CHC Payer Updates (June 2025)

June 2025

June Payer Processing Issues

Summary

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

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

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

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

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

Payer impacted: 

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09577457.

6/30/2025

Claims Reactivation for CPIDs 2871, 3906 Insurance Design Administrators - 13315

Optum recently restored electronic claims connectivity for the following payer:

Payer Name: Insurance Design Administrators - 13315
Institutional CPID: 3906
Institutional Old Edit Master: HE9E049
Institutional New Edit Master: HE9T007
Professional CPID: 2871
Professional Old Edit Master: PE_E049
Professional New Edit Master: PE_T007
Payer-assigned Payer ID: 13315
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National 

Action Required:

  • Add the payers to your system to begin using the new reactivated payer connection.
  • Modify any bridge routines based on edit masters.
  • 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.

6/30/2025

Claims Reactivation for CPIDs 2871, 3906 Insurance Design Administrators- 13315

Optum recently restored electronic claims connectivity for the following payer:

Payer Name: Insurance Design Administrators - 13315
Institutional CPID: 3906
Professional CPID: 2871
Payer-assigned Payer ID: 13315
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National
Claims Fee: N/A

Action Required: 

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

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

6/30/2025

Report Generation Delay for CPID 8920 Healthcare Management Administrators

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

Payer impacted: 

  • CPID 8920 Healthcare Management Administrators

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09577396.

6/30/2025

Report Generation Delay for CPID 2234 Illinois Health Partners

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

Payer impacted: 

  • CPID 2234 Illinois Health Partners

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09577332.

6/30/2025

Report Generation Delay for CPIDs 5959 and 4258 VNS Health

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

Payer impacted: 

  • CPID 5959 VNS Health
  • CPID 4258 VNS Health

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

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

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

6/30/2025

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: TrueCare Mississippi Medicaid
Institutional CPID: 9014
Professional CPID: 3488
Payer-assigned Payer ID: MSMCDCS1
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Mississippi
Claims Fee: N/A
Remittance Fee: N/A

Action Required:

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

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

6/30/2025

Report Generation Delay for CPID 3577 Regence Group Administrators

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

Payer impacted: 

  • CPID 3577 Regence Group Administrators

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09576896.

6/30/2025

New Assurance Attach Assist Medical Attachment Connections Available

Optum has new electronic medical attachment connections available:

Payer Name: Keystone First - CHIP
Professional CPID: 2897
Institutional CPID: 8098
Payer-assigned Payer ID: 30070
Accepted Attachment Types: Solicited and Unsolicited
Payer Enrollment Required: No
Payer Location: PA

Action Required:

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

6/30/2025

New Electronic Medical Attachment Connections Available

Optum has new electronic medical attachment connections available:

Payer Name: Keystone First - CHIP
Professional CPID: 2897
Institutional CPID: 8098
Payer-assigned Payer ID: 30070
Accepted Attachment Types: Solicited and Unsolicited
Payer Enrollment Required: No
Payer Location: PA

Action Required:

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

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

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

6/30/2025

Report Generation Delay for CPIDs 9656 and 7715 Hopkins Health Advantage

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

Payer impacted: 

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09576821.

6/30/2025

Electronic Claims Connection Suspended

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

Payer Name: Medigold HMO
CPIDs: 1584, 4714
Payer ID: 95655
Reason: Payer unavailable electronically 

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

6/30/2025

PAR Status Change for Claim Payers

Effective July 1, 2025, the PAR Status for the list of claim payers below will change.

Payer Name: Aetna Better Health of Illinois - Medicaid
Industry Payer ID: 68024
Exchange Inst CPID: 5013
Exchange Prof CPID: 8861
Current Par Status: Non Par
New Par Status:  Par

Payer Name: Allied Benefit System
Industry Payer ID: 37308
Exchange Inst CPID: 8573
Exchange Prof CPID: 1759
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Alternative Insurance Resources
Industry Payer ID: IHS06
Exchange Inst CPID: 5061
Exchange Prof CPID: 9106
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Anchor Benefit Consulting
Industry Payer ID: 53085
Exchange Inst CPID: 8948
Exchange Prof CPID: 4269
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Assurant Health Self Funded
Industry Payer ID: 75068
Exchange Inst CPID: 7675
Exchange Prof CPID: 7117
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Atlantic Medical Insurance
Industry Payer ID: 22285
Exchange Inst CPID: 9562
Exchange Prof CPID: 6429
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Behavioral Health Systems
Industry Payer ID: 63100
Exchange Inst CPID: 1012
Exchange Prof CPID: 6106
Current Par Status: Non Par
New Par Status: Par

Payer Name: Britcay Medical
Industry Payer ID: 22286
Exchange Inst CPID: 8567
Exchange Prof CPID: 1218
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Butler Benefit
Industry Payer ID: 42150
Exchange Inst CPID: 8946
Exchange Prof CPID: 3250
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: C & O Employees' Hospital Association
Industry Payer ID: 23708
Exchange Inst CPID: 5027
Exchange Prof CPID: 2850
Current Par Status: Non Par
New Par Status: Par

Payer Name: Christian Brothers Services
Industry Payer ID: 38308
Exchange Inst CPID: 4674
Exchange Prof CPID: 6202
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Christus Health Medicare Advantage
Industry Payer ID: 10629
Exchange Inst CPID: 8579
Exchange Prof CPID: 7805
Current Par Status: Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Christus Health Plan Health Insurance Exchange
Industry Payer ID: 52106
Exchange Inst CPID: 9657
Exchange Prof CPID: 7716
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Christus Health Plan US Family HP
Industry Payer ID: 90551
Exchange Inst CPID: 4952
Exchange Prof CPID: 4493
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Colonial Medical Bermuda
Industry Payer ID: 22284
Exchange Inst CPID: 8999
Exchange Prof CPID: 5811
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Consolidated Associates Railroad
Industry Payer ID: 75284
Exchange Inst CPID: 7967
Exchange Prof CPID: 2233
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: DirectCARE
Industry Payer ID: 55731
Exchange Inst CPID: 1654
Exchange Prof CPID: 1719
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Employee Benefits Administration & Management (EBA&M)
Industry Payer ID: 95288
Exchange Inst CPID: N/A
Exchange Prof CPID: 5205
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Farm Family
Industry Payer ID: 14140
Exchange Inst CPID: 8945
Exchange Prof CPID: 5876
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Fringe Benefit Coordinators (Medical and Accident)
Industry Payer ID: 59204
Exchange Inst CPID: 8944
Exchange Prof CPID: 5247
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Health Services Preferred (HSP) Emerald Health
Industry Payer ID: 34167
Exchange Inst CPID: 6664
Exchange Prof CPID: 6768
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Healthcare Solutions Group
Industry Payer ID: 73147
Exchange Inst CPID: 3965
Exchange Prof CPID: 4267
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: HealthSmart ACCEL Network
Industry Payer ID: 75237
Exchange Inst CPID: 9584
Exchange Prof CPID: 5280
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Healthy York Network
Industry Payer ID: 22251
Exchange Inst CPID: N/A
Exchange Prof CPID: 6883
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Innovante Benefit Administrators
Industry Payer ID: 31172
Exchange Inst CPID: 5685
Exchange Prof CPID: 6134
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: MedCom
Industry Payer ID: 59231
Exchange Inst CPID: 4939
Exchange Prof CPID: 3271
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Med-Pay
Industry Payer ID: 88058
Exchange Inst CPID: 7075
Exchange Prof CPID: 7480
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Mutual of Omaha
Industry Payer ID: 71412
Exchange Inst CPID: 4530
Exchange Prof CPID: 2420
Current Par Status: Non Par
New Par Status: Par

Payer Name: NAMCI/Global Care
Industry Payer ID: L0110
Exchange Inst CPID: 2076
Exchange Prof CPID: 8221
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Northwestern Medicine Physicians Network
Industry Payer ID: 23550
Exchange Inst CPID: 1918
Exchange Prof CPID: 3229
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Nueces County Hospital Dist
Industry Payer ID: 45210
Exchange Inst CPID: 4646
Exchange Prof CPID: 6167
Current Par Status: Non Par
New Par Status: Gateway

Payer Name: Partners Health Plan
Industry Payer ID: 14966
Exchange Inst CPID: 9521
Exchange Prof CPID: 1111
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Trilogy Health Network
Industry Payer ID: 62777
Exchange Inst CPID: 3624
Exchange Prof CPID: 5835
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: UMWA H & R Funds
Industry Payer ID: 52180
Exchange Inst CPID: 2991
Exchange Prof CPID: 1758
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: Unite Health Share Ministries
Industry Payer ID: 07689
Exchange Inst CPID: 4006
Exchange Prof CPID: 8728
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: US Benefits
Industry Payer ID: 93092
Exchange Inst CPID: 4970
Exchange Prof CPID: 2241
Current Par Status: Non Par
New Par Status: Transitional

Payer Name: William C Earhart
Industry Payer ID: 93050
Exchange Inst CPID: 3919
Exchange Prof CPID: 3465
Current Par Status: Non Par
New Par Status: Transitional

Action Required: Please be aware of the upcoming changes.

