronic remittance through Optum for CPIDs 2487, 3645 Neighborhood Health Plan of Rhode Island, must complete a new enrollment form.
- New providers must complete a new enrollment form.

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

Action Required:

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

7/16/2026

New Real Time Eligibility 270/271 Connection Available

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

Payer Name: Managed Care of North America
Industry Payer ID: 14317
IMN Real Time ID: 14317
Exchange Real Time ID: MDCNA
Optum IEDI Real Time ID: 14317
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

7/16/2026

New Real Time Eligibility 270/271 and Claim Status 276/277 Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271, Claim Status Inquiry and Response 276/277 for the below payer, effective July 14, 2026:

Payer Name: MAMSI Health Plan
Industry Payer ID: 52148
IMN Real Time ID: MAMSI
Exchange Real Time ID: MAMHP
Optum IEDI Real Time ID: 10122
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

Eligibility Dependent

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

Claim Status Inquiry Subscriber

Member ID, First Name, Last Name, Date of Birth
- Optional additional elements: Payer claim number, Total submitted charges

Claim Status Inquiry Dependent

Member ID, Dependent First Name, Dependent Last Name, Dependent Date of Birth, Subscriber Last Name
- Optional additional elements: Payer claim number, Total submitted charges

7/16/2026

New Payer Edit for CPID 8834

The payer has informed Optum of a new edit requirement effective immediately. In order to meet the new requirement, we will add the following edit July 22, 2026:

PREF02A019: INVALID SERVICE LINE PRIOR AUTHORIZATION – Only one Service Line Prior Authorization Number is allowed per service line.

Note: If this requirement does not apply to your billing situation, you can override the edit within the Error Text. LOOP 2400 REF02

Edit applies to:

CPID 8834 Commonwealth Care Alliance

Action Required: Please be aware of updated edit requirements.

7/16/2026

Electronic Claims Connection Suspended

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

Payer Name: New York Life Long Term Care
CPID: 4403
Industry Standard Payer ID: NYL11
Reason: Payer unavailable electronically.

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

7/16/2026

North American Medical Management Northern California claims reroute

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: North American Medical Management - Northern California
Professional CPID: 1782
Institutional CPID: 2931
Industry Standard Payer ID: E3510
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claim Par Status: Non Par
Claim 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.

7/15/2026

North American Medical Management Northern California claims reroute

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

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.

7/15/2026

North American Medical Management Northern California claims reroute

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: North American Medical Management - Northern California
Professional CPID: 1782
Current Edit Master: PE_N000
New Edit Master: PE_B800
Institutional CPID: 2931
Current Edit Master: HE9E049
New Edit Master: HE9B801
Industry Standard Payer ID: E3510
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claim Par Status: Non Par

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/15/2026

Cherokee Nation Comprehensive Care Agency claims reroute

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: Cherokee Nation Comprehensive Care Agency
Professional CPID: 8231
Institutional CPID: 2083
Industry Standard Payer ID: CHERO
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claim Par Status: Transitional
Claim Fee: N/A

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/15/2026

Cherokee Nation Comprehensive Care Agency claims reroute

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: Cherokee Nation Comprehensive Care Agency
Professional CPID: 8231
Edit Master: PE_T007
Institutional CPID: 2083
Edit Master: HE9T007
Industry Standard Payer ID: CHERO
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claim Par Status: Transitional

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.

7/15/2026

White Memorial Medical Center Remittance Connection No Longer Available

The payer listed below is no longer available at Optum for remittance processing, effective July 15, 2026.

Payer Name: White Memorial Medical Center
Remittance CPIDs: 4154, 6626
Industry Standard Payer ID: NMM01
Reason: Payer no longer offers an electronic connection.

Action Required: Please make any necessary system changes.

7/15/2026

White Memorial Medical Center Remittance Connection No Longer Available

The payer listed below is no longer available at Optum for remittance processing, effective July 15, 2026.

Payer Name: White Memorial Medical Center
Remittance CPIDs: 4154, 6626
Line of Business (LOB) Code: U2Q
Industry Standard Payer ID: NMM01
Reason: Payer no longer offers an electronic connection.

Action Required: Please make any necessary system changes.

7/15/2026

Electronic Routing Change for CPIDs 8222 and 2077 Provider Partners Health Plan of Pennsylvania

Effective July 15, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: Provider Partners Health Plan of Pennsylvania
Professional CPID: 8222
Current Edit Master: PE_C051
New Edit Master: PE_T007
Institutional CPID: 2077
Current Edit Master: HE9C051
New Edit Master: HE9T007
Industry Standard Payer ID: 31400
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claim Par Status: Transitional

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

7/15/2026

Update: Electronic Claims Connection Suspended

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

Payer Name: U.S. Family Health Plan Northwest Region
Professional CPID: 2868
Current Edit Master: PE_T007
New Edit Master: PE_B800
Institutional CPID: 8071
Current Edit Master: HE9T007
New Edit Master: HE9B801
Payer-assigned Payer ID: 87347
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claim Par Status: Non Par

Original notification sent on July 8, 2026

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

Payer Name: U.S. Family Health Plan Northwest Region
CPID(s): 2868, 8071
Industry Standard Payer ID: 87347
Reason: Payer unavailable electronically.

Action Required: Please refrain from submitting claims until further notice

7/15/2026

Electronic Routing Change for CPIDs 8222 and 2077 Provider Partners Health

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: Provider Partners Health Plan of Pennsylvania
Professional CPID: 8222
Institutional CPID: 2077
Industry Standard Payer ID: 31400
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claim Par Status: Transitional
Claim Fee: N/A

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/15/2026

Update: Electronic Claims Connection Suspended

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

Payer Name: U.S. Family Health Plan Northwest Region
Professional CPID: 2868
Institutional CPID: 8071
Payer-assigned Payer ID: 87347
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claim Par Status: Non Par
Claim Fee: $0.10

Original notification sent July 8, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: U.S. Family Health Plan Northwest Region
CPID(s): 2868, 8071
Industry Standard Payer ID: 87347
Reason: Payer unavailable electronically.

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

7/15/2026

Report Generation Delay for CPID 6130 Premier Eye Care

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted since July 7, 2026.

Payer impacted:

CPID 6130 Premier Eye Care

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 10378935.

7/15/2026

Electronic Claims Connection Suspended

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

Payer Name: Gonzaba Medical Group
Payer ID: GMGSA
Reason: Payer unavailable electronically.

Payer Name: West Suburban Health Providers
Payer ID: 80942
Reason: Payer unavailable electronically.

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

7/14/2026

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Blue Ridge Independence at Home PACE
Institutional CPID: 1906
Professional CPID: 2152
Industry Standard Payer ID: R3464
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Virginia
Claims Fee: N/A

Action Required:

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

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

7/14/2026

Electronic Claims Connection Suspended

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

Payer Name: West Suburban Health Providers
CPID(s): 4620, 6137
Industry Standard Payer ID: 80942
Reason: Payer unavailable electronically.

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

7/14/2026

Report Generation Delay for CPID 6987 Veterans Affairs Financial Services Center

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

Payer impacted:

CPID 6987 Veterans Affairs Financial Services Center

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 10377847.

7/14/2026

Electronic Claims Connection Suspended

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

Payer Name: Gonzaba Medical Group
CPIDs: 3017, 8266
Industry Standard Payer ID: GMGSA
Reason: Payer unavailable electronically.

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

7/14/2026

Edit Master for CPIDs 8722 and 3099 Health Source MSO

Optum is changing Edit Masters for the following payer, effective July 14, 2026:

Payer Name: Health Source MSO
Professional CPID: 8722
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 3099
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: HSMSO

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

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

7/14/2026

Payer Consolidation - Blue Cross Blue Shield of Arizona

Effective Aug 13, 2026, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: Blue Cross Blue Shield of Arizona
Payer ID: 12B02
Claim Type: Institutional
Payer ID: 53589, BCBSAZ, SB530
Claim Type: Professional

Payer IDs 12B02, BCBSAZ, 53589 (Prof), SB530 will be terminated effective August 14, 2026.

Providers must begin using the following ID for electronic claims for Blue Cross Blue Shield of Arizona:

Institutional Payer ID: 53589
Professional Payer ID: AZBLS

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/14/2026

Payer Consolidation - Blue Cross Blue Shield of Minnesota

Claims currently exchanged with the following payer must use a different payer ID, effective Aug 13, 2026:

Payer Name: Blue Cross Blue Shield of Minnesota
Payer ID: 00220, 00720, 00722, MNBLS
Claim Type: Professional

Payer IDs 00220, 00720, 00722, MNBLS will be terminated effective August 14, 2026.

Providers must begin using the following ID for electronic claims for Blue Cross Blue Shield of Minnesota:

Professional Payer ID: SB720

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/14/2026

Payer Consolidation - Blue Cross Blue Shield of North Dakota

Claims currently exchanged with the following payer must use a different payer ID, effective Aug 13, 2026:

Payer Name: Blue Cross Blue Shield of North Dakota
Payer ID: 55891, NDBLS
Claim Type: Professional

Payer IDs 55891, NDBLS will be terminated effective August 14, 2026.

Providers must begin using the following ID for electronic claims for Blue Cross Blue Shield of North Dakota:

Institutional Payer ID: 12B78
Professional Payer ID: SB820

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/14/2026

Payer Consolidation - Blue Cross Blue Shield of South Carolina

Claims currently exchanged with the following payer must use a different payer ID, effective immediately:

Payer Name: Blue Cross Blue Shield of South Carolina
Payer ID: 00401, SC402, SCBLS, SX084, SX085, SX103, SX104
Claim Type: Professional

Payer IDs 00401, SC402, SCBLS, SX084, SX085, SX103, SX104 will be terminated effective August 14, 2026.

Providers must begin using the following ID for electronic claims for Blue Cross Blue Shield of South Carolina:

Professional Payer ID: SB880

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/14/2026

Report Generation Delay for CPIDs 9054 and 3788 CareSource Nevada Medicaid

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

Payer impacted:

CPID 9054 CareSource Nevada Medicaid
CPID 3788 CareSource Nevada 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 10376932.

7/14/2026

Report Generation Delay for CPIDs 4093 and 8834 Commonwealth Care Alliance

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since June 27, 2026.

Payer impacted:

CPID 4093 Commonwealth Care Alliance
CPID 8834 Commonwealth Care Alliance

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10376227.

7/14/2026

Report Generation Delay for CPID 9414 Evry Health

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

Payer impacted:

CPID 9414 Evry Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10376225.

7/14/2026

Delay in Electronic Remittance Advice (ERA) for CPID 3807 & 1503, CHAMPVA – HAC

Due to a payer processing issue, there has been a delay affecting some Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for check dates June 25, 2026-July 1, 2026.

Payer affected:

CPID 3807 CHAMPVA – HAC
CPID 1503 CHAMPVA – HAC

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000005179.

7/14/2026

Payer Processing Issue for CPID 2297 Health Services for Children

Due to a payer processing issue, some Professional claims transmitted to the payer listed below July 10, 2026 were not processed by the payer.

Payer impacted:

CPID 2297 Health Services for Children with Special Needs

A resolution has been implemented and the claims were retransmitted to the payer July 14, 2026.

This delay affected claims released to Optum July 9, 2026, 9:00 a.m.-July 10, 2026, 9:00 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 10376536.

7/14/2026

PAR Status Change for Island Home Insurance (ISLAH)

Effective August 12, 2026, the PAR Status will change for the following eligibility payer:

Island Home Insurance
IMN ID: ISLAH
Transaction: Eligibility
New PAR Status: Non Par

Action Required: Please be aware of the upcoming PAR Status change.

7/13/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: HealthLink PPO
Payer ID: 90001
Payer Enrollment Required: Yes
Payer Location: Arkansas, Illinois, Kentucky, Missouri, Ohio

Payer Name: Memorial Medical Center
Payer ID: 87166
Payer Enrollment Required: Yes
Payer Location: California

Action Required:

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

7/13/2026

Electronic Routing Change for CPIDs 8941 and 3408 Provider Partners Health Plans of North Carolina

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: Provider Partners Health Plans of North Carolina
Professional CPID: 3408
Current Edit Master: PE_C051
New Edit Master: PE_T007
Institutional CPID: 8941
Current Edit Master: HE9C051
New Edit Master: HE9T007
Industry Standard Payer ID: 31406
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/13/2026

Electronic Routing Change for CPIDs 8941 and 3408 Provider Partners Health Plans of North Carolina

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: Provider Partners Health Plans of North Carolina
Professional CPID: 3408
Institutional CPID: 8941
Industry Standard Payer ID: 31406
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/13/2026

Electronic Routing Change for CPIDs 7023 and 9407 Provider Partners Health Plans of Texas

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: Provider Partners Health Plans of Texas
Professional CPID: 9407
Current Edit Master: PE_C051
New Edit Master: PE_T007
Institutional CPID: 7023
Current Edit Master: HE9C051
New Edit Master: HE9T007
Industry Standard Payer ID: 31405
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/13/2026

Electronic Routing Change for CPIDs 7023 and 9407 Provider Partners Health Plans of Texas

Optum is changing electronic claims routing for the following payer, effective July 15, 2026:

Payer Name: Provider Partners Health Plans of Texas
Professional CPID: 9407
Institutional CPID: 7023
Industry Standard Payer ID: 31405
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/13/2026

Edit Master for Health Network Solutions Blue Cross Blue Shield of North Carolina and Health Network Solutions Select Health South Carolina

Optum is changing Edit Masters for the following payers, effective July 13, 2026:

Payer Name: Health Network Solutions Blue Cross Blue Shield of North Carolina
Professional CPID: 7206
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: HBC01

Payer Name: Health Network Solutions Select Health South Carolina
Professional CPID: 7198
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: HSH02

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

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

7/13/2026

Edit Master for CPIDs 4292 and 5678 Health Plan of San Mateo
Optum is changing Edit Masters for the following payer, effective July 13, 2026:

Payer Name: Health Plan of San Mateo
Professional CPID: 4292
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 5678
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: HPSM1

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

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

7/13/2026

Electronic Routing Change for CPIDs 2134 and 4669 Freedom Life Insurance Company

Optum is changing electronic claims routing for the following payer, effective July 13, 2026:

Payer Name: Freedom Life Insurance Company
Professional CPID: 2134
Institutional CPID: 4669
Industry Standard Payer ID: 62324
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/13/2026

Electronic Routing Change for CPIDs 2134 and 4669 Freedom Life Insurance Company

Optum is changing electronic claims routing for the following payer, effective July 13, 2026:

Payer Name: Freedom Life Insurance Company
Professional CPID: 2134
Current Edit Master: PE_C051
New Edit Master: PE_T007
Institutional CPID: 4669
Current Edit Master: HE9C051
New Edit Master: HE9T007
Industry Standard Payer ID: 62324
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/13/2026

Update: Electronic Claims Connection Suspended

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

Payer Name: Dignity Health Sacramento Hospital
Professional CPID: 8232
Institutional CPID: 2084
Payer-assigned Payer ID: HOSH1
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: N/A

Original notification sent July 8, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Dignity Health Sacramento Hospital
CPIDs: 8232, 2084
Industry Standard Payer ID: HOSH1
Reason: Payer unavailable electronically.