6/30/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Nationwide
Professional CPID: 3490
Payer-assigned Payer ID: 32787
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National 

Action Required: 

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

6/30/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Nationwide
Professional CPID: 3490
Payer-assigned Payer ID: 32787
Line of Business (LOB) Code: E31
Payer Enrollment Required: Yes
Payer Location: National 

Action Required: 

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

6/30/2025

Report Generation Delay for CPID 4480 SelectHealth

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

Payer impacted:

  • CPID 4480 SelectHealth

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 09577554.

6/30/2025

Report Generation Delay for CPIDs 4591 and 5403 Amalgamated Life

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

Payer impacted:

  • CPID 4591 Amalgamated Life
  • CPID 5403 Amalgamated Life

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 09576349.

6/30/2025

Payer Name Electronic Remittance Connection No Longer Available

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

Payer Name: United Group Programs
Remittance CPIDs: 7632, 6849
Payer-assigned Payer ID: UGP19
Reason: Payer no longer offers an electronic connection.

Action Required: None.

6/30/2025

Payer Name Electronic Remittance Connection No Longer Available

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

Payer Name: United Group Programs
Remittance CPIDs: 7632, 6849
Remittance LOB: K35
Payer-assigned Payer ID: UGP19
Reason: Payer no longer offers an electronic connection.

Action Required: None.

6/30/2025

Payer Processing Issue for CPID 2554 Louisiana Medicaid Medicare Advantage Crossovers

Due to a payer processing issue, some Institutional claims transmitted to the payer listed below June 18, 2025-June 19, 2025 were not processed by the payer.

Payer impacted:

  • CPID 2554 Louisiana Medicaid Medicare Advantage Crossovers

A resolution has been implemented and the claims were retransmitted to the payer June 30, 2025.

This delay affected some claims released to Optum June 18, 2025, 10:00 a.m.-June 19, 2025, 8:00 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 09565808.

6/30/2025

Update: Report Generation Delay for CPID 2254 Scott & White Health Plan

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted May 30, 2025-June 2, 2025.

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

Original notify sent June 10, 2025:

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

Payer impacted: 

  • CPID 2254 Scott & White Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09546949.

6/30/2025

Update: Report Generation Delay for CPID 4427 Montana Medicaid

Update: It has been determined that part of the report delay below was due to a payer claims processing issue. We have retransmitted the impacted claims to the payer intermediary June 30, 2025. Reports will be delivered once the claims have successfully processed at the payer.

Action Required: Please be aware of delays.

Original Notice Sent June 26, 2025:

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

Payer impacted:

  • CPID 4427 Montana 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 09572941.

6/30/2025

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: TrueCare Mississippi Medicaid
Institutional CPID: 9014
Professional CPID: 3488
Payer-assigned Payer ID: MSMCDCS1
Line of Business (LOB) Code: E28
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Mississippi

Action Required:

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

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

6/30/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name: UHSM
Institutional CPID: 9001
Professional CPID: 3450
Payer-assigned Payer ID: UHSM1
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Virginia
Claims Fee: N/A

UHSM, Payer ID UHSM1 is a new connection that is effective July 1, 2025. This Payer ID is ONLY applicable for the WeShare legacy program.

Action Required:

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

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

6/30/2025

Report Generation Delay for CPIDs 1004 and 7829 Passport Advantage

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

Payer impacted: 

  • CPID 1004 Passport Advantage
  • CPID 7829 Passport Advantage

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09576959.

6/30/2025

New Payer Name

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

Previous Payer Name:  FiServ Health (Kansas & Tennessee)
New Payer Name: Harrington Health - Kansas
Professional CPID:  1806
Professional Edit Master: PE_E049
Institutional CPID: 8521
Institutional Edit Master: HE9E049

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

Action Required: None

6/30/2025

New Payer Name

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

Previous Payer Name: FiServ Health (Kansas & Tennessee)
New Payer Name: Harrington Health - Kansas
Professional CPID: 1806
Institutional CPID: 8521

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

6/30/2025

Update: Report Generation Delay for CPIDs 3509 and 2481 Ohio Medicaid

Update: The payer has been unable to generate and deliver the reports for some claims submitted on June 19, 2025 and June 23, 2025.

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

Original notify sent June 26, 2025:

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted on June 19, 2025 and June 23, 2025.

Payer impacted:

  • CPID 3509 Ohio Medicaid
  • CPID 2481 Ohio Medicaid

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 09572845.

6/30/2025

Update: Report Generation Delay for CPID 2164 Carelon Behavioral Health Maryland

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on May 30, 2025.

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

Original notify sent June 10, 2025:

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

Payer impacted: 

  • CPID 2164 Carelon Behavioral Health Maryland

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 09546901.

6/30/2025

Update: Report Generation Delay for CPID 6127 Carelon Behavioral Health, MBHP

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from May 23, 2025 through May 29, 2025.

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

Original notify sent June 5, 2025:

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

Payer impacted: 

  • CPID 6127 Carelon Behavioral Health, MBHP

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 09528339.

6/30/2025

Eligibility Fee Change

Effective 07/01/2025, the following eligibility payer fees will change:

Payer Name: ASR Health Benefits

Industry Payer ID: 10984

Exchange RT ID: ASRHLT

Exchange Inst CP: n/a

Exchange Prof CP: n/a

Current Fee: 0.0200

New Fee: 0.0000

 

Payer Name: Avera Health Plans

Industry Payer ID: 46045

Exchange RT ID: AVRHP

Exchange Inst CP: 8561

Exchange Prof CP: 1786

Current Fee: 0.0155 

New Fee: 0.0000

 

Payer Name: Claims Management Services Inc

Industry Payer ID: 11001

Exchange RT ID: CLMSMS

Exchange Inst CP: n/a

Exchange Prof CP: n/a

Current Fee: 0.0200

New Fee: 0.0000

 

Payer Name: Colonial Penn Life Ins Co

Industry Payer ID: 37077

Exchange RT ID: CPLIC

Exchange Inst CP: 2550

Exchange Prof CP: 1180

Current Fee: 0.0100

New Fee: 0.0000

 

Payer Name: Kansas Medicaid

Industry Payer ID: SKKS0

Exchange RT ID: KSCAID

Exchange Inst CP: 5520

Exchange Prof CP: 1485

Current Fee: 0.0000

New Fee: 0.0400

 

Payer Name: Neighborhood Health Plan (RI)

Industry Payer ID: 05047

Exchange RT ID: RINHP

Exchange Inst CP: 3645

Exchange Prof CP: 2487

Current Fee: 0.0700

New Fee: 0.0000

 

Payer Name: State Farm Insurance

Industry Payer ID: 31053

Exchange RT ID: STFARM

Exchange Inst CP: 6573

Exchange Prof CP: 5419

Current Fee: 0.0155

New Fee: 0.0000

 

Payer Name: University of Utah Health Plan

Industry Payer ID: SX155

Exchange RT ID: UNUTHP

Exchange Inst CP: 5920

Exchange Prof CP: 4779

Current Fee: 0.0155

New Fee: 0.0000

Action Required: Please be aware of the upcoming fee changes.

6/30/2025

Claim Fee Change

Effective 08/01/2025, the following claim payer fees will change:

Payer Name: Amida Care
CPIDs: 3940, 3466
Industry ID: 24818
Current Fee: $0.00
New Fee: $0.10

Action Required: Please be aware of the upcoming changes.

Fee amount may be different based on individual submitter contracts.

6/30/2025

Electronic Claims Connection Suspended

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

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

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

6/27/2025

Payer Change for CPIDs 7720, 9665 Kalos Health

Effective immediately, claims and remittance currently exchanged with the following payer must use different CPIDs:

Payer Name: Kalos Health
Professional CPID: 7720
Institutional CPID: 9665
Remittance Available: Yes
Payer-assigned Payer ID: 40137

Kalos Health will be terminated effective June 30, 2025.

Providers must begin using the following payer for electronic claims:

Payer Name: ResourceOne Administrators
Professional CPID: 3257
Institutional CPID: 4929
Remittance Available: No
Payer-assigned Payer ID: 66456
Claim Fee: Yes

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.

6/27/2025

Payer Change for CPIDs 7720, 9665 Kalos Health

Effective immediately, claims and remittance currently exchanged with the following payer must use different CPIDs:

Payer Name: Kalos Health
Professional CPID: 7720
Professional Edit Master: PE_T007
Institutional CPID: 9665
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: 40137
Line of Business Code (LOB): K4S

Kalos Health will be terminated effective June 30, 2025.

Providers must begin using the following payer for electronic claims:

Payer Name: ResourceOne Administrators
Professional CPID: 3257
Professional Edit Master: PE_B800
Institutional CPID: 4929
Institutional Edit Master: HE9B801
Payer-assigned Payer ID: 66456
Line of Business Code (LOB): 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:

  • 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.

6/27/2025

Electronic Claims Connection Suspended

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

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

Payer Name: Choice Medical Group
CPIDs: 8023
Payer ID: CMG01
Reason: Payer unavailable electronically 

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

6/27/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Memorial Hermann Health Solutions
Institutional CPID: 8915
Professional CPID: 3475
Payer-assigned Payer ID: MHHNP
Line of Business (LOB) Code: U91
Payer Enrollment Required: Yes
Payer Location: Texas 

Action Required: 

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

6/27/2025

Electronic Routing Change for CPIDs 6595 and 1757 Healthgram

Effective June 30, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Healthgram
Professional CPID: 1757
Current Edit Master: PE_N000
New Edit Master: PE_T007
Institutional CPID: 6595
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 56144 

Enrollment Requirements: 

Claims:

  • Payer enrollment for electronic claims is not required. 

Report Changes:

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

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

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

6/26/2025

Electronic Routing Change for CPIDs 3273 and 3989 Companion Life

Effective June 26, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Companion Life
Professional CPID: 3273
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 3989
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 37322
Payer Claim Enrollment Required: N
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

6/26/2025

Report Generation Delay for CPID 1663 Commons Clinic Medical Network

The payer listed below is experiencing issues affecting Institutional report generation for some claims submitted on June 17, 2025.

Payer impacted:

  • CPID 1663 Commons Clinic Medical Network

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

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 09573508.

6/26/2025

Enrollment Form Update

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

  • CPID 1465/2205/4938/5503 - New Jersey Medicare
  • CPID 1522/4921- District of Columbia Medicare
  • CPID 2163/2456/4920/5912- Delaware Medicare
  • CPID 2165/2459- District of Columbia Metropolitan Area (DCMA) Medicare
  • CPID 2201/2464/4930/5554/7402- Maryland Medicare
  • CPID 2207/2457/4944/5598- Pennsylvania Medicare
  • CPID 2461- VIRGINIA MEDICARE (ALEX, ARLGTN, FAIRFAX)
  • CPID 3677/4950- JL Mutual of Omaha DC, DE, MD, NJ, PA
  • CPID 1440/2208/4946/5502- Texas Medicare
  • CPID 1449/1547/2162/4917- Colorado Medicare
  • CPID 1457/2204/4937/5566- New Mexico Medicare
  • CPID 1458/1558/2206/4942- Oklahoma Medicare
  • CPID 2451/2203/4934/5556- Mississippi Medicare
  • CPID 1458/1558/2206/4942- Louisiana Medicare
  • CPID 1526/2161/2455/4904- Arkansas Medicare
  • CPID 3650/4903- JH Mutual of Omaha CO, NM, OK, TX

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. 

6/26/2025

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 on June 23, 2025.

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 09573632.

6/26/2025

Electronic Routing Change for CPIDs 3273 and 3989 Companion Life

Effective June 26, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Companion Life
Professional CPID: 3273
Institutional CPID: 3989
Payer-assigned Payer ID: 37322
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

6/26/2025

Report Generation Delay for CPIDs 2400 and 1486 Utah Medicaid

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

Payers impacted:

  • CPID 2400 Utah Medicaid
  • CPID 1486 Utah 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 09573560.

6/26/2025

Resolved: Optum Alert: Delay in Electronic Remittance Advice (ERA) for Multiple CPIDs

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

Original Notification Sent on June 18, 2025:

Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check date of June 2, 2025.

  • CPID 1503 ChampVA HAC
  • CPID 3807 ChampVA HAC
  • CPID 1507 Veterans Administration Fee Basis Programs
  • CPID 3887 Veterans Administration Fee Basis Programs

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000002847.

6/26/2025

Payer Processing Issue for CPID 1493 Kentucky Medicaid

Due to a payer processing issue, some Professional claims transmitted to the payer listed below on June 20, 2025 were not processed by the payer.

Payer impacted: 

  • CPID 1493 Kentucky Medicaid

A resolution has been implemented and the claims were retransmitted to the payer on June 26, 2025.

This delay affected claims released to Optum between 12 p.m. CT on June 19, 2025 and 10 a.m. CT on June 20, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09565883.

6/26/2025

New Electronic Eligibility Connection Available

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

Payer Name: Adventist Health System
Industry Payer ID: 95340
IMN Real Time ID: 95340
Exchange Real Time ID: ADVHS
CPID(s): 2932, 2114
Optum IEDi Real Time ID: 95340
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Subscriber

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

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

6/26/2025

Delay in Electronic Remittance Advice (ERA) for CPIDs 2416, 5596, Blue Cross Blue Shield Arkansas

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

  • CPID 2416 Blue Cross Blue Shield Arkansas
  • CPID 5596 Blue Cross Blue Shield Arkansas

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000002904.

6/26/2025

New Electronic Remittance (ERA) Connections Available on RPA

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

5477S – Pennsylvania Highmark BCBS Southeastern
R3475 – LIFE Beaver and Lawrence Counties
R3476 – LIFE Armstrong County
R3477 – LIFE Butler County

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

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

6/26/2025

New Electronic Claims Connections Available on RPA

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

00128 – Tucker Administrators Inc
31129 – Integra Group - CHA
77124 – Delano IPA
BVAP1 – Buenaventura Affiliated Physicians
MERP1 – MERP Administration Services
MPM49 – Hollywood Presbyterian San Judas

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

00128 – Tucker Administrators Inc
31128 – Integra Group - Home
BVAP1 – Buenaventura Affiliated Physicians
MERP1 – MERP Administration Services
MPM49 – Hollywood Presbyterian San Judas

6/26/2025

New Electronic Eligibility Connection Available

Effective June, 3, 2025 Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer:

Payer Name: Healthcare Management Administrators
Industry Payer ID: HMA01
IMN Real Time ID: HMA01
Exchange Real Time ID: HMAWR
CPID(s): 5243, 8920
Optum IEDi Real Time ID: 11084
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Subscriber

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

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

6/26/2025

New Electronic Claims and Remittance Connections Available

Effective July 1, 2025, Optum will have new electronic claims and remittance connections available for the below payer. Claims must contain dates of service on or after 7/1/25 to avoid rejections.

Payer Name: Keystone First - CHIP
Institutional CPID: 8098
Professional CPID: 2897
Payer-assigned Payer ID: 30070
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes - providers may begin enrolling prior to 7/1/25
Secondary Claims Accepted: Yes
Payer Location: Pennsylvania
Claims Fee: N/A
Remittance Fee: N/A

Action Required:

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

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

6/26/2025

Report Generation Delay for CPID 4427 Montana Medicaid

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

Payer impacted: 

  • CPID 4427 Montana 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 09572941.

6/26/2025

Report Generation Delay for CPIDs 3591 and 7459 Priority Health of Michigan

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted on June 20, 2025.

Payer impacted: 

  • CPID 3591 Priority Health of Michigan
  • CPID 7459 Priority Health of Michigan

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 09572742.

6/26/2025

Report Generation Delay for CPIDs 5522 and 7445 Premera Blue Cross Blue Shield of Washington and Alaska

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

Payer impacted: 

  • CPID 5522 Premera Blue Cross Blue Shield of Washington and Alaska
  • CPID 7445 Premera Blue Cross Blue Shield of Washington and Alaska

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09572588.

6/26/2025

Report Generation Delay for CPIDs 3509 and 2481 Ohio Medicaid

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted on June 19, 2025 and June 23, 2025.

Payer impacted: 

  • CPID 3509 Ohio Medicaid
  • CPID 2481 Ohio Medicaid

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 09572845.

6/26/2025

Resolved: Delay in Electronic Remittance Advice (ERA) for CPIDs: 6286, 5648, Tricare West Region

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

UPDATE: The January dated ERAs are all uploaded to the payer portal now and providers can go there to download them.

Original Notice Sent on February 28, 2025:

Due to a payer processing issue, there has been a delay in Electronic Remittance Advices (ERA) for the following payers for January 23, 2025, through present:

  • CPID 6286 TRICARE West Region
  • CPID 5648 TRICARE West Region

The January dated ERAs are all uploaded to the payer portal now and providers can go there to download them.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case INC-000002332.

6/25/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Create
Institutional CPID: 6525
Professional CPID: 1279
Payer-assigned Payer ID: CREA8
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: New York
Claims Fee: N/A

Action Required: 

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

6/25/2025

Electronic Remittance Connection Suspended

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

Payer Name: Optum Care Network - Monarch
CPIDs: 2475, 6606
Payer ID: IP095
LOB Code: K75
Reason: Payer unavailable electronically. 

Action Required: None. 

6/25/2025

Electronic Remittance Connection Suspended

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

Payer Name: Optum Care Network - Monarch
CPIDs: 2475, 6606
Payer ID: IP095
Reason: Payer unavailable electronically. 

Action Required: None. 

6/25/2025

Report Generation Delay for CPID 9178 AIDS Healthcare Foundation

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

Payer impacted:

  • CPID 9178 AIDS Healthcare Foundation - PHC

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 09570857.

6/25/2025

Report Generation Delay for CPID 6884 Positive Healthcare

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

Payer impacted:

  • CPID 6884 Positive Healthcare

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 09570857.

6/25/2025

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

Correction from a previous notify sent on June 24, 2025:

Assurance Reimbursement Management is experiencing a payer processing issue causing missing claim rejections. This may result in an error when viewing claims or reports.  

Errors: 

- “Code 7350: No Message Returned” is being returned when viewing claims with no rejection details. 

- “ERRORED|R – REJECTED” with no rejection details.

Affected payers:

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

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

We apologize for any inconvenience. 