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

7/13/2026

Update: Electronic Claims Connection Suspended

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

Payer Name: Dignity Health Sacramento Hospital
Professional CPID: 8232
Edit Master: PE_T007
Institutional CPID: 2084
Edit Master: HE9T007
Payer-assigned Payer ID: HOSH1
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Original notification sent July 8, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Dignity Health Sacramento Hospital
CPIDs: 8232, 2084
Industry Standard Payer ID: HOSH1
Reason: Payer unavailable electronically.

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

7/13/2026

Report Generation Delay for CPID 8848 Clever Care Health Plan, Inc.

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted July 6, 2026 and July 7, 2026.

Payer impacted:

CPID 8848 Clever Care Health Plan, Inc.

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10375312.

7/13/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Memorial Medical Center
Professional CPID: 1711
Industry Standard Payer ID: 87166
Line of Business (LOB) Code: K16
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California

Action Required:

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

7/13/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Memorial Medical Center
Professional CPID: 1711
Industry Standard Payer ID: 87166
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California

Action Required:

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

7/13/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: HealthLink PPO
Professional CPID: 4448
Institutional CPID: 8508
Industry Standard Payer ID: 90001
Line of Business (LOB) Code: E71
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Arkansas, Illinois, Kentucky, Missouri, Ohio

Action Required:

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

7/13/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: HealthLink PPO
Professional CPID: 4448
Institutional CPID: 8508
Industry Standard Payer ID: 90001
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Arkansas, Illinois, Kentucky, Missouri, Ohio

Action Required:

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

7/13/2026

Lone Star Medical Group New Real Time Eligibility 270/271 Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective July 9, 2026:

Payer Name: Lone Star Medical Group
Industry Payer ID: LNSTR
IMN Real Time ID: LNSTR
Exchange Real Time ID: LNSTR
Optum IEDI Real Time ID: 11013
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

Eligibility Dependent

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

Action Required by customer:

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

7/14/2026

Electronic Claims Connection Suspended

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

Payer Name: Preferred Benefit Administrators (Longwood, Florida)
CPID(s): 1652, 3198
Industry Standard Payer ID: 53476
Reason: Payer unavailable electronically.

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

7/10/2026

Report Generation Delay for CPIDs 7868 and 1039 South Country Health Alliance

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted since July 1, 2026.

Payer impacted:

CPID 7868 South Country Health Alliance
CPID 1039 South Country Health Alliance

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 10373926.

7/10/2026

Electronic Claims Connection Suspended- Preferred Benefit Administrators (Longwood, Florida)

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

Payer Name: Preferred Benefit Administrators (Longwood, Florida)
Payer ID: 53476
Reason: Payer unavailable electronically.

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

7/10/2026

Report Generation Delay for CPID 2525 HAP CareSource

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted June 26, 2026.

Payer impacted:

CPID 2525 HAP CareSource

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 10373583.

7/10/2026

Report Generation Delay for CPIDs 2570 and 1194 CareSource of Georgia

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

Payer impacted:

CPID 2570 CareSource of Georgia
CPID 1194 CareSource of Georgia

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 10373449.

7/10/2026

Report Generation Delay for CPID 3788 CareSource Nevada Medicaid

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

Payer impacted:

CPID 3788 CareSource Nevada Medicaid

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 10373106.

7/10/2026

Electronic Routing Change for CPIDs 8412 and 3053 Provider Partners Health Plan of Illinois

Optum is changing electronic claims routing for the following payer, effective July 13, 2026:

Payer Name: Provider Partners Health Plan of Illinois
Professional CPID: 8412
Institutional CPID: 3053
Industry Standard Payer ID: 31401
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/10/2026

Electronic Routing Change for CPIDs 8412 and 3053 Provider Partners Health Plan of Illinois

Optum is changing electronic claims routing for the following payer, effective July 13, 2026:

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.

7/10/2026

Report Generation Delay for CPIDs 7688 and 7143 CareSource of Indiana

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

Payer impacted:

CPID 7688 CareSource of Indiana
CPID 7143 CareSource of Indiana

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 10373196.

7/10/2026

New electronic eligibility connection available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective July 8, 2026:

Payer Name: Providence PACE CA, OR & WA Elderplace
IMN Real Time ID: 77240
Exchange Real Time ID: PRVPCA
CPID(s): 4088 (I), 8830 (P)
Optum IEDI Real Time ID: 77240
Payer Enrollment Required: NO
Connection Type: X12

Search Options:
Eligibility Subscriber

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

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

7/10/2026

Report Generation Delay for CPIDs 6802 and 6695 Center for Elders Independence

Update: The payer has been unable to generate and deliver the reports for some claims submitted between June 2, 2026 and June 11, 2026.

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

Original notice sent July 6, 2026:

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

Payer impacted:

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

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 10367389.

7/10/2026

Update: Report Generation Delay for CPIDs 2296 and 8972 MetroPlus Health Plan

Update: The payer has been unable to generate and deliver the reports for some claims submitted between June 1, 2026 and June 3, 2026.

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

Original notice sent July 2, 2026:

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted between June 1, 2026 and June 3, 2026.

Payer impacted:

CPID 2296 MetroPlus Health Plan
CPID 8972 MetroPlus Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10338139.

7/10/2026

Electronic Claims Connection Suspended - SOMOS Emblem

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

Payer Name: SOMOS Emblem
Payer ID: 81336
Reason: Payer unavailable electronically.

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

7/9/2026

New Electronic Remittance (ERA) Connections Available on RPA

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

75234 – HealthFirst TPA (Tyler, TX)
84133 – Denver Health and Hospital Authority
BKRFM – Bakersfield Family Medical Center
MAI58 – VitalCore Millette

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

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

7/9/2026

New Real-time Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective July 8, 2026:

Payer Name: KELSEY-SEYBOLD
Industry Payer ID: KELSE, KELSI
IMN Real Time ID: KELSE
Exchange Real Time ID: KELSE
Optum IEDI Real Time ID: 14336
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber

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

Action Required by customer:

7/9/2026

Electronic Routing Change for CPIDs 1907 and 2285 iCare (Independent Care Health Plan)

Optum is changing electronic claims routing for the following payer, effective July 13, 2026:

Payer Name: iCare (Independent Care Health Plan)
Professional CPID: 2285
Current Edit Master: PE_C051
New Edit Master: PE_T007
Institutional CPID: 1907
Current Edit Master: HE9C051
New Edit Master: HE9T007
Industry Standard Payer ID: 11695
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/9/2026

Electronic Routing Change for CPIDs 1907 and 2285 iCare (Independent Care Health Plan)

Optum is changing electronic claims routing for the following payer, effective July 13, 2026:

Payer Name: iCare (Independent Care Health Plan)
Professional CPID: 2285
Institutional CPID: 1907
Industry Standard Payer ID: 11695
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/9/2026

Electronic Claims Connection Suspended

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

Payer Name: SOMOS Emblem
CPID(s): 4072, 8816
Industry Standard Payer ID: 81336
Reason: Payer unavailable electronically.