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

6/25/2025

Electronic Routing Change for CPIDs 8673 and 7256 Key Solutions

Effective June 26, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Key Solutions
Professional CPID: 7256
Institutional CPID: 8673
Payer-assigned Payer ID: 37323
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

6/25/2025

Electronic Routing Change for CPIDs 7505 and 2821 Key Benefit Administrators

Effective June 26, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Key Benefit Administrators
Professional CPID: 2821
Institutional CPID: 7505
Payer-assigned Payer ID: 37217
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:

Claims:

  • Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

6/25/2025

Report Generation Delay for CPID 8551 Wellcare Health Plans

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

Payer impacted: 

  • CPID 8551 Wellcare Health Plans

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09569054.

6/24/2025

999 Payer Batch Rejections for CPID 1421 Blue Cross Blue Shield of Michigan

Professional claims transmitted to the payer listed below from Optum June 19, 2025 were not processed by the payer due to a 999 Batch Rejection.

  • CPID 1421 Blue Cross Blue Shield of Michigan

A resolution has been implemented and the claims were retransmitted to the payer June 24, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09568803.

6/24/2025

999 Payer Batch Rejections for CPID 1775 Wellpoint

Professional claims transmitted to the payer listed below from Optum June 19, 2025 were not processed by the payer due to a 999 Batch Rejection.

  • CPID 1775 Wellpoint

A resolution has been implemented and the claims were retransmitted to the payer June 24, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09568803.

6/24/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: CareFirst BlueCross BlueShield Community Health Plan Maryland
Institutional CPID: 6647
Professional CPID: 6749
Payer-assigned Payer ID: 45281
Line of Business (LOB) Code: J78
Payer Enrollment Required: Yes
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.

6/20/2025

Electronic Routing Change for CPIDs 9643 and 7487 CareFirst BlueCross BlueShield 

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

Payer Name: CareFirst BlueCross BlueShield Medicare Advantage
Professional CPID: 7487
Institutional CPID: 9643
Payer-assigned Payer ID: 45282
Line of Business Code (LOB): H57
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.

6/20/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: CareFirst BlueCross BlueShield Community Health Plan Maryland
Institutional CPID: 6647
Professional CPID: 6749
Payer-assigned Payer ID: 45281
Payer Enrollment Required: Yes
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.

6/20/2025

Electronic Routing Change for CPIDs 9643 and 7487 CareFirst BlueCross BlueShield Medicare Advantage

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

Payer Name: CareFirst BlueCross BlueShield Medicare Advantage
Professional CPID: 7487
Institutional CPID: 9643
Payer-assigned Payer ID: 45282
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A

Enrollment Requirements:

Remittance:

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

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

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

6/20/2025

Payer Change for CPIDs 8041, 9759 Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022

REMINDER

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

Claims / Remittance sent or received on or prior to June 26, 2025, may continue to use the following:

Payer Name: Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022
Professional CPID: 9759
Professional Edit Master: PE_B800
Institutional CPID: 8041
Institutional Edit Master: HE9B801
RTE Payer ID: WELLCR
Payer-assigned Payer ID: 14163
Line of Business Code (LOB): H6A

Claims and Remittance sent or received on or after June 27, 2025, must begin using the following:

Current Payer Name: Care1st Health Plan of Arizona Medicaid DOS after 11/30/2022

New Payer Name: Care1st Health Plan of Arizona Medicaid
Professional CPID: 2289
Professional Edit Master: PE_B800
Institutional CPID: 2949
Institutional Edit Master: HE9B801
RTE Payer ID: CNTENE
Payer-assigned Payer ID: 68069
Line of Business Code (LOB): H6A

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 2289, 2949 Care1st Health Plan of Arizona Medicaid do not need to complete a new enrollment form.
    • Providers not receiving electronic remittance through Optum for CPIDs 2289, 2949 Care1st Health Plan of Arizona Medicaid must complete a new enrollment form.
    • New providers must complete a new enrollment form.

Eligibility:

  • Payer enrollment for electronic eligibility 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.

6/18/2025

Report Generation Delay for CPID 1558 Oklahoma Medicare

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

Payer impacted:

  • CPID 1558 Oklahoma Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09559371.

6/18/2025

Report Generation Delay for CPID 5598 Pennsylvania Medicare

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

Payer impacted:

  • CPID 5598 Pennsylvania Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09559394.

6/18/2025

Report Generation Delay for CPID 7551 The Health Plan of West Virginia

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

Payer impacted:

  • CPID 7551 The Health Plan of West Virginia

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09559408.

6/18/2025

Electronic Routing Change for CPIDs 2433 and 2943 Denver Health and Hospital Authority

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

Payer Name: Denver Health and Hospital Authority
Professional CPID: 2433
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 2943
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 84133
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

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

6/17/2025

Electronic Routing Change for CPIDs 2433 and 2943 Denver Health and Hospital Authority

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

Payer Name: Denver Health and Hospital Authority
Professional CPID: 2433
Institutional CPID: 2943
Payer-assigned Payer ID: 84133
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

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

6/17/2025

Report Generation Delay for CPID 2803 UPMC Health Plan

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

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 09557793.

6/17/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Greater Newport IPA
Institutional CPID: 9000
Professional CPID: 3485
Payer-assigned Payer ID: GNPMG
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California
Claims Fee: N/A

Action Required: 

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

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

6/17/2025

Payer Change for CPIDs 1495, 1955 Managed Health Network

Effective May 28, 2025, claims currently exchanged with the following payer must use different CPIDs:
Payer Name: Managed Health Network
Professional CPID: 1495
Institutional CPID: 1955
Remittance Available: Yes
Payer-assigned Payer ID: 22771 

Claims and Remittance must begin using the following:
Payer Name: Health Net of California
Professional CPID: 2855
Institutional CPID: 6514
Remittance Available: Yes
Payer-assigned Payer ID: 95567
Claim Fee: N/A 

CPIDs 1495 and 1955 Managed Health Network will be terminated effective June 18, 2025.

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 2855, 6514 Health Net of California do not need to complete a new enrollment form.  
  • Providers not receiving electronic remittance through Optum for CPIDs 2855, 6514 Health Net of California must complete a new enrollment form. 
  • New providers must complete a new enrollment form.

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.

6/17/2025

Payer Change for CPIDs 1495, 1955 Managed Health Network

Effective May 28, 2025, claims currently exchanged with the following payer must use different CPIDs:

Payer Name: Managed Health Network
Professional CPID: 1495
Professional Edit Master: PE_E049
Institutional CPID: 1955
Institutional Edit Master: HE9E049
RTE Payer ID: CNTENE
Payer-assigned Payer ID: 22771
Line of Business Code (LOB): J33 

Claims and Remittance must begin using the following:
Payer Name: Health Net of California
Professional CPID: 2855
Professional Edit Master: PE_N000
Institutional CPID: 6514
Institutional Edit Master: HE9E049
RTE Payer ID: CNTENE
Payer-assigned Payer ID: 95567
Line of Business Code (LOB): H20 

CPIDs 1495 and 1955 Managed Health Network will be terminated effective June 18, 2025.

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 2855, 6514 Health Net of California do not need to complete a new enrollment form.  
  • Providers not receiving electronic remittance through Optum for CPIDs 2855, 6514 Health Net of California must complete a new enrollment form. 
  • New providers must complete a new enrollment form. 

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. 

6/17/2025

Update: Report Generation Delay for CPID 6884 Positive Healthcare

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted May 9, 2025-May 12, 2025.

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

Original notify sent May 20, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted May 9, 2025-May 12, 2025.

Payer impacted:

  • CPID 6884 Positive Healthcare 

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 09508922.

6/17/2025

Report Generation Delay for CPID 3757 IMAGINE360 ADMINISTRATORS (GPA)

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

Payer impacted: 

  • CPID 3757 IMAGINE360 ADMINISTRATORS (GPA)

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09557366.

6/17/2025

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

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

Payer impacted: 

  • CPID 1402 Blue Cross Blue Shield of Minnesota

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09557255.

6/17/2025

Report Generation Delay for CPIDs 8677 and 7264 Quartz ASO

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

Payer impacted: 

  • CPID 8677 Quartz ASO
  • CPID 7264 Quartz ASO

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09557227.

6/17/2025

Electronic Routing Change for CPIDs 6408 and 4516 Cigna Select Great-West Healthcare

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

Payer Name: Cigna Select Great-West Healthcare
Professional CPID: 6408
Institutional CPID: 4516
Payer-assigned Payer ID: 62308
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

  • 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.

6/16/2025

Electronic Routing Change for CPIDs 6408 and 4516 Cigna Select Great-West Healthcare

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

Payer Name: Cigna Select Great-West Healthcare
Professional CPID: 6408
Institutional CPID: 4516
Payer-assigned Payer ID: 62308
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

  • 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.

6/16/2025

Electronic Routing Change for CPIDs 6408 and 4516 Cigna Select Great-West Healthcare

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

Payer Name: Cigna Select Great-West Healthcare
Professional CPID: 6408
Institutional CPID: 4516\
Payer-assigned Payer ID: 62308
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

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

6/16/2025

Update: Report Generation Delay for CPID 3442 Health Network One

Update: The payer has been unable to generate and deliver the reports for some claims submitted June 6, 2025-June 7, 2025.

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

Original notify sent June 11, 2025:
The payer listed below is experiencing issues affecting Professional report generation for some claims submitted since June 5, 2025.