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

7/9/2026

Report Generation Delay for CPID 5981 Freedom Health Plan

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted June 30, 2026.

Payer impacted:

CPID 5981 Freedom 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 10371769.

7/9/2026

Central Health Medicare Plan New RT Eligibility 270/271 Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective July 8, 2026:

Payer Name: Central Health Medicare Plan
Industry Payer ID: CHCPI
IMN Real Time ID: CHCPI
Exchange Real Time ID: CNHLT
Optum IEDI Real Time ID: 14305
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

Eligibility Dependent

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

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

7/9/2026

Report Generation Delay for CPIDs 2526 and 3826 CareSource of Ohio

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

Payer impacted:

CPID 2526 CareSource of Ohio
CPID 3826 CareSource of Ohio

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10371634.

7/9/2026

Electronic Routing Change for CPIDs 3223 and 8533 Provider Partners Health Plan of Indiana

Optum is changing electronic claims routing for the following payer, effective July 13, 2026:

Payer Name: Provider Partners Health Plan of Indiana
Professional CPID: 3223
Institutional CPID: 8533
Industry Standard Payer ID: 31407
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/9/2026

Electronic Routing Change for CPIDs 3223 and 8533 Provider Partners Health Plan of Indiana

Optum is changing electronic claims routing for the following payer, effective July 13, 2026:

Payer Name: Provider Partners Health Plan of Indiana
Professional CPID: 3223
Current Edit Master: PE_C051
New Edit Master: PE_T007
Institutional CPID: 8533
Current Edit Master: HE9C051
New Edit Master: HE9T007
Industry Standard Payer ID: 31407
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/9/2026

Electronic Routing Change for Payer ID R3460 PACE Southeast Michigan

Optum is changing electronic remittance routing for the following payer, effective July 9, 2026:

Payer Name: PACE Southeast Michigan
Payer ID: R3460
Payer Remittance Enrollment Required: Yes
New Par Status: Nonpar

Enrollment Requirements:
Remittance:

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

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

To access the new enrollment forms, please visit IEDI.

7/9/2026

Electronic Claims Connection Suspended

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

Payer Name: Choice Physicians Net First Choice
Payer ID: CPNFC
Reason: Payer unavailable electronically.

Payer Name: HeadsUp Healthcare
Payer ID: RP067
Reason: Payer unavailable electronically.

Payer Name: Peak Pace Solutions
Payer ID: 27034
Reason: Payer unavailable electronically.

Payer Name: The Macaluso Group
Payer ID: 82694
Reason: Payer unavailable electronically.

Payer Name: U.S. Family Health Plan Northwest Region
Payer ID: 87347
Reason: Payer unavailable electronically.

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

7/9/2026

Report Generation Delay for CPID 5422 Klais & Company

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on June 29, 2026 and June 30, 2026.

Payer impacted:

CPID 5422 Klais & Company

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 10371291.

7/9/2026

Electronic Claims Connection Suspended

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

Payer Names:

U.S. Family Health Plan Northwest Region

- - CPIDs 2868, 8071
  - Industry Standard Payer ID 87347

Choice Physicians Net First Choice

- - CPIDs 1794, 8661
  - Industry Standard Payer ID CPNFC

Peak Pace Solutions

- 5663, 6862
- Industry Standard Payer ID 27034

Reason: Payers unavailable electronically.

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

7/9/2026

Real-time Eligibility Termination for Payer ID 62179 on RPA

Real Time Eligibility 270/271 transactions for the payer listed below are no longer available at Optum, on the Revenue Performance Advisor system, effective immediately.

Payer Name: Health Choice Arizona
RPA Payer ID: 62179

Reason: Payer no longer offers an electronic connection.

Action Required:

Providers should review the patient's current insurance ID card for claim filing information. Remove the above Payer ID within your practice management software or contact your software vendor for assistance, as needed.

7/9/2026

Update: Report Generation Delay for CPIDs 5654 and 6296 Vivant Health

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

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

Original notice sent July 2, 2026:

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

Payer impacted:

CPID 5654 Vivant Health
CPID 6296 Vivant Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10365746.

7/8/2026

Electronic Routing Change for CPIDs 8980 and 7279 PACE Southeast Michigan

Effective July 08, 2026, Optum will be changing electronic remittance routing for the following payer:

Payer Name: PACE Southeast Michigan
Professional CPID: 7279
Institutional CPID: 8980
Industry Standard Payer ID: R3460
Payer Remittance Enrollment Required: Yes

Enrollment Requirements:

Remittance:

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

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

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

7/8/2026

Electronic Routing Change for CPIDs 8980 and 7279 PACE Southeast Michigan

Effective July 08, 2026, Optum will be changing electronic remittance routing for the following payer:

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

Enrollment Requirements:

Remittance:

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

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

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

7/8/2026

Electronic Claims Connection Suspended

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

Payer Name: HeadsUp Healthcare
CPID(s): 9483, 7080
Industry Standard Payer ID: RP067

Reason: Payer unavailable electronically.

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

7/8/2026

Report Generation Delay for CPIDs 3447 and 3568 CenCal Health

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since July 3, 2026.

Payer impacted:

CPID 3447 CenCal Health
CPID 3568 CenCal Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10370540.

7/8/2026

Electronic Claims Connection Suspended - Dignity Health Sacramento Hospital

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

Payer Name: Dignity Health Sacramento Hospital
CPID(s): 8232, 2084
Industry Standard Payer ID: HOSH1
Reason: Payer unavailable electronically.

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

7/8/2026

Electronic Claims Connection Suspended

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

Payer Name: The Macaluso Group
CPID(s): 1273, 6517
Industry Standard Payer ID: 82694
Reason: Payer unavailable electronically.

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

7/8/2026

Edit Master for CPIDs 5687 and 6706 Healthcare Partners of Arizona

Optum is changing Edit Masters for the following payer, effective July 9, 2026:

Payer Name: Healthcare Partners of Arizona
Professional CPID: 6706
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 5687
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: HCP02

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

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

7/8/2026

Update: Report Generation Delay for CPIDs 3259 and 8541 MERP Administration Services

Update: The payer has been unable to generate and deliver the reports for some claims submitted June 12, 2026 and June 30, 2026.

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

Original notice sent June 22, 2026:
A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since June 11, 2026.

Payer impacted:

CPID 3259 MERP Administration Services
CPID 8541 MERP Administration Services

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 10354383.

7/8/2026

Electronic Routing Change for CPIDs 5869 El Proyecto Del Barrio

Effective July 8, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: El Proyecto Del Barrio
Professional CPID: 5869
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: MPM04
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 CPID are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

7/8/2026

Edit Master for CPID 8691 El Proyecto Del Barrio

Effective July 8, 2026, Optum will be changing Edit Masters for the following payer:

Payer Name: El Proyecto Del Barrio
Institutional CPID: 8691
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: MPM04

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

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

7/8/2026

Electronic Routing Change for CPIDs 5869 El Proyecto Del Barrio

Effective July 8, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: El Proyecto Del Barrio
Professional CPID: 5869
Industry Standard Payer ID: MPM04
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

7/8/2026

New Real-time Eligibility and Claim Status Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271, Claim Status Inquiry and Response 276/277 for the below payer, effective June 30, 2026:

Payer Name: HSBS Memphis FKA Pittman and Associates
Industry Payer ID: 10408
IMN Real Time ID: 10408
Exchange Real Time ID: HSBSM
Optum IEDI Real Time ID: 10408
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber

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

Claim Status Inquiry subscriber

Member ID, First Name, Last Name, Date of Birth
- Optional additional elements: Payer claim number; Total submitted charges

Action Required by customer:

7/8/2026

Edit Master for Health Services Management and HealthCosmos of New Mexico LLC

Optum is changing Edit Masters for the following payers, effective July 8, 2026:

Payer Name: Health Services Management
Professional CPID: 7243
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 8679
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: HSM01

Payer Name: HealthCosmos of New Mexico LLC
Professional CPID: 1724
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 1676
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: COSNM

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

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

7/8/2026

Electronic Claims Connection Suspended- United Group Programs

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

Payer Name: United Group Programs
Payer ID: UGP19
Reason: Payer unavailable electronically.