Payer impacted: 

  • CPID 3442 Health Network One

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 09549771.

6/16/2025

Report Generation Delay for CPID 1116 Special Agents Mutual Benefit Association (SAMBA) Teledoc only

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted June 5, 2025.

Payer impacted:

  • CPID 1116 Special Agents Mutual Benefit Association (SAMBA) Teledoc only

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 09555622.

6/16/2025

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

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

Payer impacted: 

  • CPID 1404 Wellmark Blue Cross Blue Shield of Iowa

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09555547.

6/16/2025

Electronic Routing Change for CPIDs 2801 and 2510 Advocate Health Partners

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

Payer Name: Advocate Health Partners
Professional CPID: 2801
Current Edit Master: PE_N000
New Edit Master: PE_T007
Institutional CPID: 2510
Current Edit Master: HE9B801
New Edit Master: HE9T007
Payer-assigned Payer ID: 65093
Line of Business Code (LOB): U2X
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

Remittance:

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

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

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

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

6/13/2025

Update: Report Generation Delay for multiple CPIDs

Update: Additional affected payers are identified below for this report generation delay.

  • CPID 2581 Lifewise Health Plan of Oregon
  • CPID 2854 Lifewise Health Plan of Oregon

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

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

Original Notify sent June 12, 2025:
A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since June 9, 2025.

Payer impacted:

  • CPID 5522 Premera Blue Cross Blue Shield of Washington and Alaska
  • CPID 7445 Premera Blue Cross Blue Shield of Washington and Alaska

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09552081.

6/13/2025

Update: Report Generation Delay for CPIDs 1876 and 8990 Group Health Cooperative of South Central Wisconsin

Update: The payer has been unable to generate and deliver the reports for some claims submitted June 5, 2025.

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

Original notify sent June 10, 2025:
A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since June 5, 2025.

Payer impacted:

  • CPID 1876 Group Health Cooperative of South Central Wisconsin
  • CPID 8990 Group Health Cooperative of South Central Wisconsin

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 09547118.

6/13/2025

Sutter and Aetna Insurance Company Medical Attachment Connections No Longer Available

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

Payer Name: Sutter and Aetna Insurance Company
Medical Attachment CPIDs: 7781, 8509
Payer-assigned Payer ID: 60624
Reason: Payer no longer offers an electronic connection.

Action Required: None

6/12/2025

Sutter and Aetna Insurance Company Electronic Claims Connection No Longer Available

Effective June 12, 2025, the payer listed below is longer be available at Optum for claims processing.

Payer Name: Sutter and Aetna Insurance Company
Claims CPIDs: 7781, 8509
RTE Payer ID: SUTAET
Payer-assigned Payer ID: 60624
Reason: Payer no longer offers an electronic connection.

Payer will no longer accept paper claims

Action Required: Real Time transactions are no longer available for Assurance Reimbursement Management submitters when claim connections are terminated.

6/12/2025

Electronic Connection No Longer Available CPIDs 7781 & 8509

Effective June 12, 2025, the payer listed below is no longer available at Optum for claims processing.

Payer Name: Sutter and Aetna Insurance Company
Claim CPIDs: 7781, 8509
Payer-assigned Payer ID:60624
Reason: Payer no longer offers an electronic connection.

Payer will no longer accept paper claims.

Action Required: None.

6/12/2025

Electronic Routing Change for CPIDs 3936 and 4285 Denver Health Medical Plan

Effective June 13, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Denver Health Medical Plan
Professional CPID: 4285
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 3936
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 84135
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

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

6/12/2025

Electronic Routing Change for CPIDs 3936 and 4285 Denver Health Medical Plan

Effective June 13, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Denver Health Medical Plan
Professional CPID: 4285
Institutional CPID: 3936
Payer-assigned Payer ID: 84135
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

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

6/12/2025

Report Generation Delay for CPID 3442 Health Network One

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted since June 5, 2025.

Payer impacted:

  • CPID 3442 Health Network One

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 09549771.

6/11/2025

999 Payer Batch Rejections for CPID 5467 Anthem Missouri BC Home Infusion Therapy

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

  • CPID 5467 Anthem Missouri BC Home Infusion Therapy

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

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09548541.

6/11/2025

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 May 28, 2025.

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 09548531.

6/11/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Klyre Payments Network
Institutional CPID: 7926
Professional CPID: 2749
Payer-assigned Payer ID: RP132
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National

Action Required:

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

6/10/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Klyre Payments Network
Institutional CPID: 7926
Professional CPID: 2749
Payer-assigned Payer ID: RP132
Line of Business (LOB) Code: N22
Payer Enrollment Required: Yes
Payer Location: National

Action Required:

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

6/10/2025

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted May 14, 2025

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

Original notify sent May 27, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted May 14, 2025.

Payer impacted: 

  • CPID 7493 Blue Cross Blue Shield of Vermont

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09515653.

6/10/2025

Electronic Routing Change for CPID 2475 Optum Care Network - Monarch

Effective June 11, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Optum Care Network - Monarch
Professional CPID: 2475
Payer-assigned Payer ID: IP095
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

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

6/10/2025

Electronic Routing Change for CPID 2475 Optum Care Network - Monarch

Effective June 11, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Optum Care Network - Monarch
Professional CPID: 2475
Payer-assigned Payer ID: IP095
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

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

6/10/2025

Renaissance Physicians Organization Electronic Claims Connection No Longer Available

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

Payer Name: Renaissance Physicians Organization
Claims CPIDs: 7948, 3197
Payer-assigned Payer ID: 76066
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: Claims must be submitted to Optum on paper. 

6/10/2025

Renaissance Physicians Organization Electronic Claims Connection No Longer Available

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

Payer Name: Renaissance Physicians Organization
Claims CPIDs: 7948, 3197
Payer-assigned Payer ID: 76066
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. 

  • Immediately revalidate unreleased claims to edit correctly to send paper claims. 
  • Modify any bridge routines based on Edit Masters for paper claims. 

6/10/2025

Report Generation Delay for CPID 3887 Veterans Administration Fee Basis Programs

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

Payer impacted:

  • CPID 3887 Veterans Administration Fee Basis Programs

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 09547276.

6/10/2025

Report Generation Delay for CPID 1167 Blue Cross Medicare Advantage PPO/HMO

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

Payer impacted: 

  • CPID 1167 Blue Cross Medicare Advantage PPO/HMO

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09547096.

6/10/2025

Report Generation Delay for CPID 2254 Scott & White Health Plan

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

Payer impacted:

  • CPID 2254 Scott & White Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09546949.

6/10/2025

Northwest Community Health Partners Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: Northwest Community Health Partners
Claims and Remittance CPIDs: 8480, 3070
Remittance LOB:H26
Payer-assigned Payer ID: NWCHP

Reason: Payer no longer offers an electronic connection.
Payer will no longer accept paper claims.

Action Required: None.

6/9/2025

Northwest Community Health Partners Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: Northwest Community Health Partners
Claim and Remittance CPIDs: 8480, 3070
Payer-assigned Payer ID: NWCHP
Reason: Payer no longer offers an electronic connection.
Payer will no longer accept paper claims.

Action Required: None.

6/9/2025

Payer Change for CPIDs 6598, 7745 Alphacare Medical Group

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

Payer Name: Alphacare Medical Group
Professional CPID: 7745
Institutional CPID: 6598
Remittance Available: No
Payer-assigned Payer ID: MPM32

Claims sent on or after June 16, 2025, must begin using the following:
Payer Name: Alphacare Medical Group
Professional CPID: 8247
Institutional CPID: 3000
Remittance Available: Yes
Payer-assigned Payer ID: NMM04
Claim Fee: N/A

Enrollment Requirements:
Remittance:

  • Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 8247, 3000 Alphacare Medical Group do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 8247, 3000 Alphacare Medical Group must complete a new enrollment form.
  • New providers must complete a new enrollment form.

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.

6/9/2025

Payer Change for CPIDs 6598, 7745 Alphacare Medical Group

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

Payer Name: Alphacare Medical Group
Professional CPID: 7745
Professional Edit Master: PE_O007
Institutional CPID: 6598
Institutional Edit Master: HE9O007
Payer-assigned Payer ID: MPM32
Line of Business Code (LOB): N/A

Claims sent on or after June 16, 2025, must begin using the following:
Payer Name: Alphacare Medical Group
Professional CPID: 8247
Current Professional Edit Master: PE_O007
New Professional Edit Master: PE_T007
Institutional CPID: 3000
Current Institutional Edit Master: HE9O007
New Institutional Edit Master: HE9T007
Payer-assigned Payer ID: NMM04
Line of Business Code (LOB): U2W

Enrollment Requirements:
Remittance:

  • Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 8247, 3000 Alphacare Medical Group do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 8247, 3000 Alphacare Medical Group must complete a new enrollment form.
  • New providers must complete a new enrollment form.

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.

6/9/2025

Report Generation Delay for CPIDs 7543 and 2803 UPMC Health Plan

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted on June 3, 2025 and June 4, 2025.

Payer impacted:

  • CPID 7543 UPMC Health Plan
  • CPID 2803 UPMC Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09545841.

6/9/2025

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

A payer is experiencing issues affecting Professional report generation for some claims submitted between May 22, 2025 and May 30, 2025.