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

7/8/2026

Electronic Claims Connection Suspended

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

Payer Name: United Group Programs
CPIDs: 6849, 7632
Industry Standard Payer ID: UGP19
Reason: Payer unavailable electronically.

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

7/8/2026

Report Generation Delay for CPID 7459 Priority Health of Michigan

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

Payer impacted:

CPID 7459 Priority Health of Michigan

The payer has been unable to generate and deliver the reports for some claims submitted July 2, 2026.

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

If you have any questions, please contact Customer Support and refer to Case Number 10370022.

7/8/2026

Report Generation Delay for CPIDs 1942 and 3764 IMCare

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted since July 1, 2026.

Payer impacted:

CPID 1942 IMCare
CPID 3764 IMCare

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 10369931.

7/8/2026

Electronic Routing Change for CPIDs 8466 and 3064 Longevity Health Plan of New Jersey

Optum is changing electronic remittance routing for the following payer, effective July 8, 2026:

Payer Name: Longevity Health Plan of New Jersey
Professional CPID: 8466
Institutional CPID: 3064
Industry Standard Payer ID: LNJ01
Line of Business Code (LOB): N34
Payer Remittance Enrollment Required: Yes

Enrollment Requirements:
Remittance:

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

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

No Payer Alias changes are required. Payer name and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

7/8/2026

Electronic Routing Change for CPIDs 8466 and 3064 Longevity Health Plan of New Jersey

Optum is changing electronic remittance routing for the following payer, effective July 8, 2026:

Payer Name: Longevity Health Plan of New Jersey
Professional CPID: 8466
Institutional CPID: 3064
Industry Standard Payer ID: LNJ01
Payer Remittance Enrollment Required: Yes

Enrollment Requirements:
Remittance:

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

Action Required: Please 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.

7/8/2026

Real-time Claim Status Connection No Longer Available

Optum is announcing the termination of Real-time Claim Status Inquiry and Response 276/277 for the below payer, effective July 8, 2026:

Key details to use where applicable are:

Payer Name: Community First Health Plan
Industry Payer ID: COMMF
IMN Real Time ID: COMMF
Optum IEDI Real Time ID: 14375
Payer Enrollment Required: No
Connection Type: X12

7/8/2026

Report Generation Delay for CPID 5676 Alliance Behavioral Healthcare

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on June 27, 2026.

Payer impacted:

CPID 5676 Alliance Behavioral Healthcare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10369262.

7/7/2026

Report Generation Delay for CPID 6284 Trillium Health Resources

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted on June 18, 2026 and July 1, 2026.

Payer impacted:

CPID 6284 Trillium Health Resources

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10368911.

7/7/2026

Update: Report Generation Delay for CPIDs 9500 and 3803 Kern Health Systems

Update: The payer has been unable to generate and deliver the reports for some claims submitted on June 24, 2026.

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

Original notice sent June 30, 2026:

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted on June 24, 2026.

Payer impacted:

CPID 9500 Kern Health Systems
CPID 3803 Kern Health Systems

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 10362407.

7/7/2026

Report Generation Delay for CPID 2803 UPMC Health Plan

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted June 26, 2026.

Payer impacted:

CPID 2803 UPMC Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10369071.

7/7/2026

Edit Master for CPIDs 1767 and 1988 Global TBSP

Optum is changing Edit Masters for the following payer, effective July 7, 2026:

Payer Name: Global TBSP
Professional CPID: 1767
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 1988
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: MPM64

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

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

7/7/2026

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Amada Health (Los Angeles and Orange County)
Payer ID: AMDA2
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: CA

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.

7/7/2026

Electronic Routing Change for CPIDs 4267 and 3965 Healthcare Solutions Group

Optum is changing electronic claims routing for the following payer, effective July 7, 2026:

Payer Name: Healthcare Solutions Group
Professional CPID: 4267
Current Edit Master: PE_N000
New Edit Master: PE_T007
Institutional CPID: 3965
Current Edit Master: HE9N000
New Edit Master: HE9T007
Industry Standard Payer ID: 73147
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/7/2026

Electronic Routing Change for CPIDs 4267 and 3965 Healthcare Solutions Group

Optum is changing electronic claims routing for the following payer, effective July 7, 2026:

Payer Name: Healthcare Solutions Group
Professional CPID: 4267
Institutional CPID: 3965
Industry Standard Payer ID: 73147
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/7/2026

VillageCareMAX Electronic Eligibility Connection No Longer Available

Real Time Eligibility 270/271 for the payer listed below is no longer available at Optum, effective immediately.

Payer Name: VillageCareMAX
Industry Payer ID: 26545
Exchange Real Time ID: VCMX1
CPIDs: 7620, 6834
Connection Type: Portal

Reason: Payer no longer offers an electronic connection.

Action Required: None.

7/7/2026

Blue Cross Blue Shield of Arizona Electronic Eligibility Connection No Longer Available

Real Time Eligibility 270/271 for the payer listed below is no longer available at Optum, effective immediately.

Payer Name: Blue Cross Blue Shield of Arizona
Industry Payer ID: 53589
Exchange Real Time ID: AZBCB1
CPIDs: 5547, 4426
Connection Type: Portal

Reason: Payer no longer offers an electronic connection.

Action Required: None.

7/7/2026

Report Generation Delay for CPID 9685 Direct Care Administrators

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on June 18, 2026 and June 22, 2026.

Payer impacted:

CPID 9685 Direct Care Administrators

The payer intermediary has been unable to generate and deliver the reports for some claims submitted on June 18, 2026 and June 22, 2026.

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

If you have any questions, please contact Customer Support and refer to Case Number 10367418.

7/7/2026

Report Generation Delay for CPIDs 6802 and 6695 Center for Elders Independence

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

Payer impacted:

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

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 10367389.

7/7/2026

Delay in Electronic Remittance Advice (ERA) for payer Brio Living Services

There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) delivery for the following payer since June 22.

Payer Name: Brio Living Services
Payer ID/CPID(s)
LifeCircles PACE - 71498 (1037, 7866)
The Cascade PACE - RP044 (7034, 9418)
Huron Valley Pace - 54750 (9634, 7463)

Optum is actively investigating the issue and working to restore normal processing and delivery of the impacted ERA files.

Action Required: Please be aware that ERA files for the payer IDs listed above may be delayed. No action is required at this time. Updates will be provided as additional information becomes available.

We apologize for the inconvenience and appreciate your patience as we work toward resolution.