Payer impacted:

  • CPID 2824 The Health Plan of West Virginia

The payer has been unable to generate and deliver the reports for some claims submitted between May 22, 2025 and May 30, 2025.

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

If you have any questions, please contact Customer Support and refer to Case Number 09545624.

6/9/2025

New Electronic Eligibility Connection Available

Effective May, 19, 2025 Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer:

Payer Name: Medi Share (CHRISTIAN CARE MINISTRIES)

Industry Payer ID: 59355

IMN Real Time ID: 59355

Exchange Real Time ID: CCMINS

CPID(s): 7154 / 8638

Optum iEDI Real Time ID: 59355

Payer Enrollment Required: No

Connection Type: X12

Search Options:

Eligibility Subscriber

  • Member ID, First Name, Last Name, Date of Birth
  • Member ID, First name, Last Name
  • First Name, Last Name, Date of Birth
  • Member ID, 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 https://customercare.changehealthcare.com/public/home.html

6/9/2025

New Electronic Eligibility Connection Available

Effective May, 27, 2025 Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer:

Payer Name: ALLINA HEALTH AND AETNA INSURANCE COMPANY

Industry Payer ID: 54398

IMN Real Time ID: 54398

Exchange Real Time ID: AHAIC

CPID(s): 7599 / 7780

Optum iEDI Real Time ID: 54398

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

6/9/2025

Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted May 30, 2025.

Payer impacted: 

  • CPID 6671 HealthSun

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09545454.

6/9/2025

Report Generation Delay for CPID 5428 QualChoice of Arkansas

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

Payer impacted: 

  • CPID 5428 QualChoice of Arkansas

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 09545370.

6/9/2025

Report Generation Delay for CPIDs 7567 and 7499 Sentara Health Plans

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

Payer impacted: 

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09545318.

6/9/2025

Update: Report Generation Delay for CPID 1116 Special Agents Mutual

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted May 15, 2025-May 30, 2025.

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

Original notify sent May 28, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since May 15, 2025.

Payer impacted:

  • CPID 1116 Special Agents Mutual Benefit Association (SAMBA) Teledoc only

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 09517200.

6/9/2025

Electronic Routing Change for CPID 7240 Key Health Medical Solutions

Effective June 11, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Key Health Medical Solutions

Professional CPID: 7240

Payer-assigned Payer ID: 95460

Payer Claim Enrollment Required: No

Secondary Claims Accepted: No

Claims Fee: N/A

Remittance Fee: N/A

Enrollment Requirements:

Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

6/6/2025

Electronic Routing Change for CPID 7240 Key Health Medical Solutions

Effective June 11, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Key Health Medical Solutions

Professional CPID: 7240

Edit Master: PE_T007

Payer-assigned Payer ID: 95460

Payer Claim Enrollment Required: No

Secondary Claims Accepted: No

Enrollment Requirements:

Payer enrollment for electronic claims is not required.

Report Changes:

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

6/6/2025

Payer Change for CPIDs 8041, 9759 Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022

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

Claims / Remittance sent or received on or prior to June 26, 2025, may continue to use the following:

Payer Name: Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022

Professional CPID: 9759

Institutional CPID: 8041

Remittance Available: Yes

Payer-assigned Payer ID: 14163

Claims and Remittance sent or received on or after June 27, 2025, must begin using the following:

Current Payer Name: Care1st Health Plan of Arizona Medicaid DOS after 11/30/2022

New Payer Name: Care1st Health Plan of Arizona Medicaid

Professional CPID: 2289

Institutional CPID: 2949

Remittance Available: Yes

Payer-assigned Payer ID: 68069

Claim 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 2289, 2949 Care1st Health Plan of Arizona Medicaid do not need to complete a new enrollment form.
    • Providers not receiving electronic remittance through Optum for CPIDs 2289, 2949 Care1st Health Plan of Arizona Medicaid must complete a new enrollment form.
    • New providers must complete a new enrollment form.

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.

6/6/2025

Payer Change for CPIDs 8041, 9759 Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022

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

Claims / Remittance sent or received on or prior to June 26, 2025, may continue to use the following:

Payer Name: Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022

Professional CPID: 9759

Professional Edit Master: PE_B800

Institutional CPID: 8041

Institutional Edit Master: HE9B801

RTE Payer ID: WELLCR

Payer-assigned Payer ID: 14163

Line of Business Code (LOB): H6A

Claims and Remittance sent or received on or after June 27, 2025, must begin using the following:

Current Payer Name: Care1st Health Plan of Arizona Medicaid DOS after 11/30/2022

New Payer Name: Care1st Health Plan of Arizona Medicaid

Professional CPID: 2289

Professional Edit Master: PE_B800

Institutional CPID: 2949

Institutional Edit Master: HE9B801

RTE Payer ID: CNTENE

Payer-assigned Payer ID: 68069

Line of Business Code (LOB): H6A

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 2289, 2949 Care1st Health Plan of Arizona Medicaid do not need to complete a new enrollment form.
    • Providers not receiving electronic remittance through Optum for CPIDs 2289, 2949 Care1st Health Plan of Arizona Medicaid must complete a new enrollment form.
    • New providers must complete a new enrollment form.

Eligibility:

  • Payer enrollment for electronic eligibility 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.

6/6/2025

Payer Transmit issue for CPID 4480 SelectHealth

Due to a payer processing issue, Professional claims for the payer listed below were resubmitted to the payer between May 23, 2025 and June 5, 2025. 

Payer impacted: 

  • CPID 4480 SelectHealth

This issue affected claims released to Optum between May 21, 2025 and June 2, 2025.

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

If you have any questions, please contact Customer Support and refer to Case Number 09530657.

6/6/2025

New Electronic Medical Attachment Connections Available

Optum has new electronic medical attachment connections available:

Payer Name: Aspirion MVA
Professional CPID: 7113
Institutional CPID: 7670
Payer-assigned Payer ID: 46478
Accepted Attachment Types: Solicited and Unsolicited
Payer Enrollment Required: No
Payer Location: National

Action Required:

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

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

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

6/6/2025

New Assurance Attach Assist Medical Attachment Connections Available

Optum has new electronic medical attachment connections available:

Payer Name: Aspirion MVA
Professional CPID: 7113
Institutional CPID: 7670
Payer-assigned Payer ID: 46478
Accepted Attachment Types: Solicited and Unsolicited
Payer Enrollment Required: No
Payer Location: National

Action Required:

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

6/6/2025

PAR Status Change for Claim Payers effective July 1, 2025

Effective July 1, 2025, the PAR Status for the following claim payers will change:

Payer Name: Community Health Plan of Washington (CHPWA)
Industry ID: CHPWA
Exchange CPID(s): 3445, 1927
Current PAR Status: PAR
New PAR Status: NON PAR

Payer Name: Care To Care
Industry ID: 41222
Exchange CPID(s): 7671, 7114
Current PAR Status: PAR
New PAR Status: GATEWAY

Action Required: Please be aware of the upcoming changes.

6/5/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: CEHAS Plan Administrators

Institutional CPID: 9011

Professional CPID: 3481

Payer-assigned Payer ID: 91888

Payer Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: National

Claims Fee: N/A

Action Required: 

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

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

6/5/2025

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:  

Payer Name: Premier Eye Care 

Institutional CPID: 8996 

Payer-assigned Payer ID: 65054 

Payer Claim Enrollment Required: No 

Payer Remittance Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Payer Location: National 

Claims Fee: N/A 

Remittance Fee: N/A 

Payer Name: Health Network One 

Institutional CPID: 8998 

Professional CPID: 3442 

Payer-assigned Payer ID: 65062 

Payer Claim Enrollment Required: No 

Payer Remittance Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Payer Location: National 

Claims Fee: N/A 

Remittance Fee: N/A 

Plans accepted with this connection: 

  • Eye Management 
  • Health Network One 

Payer Name: HS1 Medical Management 

Professional CPID: 3444 

Payer-assigned Payer ID: 65063 

Payer Claim Enrollment Required: No 

Payer Remittance Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Payer Location: National 

Claims Fee: N/A 

Remittance Fee: N/A 

Action Required:

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

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

6/5/2025

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:  

Payer Name: Premier Eye Care 

Institutional CPID: 8996 

Payer-assigned Payer ID: 65054 

Line of Business(LOB) Code: J52 

Payer Claim Enrollment Required: No 

Payer Remittance Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Payer Location: National 

Payer Name: Health Network One 

Institutional CPID: 8998 

Professional CPID: 3442 

Payer-assigned Payer ID: 65062 

Line of Business(LOB) Code: J11 

Payer Claim Enrollment Required: No 

Payer Remittance Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Payer Location: National 

Plans accepted with this connection: 

  • Eye Management 
  • HN1 Network One 

Payer Name: HS1 Medical Management 

Professional CPID: 3444 

Payer-assigned Payer ID: 65063 

Line of Business(LOB) Code: E23 

Payer Claim Enrollment Required: No 

Payer Remittance Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Payer Location: National 

Action Required: 

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

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

6/5/2025

Electronic Routing Change for CPID 6130 Premier Eye Care

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

Payer Name: Premier Eye Care 

Professional CPID: 6130 

Payer-assigned Payer ID: 65054 

Payer Claim Enrollment Required: No 

Payer Remittance Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Claims Fee: N/A 

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 do not need to 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 are receiving.  