7/7/2026

New Clearance Payer Connections July 7, 2026

Optum has new electronic eligibility connections available:

Payer Name: Oxford Life Insurance Company
Connection Type: X12

Payer Name: Recall Systems: Group & Pension Administrators
Connection Type: X12

Full list of payers available for Eligibility transactions through Optum Clearance Patient Access Eligibility Payer List.

Action Required: If you wish to submit eligibility transactions to the payers above, please take the following actions:

Submit a request to be connected to any of the payers via the Customer Care Hub.
To access the full payer list, login to the Community:
- Already have an account? Login to your Community account.
- Go to Connect > Revenue Excellence (RCM) > Clearance Patient Access Suite > Payer List
Don’t have an account? Register for a Community account at the link above and wait for full access to be provided (up to 1 business day after registration is submitted).

If further assistance is needed contact support at [email protected] or 800-527-8133 Option 4.

7/7/2026

Report Generation Delay for CPID 2005 Empower Healthcare Solutions

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted June 26, 2026.

Payer impacted:

CPID 2005 Empower Healthcare Solutions

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 10367985.

7/7/2026

Electronic Routing Change for CPIDs 1479 and 1598 VAFSC/ICE Health Services Corps

UPDATE: Only claims with dates of service Oct. 1, 2022-Sept. 30, 2025, should be submitted to these CPIDs.

Original message sent June 19, 2026
Effective June 25, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: VAFSC/ICE Health Services Corps
Professional CPID: 1479
Institutional CPID: 1598
Industry Standard Payer ID: VAICE
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

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

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

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

7/6/2026

DOS update Routing change VAFSC/ICE Health Services Corps

UPDATE: Only claims with dates of service Oct. 1, 2022-Sept. 30, 2025, should be submitted to these CPIDs.

Original message sent June 19, 2026
Effective June 25, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: VAFSC/ICE Health Services Corps
Professional CPID: 1479
Edit Master: PE_T007
Institutional CPID: 1598
Edit Master: HE9T007
Industry Standard Payer ID: VAICE
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.

7/6/2026

Processing Issue for CPID 7278 Marpai Health

Due to a processing issue, some Professional claims transmitted to the payer listed below June 16, 2026 were not processed by the payer.

Payer impacted:

CPID 7278 Marpai Health

A resolution has been implemented and the claims were retransmitted to the payer July 6, 2026.

This delay affected claims released to Optum June 15, 2026, 5:00 a.m.-June 16, 2026, 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 10353491.

7/6/2026

Report Generation Delay for CPID 7623 Health Choice Utah

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted June 25, 2026.

Payer impacted:

CPID 7623 Health Choice Utah

The payer intermediary has been unable to generate and deliver the reports for some claims submitted June 25, 2026.

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

If you have any questions, please contact Customer Support and refer to Case Number 10367304.

7/6/2026

Report Generation Delay for CPID 5920 University of Utah Health Plans

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted June 25, 2026.

Payer impacted:

CPID 5920 University of Utah Health Plans

The payer intermediary has been unable to generate and deliver the reports for some claims submitted on June 25, 2026.

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

If you have any questions, please contact Customer Support and refer to Case Number 10367272.

7/6/2026

RESOLVED: Intelligent EDI Portal Performance Issue

Resolved: The PDF report download option for Claim Search results in the IEDI Portal has been restored. Thank you for your patience while this issue was being resolved.

Original notify sent June 29, 2026
Optum Intelligent EDI is currently experiencing an issue impacting PDF report generation from Claim Search results in the IEDI Portal.

This may result in:

Errors when attempting to generate PDF reports from Claim Search results
A new browser window displaying only an “Unknown” message instead of the requested report
Inability to successfully retrieve report output for this specific report type

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

We apologize for any inconvenience.

Action Required: None.

7/6/2026

Update: Report Generation Delay for CPID 5440 Fox Valley Medicine

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted May 23, 2026-June 16, 2026.

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

Original notice sent June 5, 2026:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since May 23, 2026.

Payer impacted:

CPID 5440 Fox Valley Medicine

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10335006.

7/6/2026

Key Benefit Administrators (Ft. Mill, SC) Electronic Claim Status Connection No Longer Available

Real Time Claim Status 276/277 for the payer listed below is no longer available at Optum, effective immediately.

Payer Name: Key Benefit Administrators (Ft. Mill, SC)
Industry Payer ID: 37216
Optum iEDI Real Time ID: 37216
Connection Type: X12

Reason: Payer no longer offers an electronic connection.

Action Required: None.

7/6/2026

Report Generation Delay for CPID 7241 TransactRX Part D

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

Payer impacted:

CPID 7241 TransactRX Part D

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 10366872.

7/6/2026

Key Benefit Administrators (Ft. Mill, SC) Electronic Eligibility Connection No Longer Available

Real Time Eligibility 270/271 for the payer listed below is no longer available at Optum, effective immediately.

Payer Name: Key Benefit Administrators (Ft. Mill, SC)
Industry Payer ID: 37216
Optum iEDI Real Time ID: 37216
Connection Type: X12

Reason: Payer no longer offers an electronic connection.

Action Required: None.

7/6/2026

Fee Change for Claim Payers

The claim fee will change for the following payers:

Amida Care
Exchange CPIDs: 3940, 3466
Current Fee: $0.10
New Fee: $0.00
Effective Date: July 1, 2026

Brokerage Concepts
Exchange CPIDs: 8562, 1830
Current Fee: $0.10
New Fee: $0.00
Effective Date: July 1, 2026

Healthchoice Select
Exchange CPIDs: 9098, 4137
Current Fee: $0.10
New Fee: $0.00
Effective Date: July 1, 2026

Meridian PACE Solutions
Exchange CPIDs: 8077, 2867
Current Fee: $0.10
New Fee: $0.00
Effective Date: July 1, 2026

PACE at Hudson Headwaters
Exchange CPIDs: 9034, 3726
Current Fee: $0.10
New Fee: $0.00
Effective Date: July 1, 2026

Banner Health Network
Exchange CPIDs: 6610, 3845
Current Fee: $0.00
New Fee: $0.10
Effective Date: Aug. 1, 2026

Central Health Medicare Plan
Exchange CPIDs: 4666, 6198
Current Fee: $0.00
New Fee: $0.10
Effective Date: Aug. 1, 2026

EasyAccess Care IPA
Exchange CPIDs: 7002, 9284
Current Fee: $0.00
New Fee: $0.10
Effective Date: Aug. 1, 2026

Physician Health Network
Exchange CPIDs: 7123
Current Fee: $0.00
New Fee: $0.10
Effective Date: Aug. 1, 2026

Serendib Healthways
Exchange CPIDs: 8025, 9742
Current Fee: $0.00
New Fee: $0.10
Effective Date: Aug. 1, 2026

Action Required: Please be aware of the claim fee changes.

7/2/2026

Payer Processing Issue for CPID 3647 Rhode Island Medicaid

Due to a payer processing issue, some Institutional claims transmitted to the payer listed below July 1, 2026 were not processed by the payer.

Payer impacted:

CPID 3647 Rhode Island Medicaid

A resolution has been implemented and the claims were retransmitted to the payer July 2, 2026.

This delay affected claims released to Optum June 30, 2026, 2:00 p.m.-July 1, 2026, 2:00 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 10366273.

7/2/2026

Update: Payer Change for CPIDs 3271, 4939 MedCom

Update: Correction to Payer ID for American Correctional Healthcare. Correct Payer ID is 26326.

Reminder notification sent June 23, 2026
Effective June 11, 2026, claims currently exchanged with CPIDs 3271 and 4939 MedCom, Payer ID 59231 must be sent using CPIDs 3750 & 9042 American Correctional Healthcare, Payer ID 26323.

CPIDs 3271 and 4939 MedCom, Payer ID 59231 will be terminated effective June 26, 2026.

Original notification sent June 10, 2026
Effective June 11, 2026, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: MedCom
Professional CPID: 3271
Institutional CPID: 4939
Remittance Available: No
Industry Standard Payer ID: 59231

Claims sent on or after June 11, 2026, must begin using the following:

Payer Name: American Correctional Healthcare
Professional CPID: 3750
Institutional CPID: 9042
Remittance Available: No
Industry Standard Payer ID: 26326
Claim Fee: N/A

CPIDs 3271 and 4939 MedCom, Payer ID 59231 will be terminated effective June 26, 2026.

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

7/2/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: HealthFirst TPA (Tyler, TX)
Payer ID: 75234
Payer Enrollment Required: Yes
Payer Location: Texas

Action Required:

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

7/2/2026

Electronic Routing Change for Multiple Payers

Optum has changed electronic remittance routing for the following payers, effective immediately:

Payer Name: Nascentia Health Options
Payer ID: 31626
Payer Remittance Enrollment Required: Yes
New Par Status: Nonpar

Payer Name: Nascentia Health Plus
Payer ID: 45529
Payer Remittance Enrollment Required: Yes
New Par Status: Nonpar

Enrollment Requirements:
Remittance:

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

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

When a payer requires enrollment, access the new enrollment forms via IEDI.

7/2/2026

Update: Payer Change for CPIDs 3271, 4939 MedCom

Update: Correction to Payer ID for American Correctional Healthcare. Correct Payer ID is 26326.

CPIDs 3271 and 4939 MedCom, Payer ID 59231 will be terminated effective June 26, 2026.

Original notification sent June 10, 2026
Effective June 11, 2026, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: MedCom
Professional CPID: 3271
Professional Edit Master: PE_T007
Institutional CPID: 4939
Institutional Edit Master: HE9T007
Industry Standard Payer ID: 59231

Claims sent on or after June 11, 2026, must begin using the following:

Payer Name: American Correctional Healthcare
Professional CPID: 3750
Professional Edit Master: PE_T007
Institutional CPID: 9042
Institutional Edit Master: HE9T007
Industry Standard Payer ID: 26326

CPIDs 3271 and 4939 MedCom, Payer ID 59231 will be terminated effective June 26, 2026.

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is not required.

Action Required: Please make the following updates to accommodate these payer changes:

Revalidate unreleased claims to edit correctly under new edit master.
Modify any bridge routines based on edit masters.
Modify related Payer Alias names to the new CPIDs.
To access the new enrollment forms, please visit Enrollment Central.

7/2/2026

Report Generation Delay for CPIDs 2296 and 8972 MetroPlus Health Plan

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted June 1, 2026 and June 3, 2026.

Payer impacted:

CPID 2296 MetroPlus Health Plan
CPID 8972 MetroPlus Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10338139.

7/2/2026

Payer Processing Issue for CPID 3501 Indiana Medicaid

Due to a payer processing issue, some Institutional claims transmitted to the payer listed below June 29, 2026 were not processed by the payer.

Payer impacted:

CPID 3501 Indiana Medicaid

A resolution has been implemented and the claims were retransmitted to the payer July 2, 2026.

This delay affected claims released to Optum June 26, 2026, 2:00 p.m.-June 29, 2026, 10:00 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 10365816.

7/2/2026

Report Generation Delay for CPIDs 5654 and 6296 Vivant Health

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

Payer impacted:

CPID 5654 Vivant Health
CPID 6296 Vivant Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10365746.

7/2/2026

Update: Delay in Electronic Remittance Advice (ERA) for CPIDs 1468 and 1568

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

Original notice sent June 17, 2026:
There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates since June 15, 2026.

Payer impacted:

CPID 1468 Minnesota Medicaid
CPID 1568 Minnesota Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10348321.

7/2/2026

New Electronic Remittance Connections Available on Revenue Performance Advisor

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

79966 – Amida Care Medicare
SALIA – Salia Healthcare

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

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

7/2/2026

Update: Delay in Electronic Remittance Advice (ERA) for CPIDs 1786 and 8561

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

Original notice sent June 19, 2026:
There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates since May 2, 2026.

Payer impacted:

CPID 1786 Avera Health Plans
CPID 8561 Avera Health Plans

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10352195.

7/2/2026

Eligibility termination for payer ID 23223 on Revenue Performance Advisor

Real Time Eligibility 270/271 transactions for the payer listed below are no longer available at Optum, on the Revenue Performance Advisor system, effective immediately.

Payer Name: The Loomis Company
RPA Payer ID: 23223

Reason: Payer no longer offers an electronic connection.

Action Required:
Providers should review the patient's current insurance ID card for claim filing information. Remove the above Payer ID within your practice management software or contact your software vendor for assistance, as needed.

7/3/2026

PAR Status change for real time payers

The PAR Status will change for the following real time payers:

Healthfirst of New York/New Jersey
iEDI Payer ID: HF1NY
Transaction: Eligibility, Claim Status
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

The Boon Group
iEDI Payer ID: BOONG
Transaction: Eligibility, Claim Status
New PAR Status: Transitional
Effective Date: July 1, 2026

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

7/3/2026

Electronic Routing Change for Multiple Payers

Optum has changed electronic remittance routing for the following payers, effective immediately:

Payer Name: Nascentia Health Options
Professional CPID: 6842
Institutional CPID: 7622
Industry Standard Payer ID: 31626
Payer Remittance Enrollment Required: Yes

Payer Name: Nascentia Health Plus
Professional CPID: 8780
Institutional CPID: 3086
Industry Standard Payer ID: 45529
Payer Remittance Enrollment Required: Yes

Enrollment Requirements:
Remittance:

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

Action Required: Please 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.

7/3/2026

Electronic Routing Change for Multiple Payers

Optum has changed electronic remittance routing for the following payers, effective immediately:

Payer Name: Nascentia Health Options
Professional CPID: 6842
Institutional CPID: 7622
Industry Standard Payer ID: 31626
Line of Business Code (LOB): J8I
Payer Remittance Enrollment Required: Yes

Payer Name: Nascentia Health Plus
Professional CPID: 8780
Institutional CPID: 3086
Industry Standard Payer ID: 45529
Line of Business Code (LOB): U7O
Payer Remittance Enrollment Required: Yes

Enrollment Requirements:
Remittance:

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

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

No Payer Alias changes are required. Payer names and CPIDs are not changing.
When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

7/3/2026

PAR Status change for Real Time payers

The PAR Status will change for the following real time payers:

Healthfirst of New Jersey
Exchange RT ID: HFSTNJ
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Healthfirst of New York/New Jersey
Exchange CPID(s): 1973, 1854
Exchange RT ID: NYHFST
Transaction: Eligibility, Claim Status
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

The Boon Group
Exchange CPID(s): 3930, 4278
Exchange RT ID: BOONGR
Transaction: Eligibility, Claim Status
New PAR Status: Transitional
Effective Date: July 1, 2026

Action Required: Please be aware of the upcoming changes.