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

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

6/5/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: ArchCare
Institutional CPID: 9010
Professional CPID: 3480
Payer-assigned Payer ID: R3495
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: New York
Claims Fee: $0.10 

Action Required: 

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

6/5/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: ArchCare
Institutional CPID: 9010
Professional CPID: 3480
Payer-assigned Payer ID: R3495
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: New York 

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. 

6/5/2025

Report Generation Delay for CPID 6127 Carelon Behavioral Health, MBHP

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

Payer impacted: 

  • CPID 6127 Carelon Behavioral Health, MBHP

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 09528339.

6/5/2025

Payer Change for CPID 2140 Florida Netpass

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

Payer Name: Florida Netpass
Professional CPID: 2140
Professional Payer-assigned Payer ID: 65063 

Claims must begin using the following:
Payer Name: HS1 Medical Management
Professional CPID: 3444
Remittance Available: Yes
Payer-assigned Payer ID: 65063
Claim Fee: N/A 

CPID 2140 Florida Netpass will be terminated effective June 12, 2025. 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

Remittance:

  • Payer enrollment for electronic remittance is required. 
  • Providers must complete a new enrollment form.

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.

6/5/2025

Payer Change for CPIDs 6910, 5229 Care Access PSN

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

Payer Name: Care Access PSN
Professional CPID: 5229
Institutional CPID: 6910
Professional Payer-assigned Payer ID: 65062
Institutional Payer-assigned Payer ID: 12K89

Claims must begin using the following:
Payer Name: Health Network One
Professional CPID: 3442
Institutional CPID: 8998
Remittance Available: Yes
Payer-assigned Payer ID: 65062
Claim Fee: N/A 

CPIDs 5229 and 6910 Care Access PSN will be terminated effective June 12, 2025. 

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required. 

Remittance:

  • Payer enrollment for electronic remittance is required. 
  • Providers must complete a new enrollment form.

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.

6/5/2025

Electronic Routing Change for CPID 6130 Premier Eye Care

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

Payer Name: Premier Eye Care 

Professional CPID: 6130 

Edit Master: PE_T007 

Payer-assigned Payer ID: 65054 

Line of Business Code (LOB): J52 

Payer Claim Enrollment Required: No 

Payer Remittance Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Enrollment Requirements: 

Claims:

  • Payer enrollment for electronic claims is not required. 

Remittance:

  • Payer enrollment for electronic remittance is required. 
  • Providers currently receiving electronic remittance through Optum do not need to 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 are receiving.  

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

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

6/5/2025

Real Time Eligibility 270/271, Claim Status Inquiry 276/277 Payer ID Change

Real Time Eligibility 270/271, Claim Status 276/277 Payer ID change for the following:

Tricare West - New Payer ID: 99726
Tricare East - New Payer ID: 99727
(Note TRICRE, TRICAR. IDs are not changing).

Effective immediately, begin using the new Payer ids Tricare West 99726, Tricare East 99727.

Legacy payer IDs 68299/TREST, 00080/TRICE,SCWI0,61125,57106, will be removed from the payer list and terminated effective June 25th.

6/4/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Healthy Mississippi
Institutional CPID: 9012
Professional CPID: 3482
Payer-assigned Payer ID: 99914
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Mississippi
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.

6/4/2025

Report Generation Delay for CPID 4248 Community Care BHO

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted May 29, 2025.

Payer impacted: 

  • CPID 4248 Community Care BHO

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09527320.

6/4/2025

Report Generation Delay for CPID 3425 New York Independent Health

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

Payer impacted:

  • CPID 3425 New York Independent 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 09519225.

6/4/2025

Report Generation Delay for CPIDs 2423 and 5558 Blue Cross Blue Shield of Alabama

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

Payer impacted:

  • CPID 2423 Blue Cross Blue Shield of Alabama
  • CPID 5558 Blue Cross Blue Shield of Alabama

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 09525222.

6/3/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Imperial Insurance Companies Exchange Nevada
Institutional CPID: 9009
Professional CPID: 3479
Payer-assigned Payer ID: IEXNV
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Nevada
Claims Fee: $0.10

Action Required: 

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

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

6/3/2025

Report Generation Delay for Multiple CPIDs

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

Payers impacted:

  • CPID   5405   1199SEIU Family of Funds
  • CPID   3262   Affiliated Physicians IPA
  • CPID   2468   Alabama Medicare
  • CPID   1455   Alaska Medicare
  • CPID   5121   Allegeant, LLC
  • CPID   6254   AmFirst Insurance
  • CPID   3270   American Chiropractic Network IPA of NY (ACNIPA)
  • CPID   1456   Arizona Medicare
  • CPID   2161   Arkansas Medicare
  • CPID   7113   Aspirion MVA
  • CPID   8840   Aspirus Medicare Advantage
  • CPID   3802   AvMed
  • CPID   4241   Bakersfield Family Medical Center
  • CPID   7722   Bankers Reserve/Wellcare
  • CPID   2416   Blue Cross Blue Shield of Arkansas
  • CPID   2415   Blue Cross Blue Shield of Mississippi
  • CPID   6792   CHOC - Childrens Hospital of Orange County Health - Rady
  • CPID   3894   CareCore National
  • CPID   2835   CareCore National Aetna Radiology
  • CPID   1727   CareCore National Oxford Radiology
  • CPID   4870   CareCore National Wellcare Radiology (NY counties only)
  • CPID   7250   Carelon Anthem Home Health
  • CPID   2795   Cigna HealthSpring Tennessee/Alabama
  • CPID   3404   Coachella Medical Group
  • CPID   2162   Colorado Medicare
  • CPID   7722   Combined Insurance Company of America
  • CPID   7722   Companion Life Insurance Company
  • CPID   2223   Connecticut Medicare
  • CPID   6814   Consumers Choice of South Carolina/HealthSCOPE Benefits
  • CPID   2831   Correctional Medical Services
  • CPID   1861   Covet Health
  • CPID   6289   Crescent Health Solutions
  • CPID   2163   Delaware Medicare
  • CPID   2425   District of Columbia CareFirst Blue Cross Blue Shield
  • CPID   2165   District of Columbia Metropolitan Area (DCMA) Medicare
  • CPID   2763   EOB TPA
  • CPID   6769   Electrical Workers Insurance Fund Local 5800
  • CPID   5817   EyeMed Vision Care
  • CPID   6453   First Choice Health Network
  • CPID   8821   FirstCarolinaCare - New
  • CPID   7822   Florida Hospital VBR
  • CPID   2216   Florida Medicare
  • CPID   7722   Forethought Life Insurance Company
  • CPID   2299   FrontPath Health Coalition
  • CPID   8472   Gateway Health Plan Medicaid Pennsylvania
  • CPID   2298   Gateway Health Plan Medicare Assured Pennsylvania
  • CPID   9274   Geisinger Health Plan - Reclamation Claims
  • CPID   1466   Georgia Medicare
  • CPID   5814   GlobalHealth OKC
  • CPID   9229   GlobalHealth Texas
  • CPID   1418   Gloria Gates
  • CPID   1877   Group Health Cooperative of South Central Wisconsin Encounters
  • CPID   2865   H.E.R.E.I.U. Welfare Pension Plan
  • CPID   2717   HFN Inc.
  • CPID   1454   HPI Vanderbilt
  • CPID   3778   HPS Paradigm
  • CPID   2467   Hawaii / Guam Medicare
  • CPID   2494   Health Alliance Medical Plans of Illinois
  • CPID   2822   Health Partners Plans of Pennsylvania
  • CPID   8431   HealthPlan Services
  • CPID   3290   High Desert Medical Group
  • CPID   2189   Horace Mann Life Insurance Company
  • CPID   1236   IU Health Plans
  • CPID   2465   Idaho Medicare
  • CPID   2224   Illinois Medicare
  • CPID   5404   Insight Benefit Administrators
  • CPID   1427   Insurance Design Administrators
  • CPID   3860   Integra Group - CHA
  • CPID   2790   Integra Group - Home
  • CPID   6163   Integrated Medical Solutions
  • CPID   6805   Intercommunity Health Network
  • CPID   5485   Intergroup Services Corporation
  • CPID   1469   Iowa Medicaid
  • CPID   2462   Kentucky Medicare
  • CPID   2821   Key Benefit Administrators
  • CPID   2884   Know the Costs
  • CPID   8153   Lasso Healthcare
  • CPID   7722   Liberty Bankers Life Insurance Company
  • CPID   3844   Life Trac
  • CPID   2171   Louisiana Medicare
  • CPID   1701   MBACLM
  • CPID   8295   MDsave
  • CPID   2766   MDwise Medicare Advantage
  • CPID   1700   MPMBA
  • CPID   1748   MVP Health Care
  • CPID   1419   Magellan Healthcare
  • CPID   6827   Maine Community Health Options
  • CPID   2225   Maine Medicare
  • CPID   2419   Maryland CareFirst Blue Cross Blue Shield
  • CPID   2201   Maryland Medicare
  • CPID   2464   Maryland Medicare (Montgomery,Prince George)
  • CPID   2229   Massachusetts Medicare
  • CPID   6739   McLaren Advantage SNP
  • CPID   6732   McLaren Health Plan Medicaid
  • CPID   3261   McLaren Medicare Supplement
  • CPID   7480   Med-Pay
  • CPID   8819   MedStar Family Choice, Inc (DC)
  • CPID   4775   MedStar Family Choice, Inc (MD)
  • CPID   4229   Medicare DME MAC Jurisdiction A
  • CPID   2209   Medicare DME MAC Jurisdiction A
  • CPID   2211   Medicare DME MAC Jurisdiction B
  • CPID   4230   Medicare DME MAC Jurisdiction B
  • CPID   2213   Medicare DME MAC Jurisdiction C
  • CPID   2215   Medicare DME MAC Jurisdiction D
  • CPID   2754   MercyCare Janesville MVP
  • CPID   5248   Miami Behavioral Health
  • CPID   2230   Minnesota Medicare
  • CPID   2203   Mississippi Medicare
  • CPID   7400   Montana Medicare
  • CPID   2167   Municipal Health Benefit Fund
  • CPID   2420   Mutual of Omaha
  • CPID   2737   My Patient Prepaid
  • CPID   6842   Nascentia Health Options
  • CPID   8780   Nascentia Health Plus
  • CPID   2733   National Telecommunications Cooperative Association
  • CPID   9419   NeueHealth
  • CPID   1446   Nevada Medicare
  • CPID   2237   New Hampshire Medicare
  • CPID   2205   New Jersey Medicare
  • CPID   2204   New Mexico Medicare
  • CPID   2244   New York Medicare Empire
  • CPID   2260   New York Medicare GHI
  • CPID   2261   New York Medicare Upstate
  • CPID   5863   New York State Dept of Health Uncompensated Care Program
  • CPID   1464   North Carolina Medicare
  • CPID   2453   North Dakota Medicare
  • CPID   1436   Northern California Medicare
  • CPID   6707   OLOLRMC Uninsured Patient Services Program
  • CPID   1447   Ohio Medicare
  • CPID   2206   Oklahoma Medicare
  • CPID   2765   Optum Rx
  • CPID   1459   Oregon Medicare
  • CPID   6862   Peak Pace Solutions
  • CPID   2207   Pennsylvania Medicare
  • CPID   8455   Peoples Health Network
  • CPID   1737   PodAmerica
  • CPID   1742   Point C
  • CPID   2292   Premier Health Systems, Inc
  • CPID   6133   ProviDRs Care Network
  • CPID   2785   Puerto Rico Medicare
  • CPID   2220   Puerto Rico Medicare
  • CPID   3272   RMSCO Inc.
  • CPID   1443   Railroad Medicare
  • CPID   2268   Rhode Island Medicare
  • CPID   7470   Rocky Mountain HMO
  • CPID   3426   SECUR Health Plan
  • CPID   2491   SISCO
  • CPID   2700   Saint Mary's Health Plan (Encounters)
  • CPID   6192   San Diego County Physician Emergency Services
  • CPID   6736   San Francisco Health Plan
  • CPID   2116   Sanford Health Plan
  • CPID   1134   Sante Community Physicians Medical Group
  • CPID   2281   Sante Health System
  • CPID   4100   Scott & White Health Plan
  • CPID   7722   Shenandoah Life Insurance Company (AIA)
  • CPID   9271   Simpra Advantage Inc.
  • CPID   2452   South Carolina Medicare
  • CPID   5173   South Dakota Chiropractic (Sanford Health Plan)
  • CPID   2454   South Dakota Medicare
  • CPID   1444   Southern California Medicare
  • CPID   7722   Standard Life And Casualty Insurance Company
  • CPID   2708   StandardHealth with Health Choice (HCS)
  • CPID   4713   Sutter Gould Medical Foundation
  • CPID   2872   TRICARE East Region
  • CPID   8827   TakeCare Insurance Company
  • CPID   1453   Tennessee Medicare
  • CPID   8471   Texas Independence Health Plan Inc.
  • CPID   2208   Texas Medicare
  • CPID   2712   The Alliance
  • CPID   3245   The City of Odessa
  • CPID   2824   The Health Plan of West Virginia, Inc
  • CPID   7722   Thrivent
  • CPID   4737   Touchstone Health PSO
  • CPID   2892   Transamerica Life Insurance Co
  • CPID   2238   Trusteed Plans Service
  • CPID   8763   U.S. Networks and Administrative Services
  • CPID   6266   UltraBenefits
  • CPID   9780   Unified Health Plan TPA
  • CPID   8817   Unite Here Health Las Vegas
  • CPID   3741   Upper Peninsula Health Plan
  • CPID   2458   Utah Medicare
  • CPID   6186   VHN
  • CPID   4753   Verdegard Administrators
  • CPID   2755   Verdegard Employee Plan
  • CPID   2278   Vermont Medicare
  • CPID   9121   Village Practice Management Company
  • CPID   4487   Virgin Islands Medicare
  • CPID   2221   Virgin Islands Medicare
  • CPID   1442   Virginia Medicare
  • CPID   2461   Virginia Medicare (Alexandria,Arlington,Fairfax)
  • CPID   1702   Vitori Health
  • CPID   1462   Washington Medicare
  • CPID   1450   West Virginia Medicare
  • CPID   7722   Western Catholic Union
  • CPID   9761   Western Pennsylvania Electrical Employees Insurance Trust Fund
  • CPID   8402   Weyco
  • CPID   2288   Wisconsin Medicare
  • CPID   2466   Wyoming Medicare
  • CPID   8246   Zing Health
  • CPID   2852   Zurich American Insurance Company
  • CPID   7722   illumifin Corporation

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 09519221.

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Institutional claims transmitted to the payers listed below June 2, 2025 were not processed by the payers.

Payers impacted:

  • CPID 1522 District of Columbia Medicare
  • CPID 1526 Arkansas Medicare
  • CPID 1547 Colorado Medicare
  • CPID 1558 Oklahoma Medicare
  • CPID 2528 New Hampshire Medicare
  • CPID 3518 Florida Medicare
  • CPID 3519 New York Medicare Empire
  • CPID 3521 Minnesota Medicare
  • CPID 3533 Connecticut Medicare
  • CPID 3547 Maine Medicare
  • CPID 3579 Louisiana Medicare
  • CPID 3650 JH Mutual of Omaha CO, NM, OK, TX
  • CPID 5502 Texas Medicare

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

This delay affected claims released to Optum June 2, 2025, 12:00 p.m.-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 09524915.

6/3/2025

Payer Processing Issue for CPID 5547 Blue Cross Blue Shield of Arizona

Due to a payer processing issue, Institutional claims transmitted to the payer listed below May 30, 2025 were not processed by the payer.

Payer impacted:

  • CPID 5547 Blue Cross Blue Shield of Arizona

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

This delay affected claims released to Optum May 29, 202, 3:00 p.m.-May 30, 2025, 3:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09524957.

6/3/2025

Report Generation Delay for CPIDs 5909 and 4743 Carelon Behavioral Health

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

Payer impacted: 

  • CPID 5909 Carelon Behavioral Health
  • CPID 4743 Carelon Behavioral Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09524643.

6/3/2025

Report Generation Delay for CPID 5575 New Jersey Charity Care Inpatient

A payer is experiencing issues affecting Institutional report generation for some claims submitted on May 28, 2025.

Payer impacted:

  • CPID 5575 New Jersey Charity Care Inpatient

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 09523006.

6/3/2025

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

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

Payer impacted: 

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09521117.

6/3/2025

UPDATE: Electronic Routing Change for claims and Reactivating and Routing Change for remittance for CPIDs 2121 and 5953 Healthy Blue South Carolina

Update:
Providers must be registered at the payer's Provider Enrollment Portal - My Provider Enrollment Portal (MyPep), prior to submitting the Remittance agreement. Providers that do not complete the registration process will not be setup to receive electronic remittance.

Original sent on April 16, 2025:
Effective April 16, 2025, Optum has changed electronic claims routing and reactivating and changing remittance routing for the following payer:

Payer Name: Healthy Blue South Carolina
Professional CPID: 2121
Institutional CPID: 5953
Payer-assigned Payer ID: 00403
Secondary Claims Accepted: Yes
Claims Fee: N/A
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 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 are receiving.

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

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

6/2/2025

UPDATE: Electronic Routing Change for claims and Reactivating and Routing Change for remittance for CPIDs 2121 and 5953 Healthy Blue South Carolina

Update:
Providers must be registered at the payers Provider Enrollment Portal - My Provider Enrollment Portal (MyPep), prior to submitting the Remittance agreement. Providers that do not complete the registration process will not be setup to receive electronic remittance.

Original sent April 16, 2025
Effective April 16, 2025, Optum changed electronic claims routing and reactivating and changing remittance routing for the following payer:

Payer Name: Healthy Blue South Carolina
Professional CPID: 2121
Institutional CPID: 5953
Payer-assigned Payer ID: 00403
Secondary Claims Accepted: Yes
Claims Fee: N/A
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 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 are receiving.

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

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

6/2/2025

Report Generation Delay for CPID 5503 New Jersey Medicare

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

Payer impacted:

  • CPID 5503 New Jersey Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09523040.

6/2/2025

Older Payer Updates

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

GET OLDER UPDATES
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