7/3/2026

AmeriHealth Caritas Pennsylvania New Electronic Claim Status connection available
Optum is pleased to announce the availability of Real-time Claim Status Inquiry and Response 276/277 for the below payer, effective June 29, 2026:

Payer Name: AmeriHealth Caritas Pennsylvania / AmeriHealth Mercy Health Plan
IMN Real Time ID: 22248
Exchange Real Time ID: AMHLTH
CPID(s): 4547 (I), 1710 (P)
IEDI Real Time ID: 10340
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Claim Status Inquiry subscribe:

Member ID, First name, Last name, Date of birth,

Optional additional elements:

Payer claim number, Total submitted charges

7/3/2026

Georgia Health Advantage New Real Time Eligibility 270/271 Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective July 1, 2026:

Payer Name: Georgia Health Advantage
Industry Payer ID: 31140
IMN Real Time ID: 31140
Exchange Real Time ID: GAHAD
Optum IEDI Real Time ID: 14391
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

7/3/2026

PAR Status change for Real Time payers

The PAR Status will change for the following real time payers:

Delta Dental of Arizona
IMN ID: 86027, DDLAZ
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Delta Dental of New Mexico
IMN ID: 85022, DDNMX
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Delta Dental of Tennessee
IMN ID: CDTN1, DDTNN
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Healthfirst of New Jersey
IMN ID: XHFNJ, HFNJ, HFSTNJ
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

HealthFirst of New York/New Jersey
IMN ID: 80141, 00240, HFNY, NYHFST
Transaction: Eligibility, Claim Status
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Kaiser Foundation Health Plan of Georgia
IMN ID: 21313, 00281, GAKAIS, KAISR00281, KSRGA
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Kaiser Foundation Health Plan of Northern California Region
IMN ID: 94135, 00282, KAISR00282, KSRCN, KSRNCA
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Kaiser Foundation Health Plan of Southern California Region
IMN ID: 94134, 00283, KAISR00283, KSRCS, KSRSCA
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Kaiser Foundation Health Plan of the Mid-Atlantic States
IMN ID: 52095, 00276, KAISMA, KAISR00276, KSRA, KSRMDA
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Kaiser Foundation Health Plan of the Northwest
IMN ID: 93079, 00279, KAISNW, KAISR00279, KSRNW
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

SelectHealth
IMN ID: SX107, UTSLHT
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

SummaCare Health Plan
IMN ID: 95202, SMAHP, SUMCHP
Transaction: Eligibility
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

The Boon Group
IMN ID: BOONG, BOONA, BOONGR
Transaction: Eligibility, Claim Status
New PAR Status: Transitional
Effective Date: July 1, 2026

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

7/1/2026

PAR Status change for claim payers

The PAR Status will change for the following claim payers:

Alta Bates Medical Group
Exchange CPID: 4028, 5846
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: Aug. 1, 2026

Altais Care Network
Exchange CPID: 7944, 2778
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: Aug. 1, 2026

American Insurance Company of Texas
Exchange CPID: 7969, 4162
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Amida Care
Exchange CPID: 3940, 3466
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Amida Care Medicare
Exchange CPID: 7689, 7144
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

ASRM Corporation
Exchange CPID: 2689, 5230
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Beacon of Life
Exchange CPID: 2086, 8234
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Brokerage Concepts
Exchange CPID: 8562, 1830
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Brown & Toland Health Services
Exchange CPID: 7645, 6867
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: Aug. 1, 2026

Brown & Toland Medical Group
Exchange CPID: 6547, 1289
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: Aug. 1, 2026

Brown & Toland Sutter Select
Exchange CPID: 5816
Transaction: Claims - Professional
New PAR Status: Transitional
Effective Date: Aug. 1, 2026

Carolina Behavioral Health Alliance
Exchange CPID: 7964, 5195
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

CenterLight Healthcare
Exchange CPID: 7613, 6820
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

ConnectiCare Molina
Exchange CPID: 9065, 3829
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Employee Benefit Management Corp (EBMC)
Exchange CPID: 4185
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Family Care Specialists IPA
Exchange CPID: 8698, 6132
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: Aug. 1, 2026

Florida PACE Centers
Exchange CPID: 3588, 1212
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Forest County Potawatomi Insurance
Exchange CPID: 9674
Transaction: Claims - Institutional
New PAR Status: Transitional
Effective Date: July 1, 2026

Group Benefit Services
Exchange CPID: 7672, 7116
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Halos Systems
Exchange CPID: 9030, 3715
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Health First Health Plans
Exchange CPID: 6685, 3205
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

HealthTeam Advantage
Exchange CPID: 1023, 7849
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

JAI Medical Systems
Exchange CPID: 8936, 6291
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

JLS Family Enterprises (dba League Medical Concepts)
Exchange CPID: 8672, 7254
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Medcore HP
Exchange CPID: 8052, 4266
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Merchant Benefit Administration (Repriced Claims Only)
Exchange CPID: 2957, 1805
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Meridian PACE Solutions
Exchange CPID: 8077, 2867
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

National Financial Insurance Company
Exchange CPID: 7970, 5201
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

National Foundation Life Insurance Company
Exchange CPID: 7971, 5203
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

PACE at Hudson Headwaters
Exchange CPID: 9034, 3726
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Progyny
Exchange CPID: 1089, 8117
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Reliance Medicare Advantage
Exchange CPID: 3057, 8444
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Sentinel Management Services
Exchange CPID: 2995, 3256
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Signature Advantage
Exchange CPID: 9567, 7282
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Solis Health Plans
Exchange CPID: 2047, 8168
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Summit Administration Services
Exchange CPID: 9524, 1114
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

Transwestern Insurance Administrators Inc.
Exchange CPID: 8141
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Variable Protection Administrators
Exchange CPID: 5612, 6245
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: Aug. 1, 2026

Action Required: Please be aware of the upcoming changes.

7/1/2026

Care1st Health Plan New Real Time Eligibility 270/271 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, 2026:

Payer Name: Care1st Health Plan
Industry Payer ID: 10973
IMN Real Time ID: ISCHP
Exchange Real Time ID: ISCHP
Optum IEDI Real Time ID: 10973
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

7/1/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: HealthFirst TPA (Tyler, TX)
Institutional CPID: 6568
Professional CPID: 1768
Industry Standard Payer ID: 75234
Line of Business (LOB) Code: K3R
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Texas

Action Required:

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

7/1/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: HealthFirst TPA (Tyler, TX)
Institutional CPID: 6568
Professional CPID: 1768
Industry Standard Payer ID: 75234
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Texas

Action Required:

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

7/1/2026

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: VitalCore Millette
Payer ID: MAI58
Payer Enrollment Required: Yes
Payer Location: National

Action Required:

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

7/1/2026

Electronic Claims Connection Suspended

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

Payer Name: Fringe Benefits
Payer ID: 23243
Reason: Payer unavailable electronically.

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

7/1/2026

Electronic Claims Connection Suspended

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

Payer Name: Fringe Benefits
CPID(s): 4066, 8810
Industry Standard Payer ID: 23243
Reason: Payer unavailable electronically.

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

7/1/2026

Gold Coast Health Plan Electronic Eligibility Connection No Longer Available

Real Time Eligibility 270/271 for the payer listed below is no longer available at Optum, effective immediately.

Payer Name: Gold Coast Health Plan
Industry Payer ID: 77160
Optum iEDI Real Time ID: 11063
Connection Type: X12

Reason: Payer no longer offers an electronic connection.

Action Required: None.

7/1/2026

Older Payer Updates

Click the link below to access payer updates prior to July 1st, 2026.

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