New Electronic Eligibility Connections Available

Optum has new electronic eligibility connections available:

Payer Name: Great American Life Assurance Medicare Supplement
Connection Type: X12

Payer Name: Iowa Health Advantage
Connection Type: X12

Payer Name: KSKJ Life ENH
Connection Type: X12

Payer Name: The Alliance
Connection Type: X12

Full list of payers available for Eligibility transactions through Optum: Clearance Patient Access Eligibility Payer List

Action Required: If you wish to submit eligibility transactions to the payer(s) above, please take the following actions:

• Submit a request to be connected to any of the payers via the Customer Care Hub https://customercare.optum.com/public/home.html
• To access the full payer list, login to the Community:
• Already have an account? Login to your Community account.
• Go to Connect > Revenue Excellence (RCM) > Clearance Patient Access Suite > Payer List
• Don’t have an account? Register for a Community account at the link above and wait for full access to be provided (up to 1 business day after registration is submitted).
• If further assistance is needed contact support at [email protected] or 800-527-8133 Option 4.

6/3/2026

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Update: Electronic Claims Connection Suspended for CPIDs 5642 and 6273 LifePath Hospice

Update: 

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

Payer Name: LifePath Hospice
CPIDs: 5642, 6273
Industry Standard Payer ID: 76870
Reason: Payer unavailable electronically.

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

Update sent 5/27/2026:

Effective May 28, 2026, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: LifePath Hospice
Professional CPID: 6273
Institutional CPID: 5642
Industry Standard Payer ID: 76870
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

6/3/2026

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Update: Electronic Claims Connection Suspended for CPIDs 5642 and 6273 LifePath Hospice

Update: 

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

Payer Name: LifePath Hospice
CPIDs: 5642, 6273
Industry Standard Payer ID: 76870
Reason: Payer unavailable electronically.

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

Update sent 5/27/2026:

Effective May 28, 2026, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: LifePath Hospice
Professional CPID: 6273
Current Edit Master: PE_B800
New Edit Master: PE_T007
Institutional CPID: 5642
Current Edit Master: HE9B801
New Edit Master: HE9T007
Industry Standard Payer ID: 76870
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

6/3/2026

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New Real-Time Eligibility Transactions Available

Effective May 29th, 2026, Optum is pleased to announce the availability of Real-time Eligibility (270/271) transactions for the below payer:

Payer Name: KSKJ Life
Transaction Type: Eligibility
Payer ID: 10748
IEDI Payer ID: 10748
Exchange Payer ID: KSKJL

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.

Moving forward, for assistance or support requests, please use the following option:

• Customer Care Hub Portal: Submit a ticket through the Customer Care Hub at https://customercare.optum.com/public/home.html
  • Please note: If you are not currently registered, you will need to complete the registration process before submitting a ticket.

Updated Payer Lists may be obtained from your software vendor or Payer List Portal.

6/3/2026

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Payer Processing Issue for CPIDs 2017 and 8152 Altura MSO

Due to a payer processing issue, some Institutional and Professional claims transmitted to the payer listed below on May 25, 2026 were not processed by the payer.

Payer impacted:

• CPID 2017 Altura MSO
• CPID 8152 Altura MSO

A resolution has been implemented and the claims were retransmitted to the payer on June 3, 2026.

This delay affected claims released to Optum between 2 a.m. CT on May 22, 2026 and 2 a.m. CT on May 25, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 10331210.

6/3/2026

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PAR Status Change for Claim Payers June 3, 2026

The PAR Status is changing for the following claim payers:

Affinity Medical Group
Exchange CPID(s): 5217, 9683
Transaction: Claims – Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

Allstate
Exchange CPID(s): 8714, 3089
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

American Postal Workers Union
Exchange CPID(s): 6436, 4503
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

Benefit Coordinators Corporation
Exchange CPID(s): 3864
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: July 1, 2026

Benefit Plan Administrators Roanoke Virginia
Exchange CPID(s): 8482, 7526
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

IU Health Transplant
Exchange CPID(s): 8149, 2015
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

Northwest Administrators
Exchange CPID(s): 6293
Transaction: Claims - Professional
New PAR Status: Transitional
Effective Date: June 1, 2026

Santa Clara County IPA HMO
Exchange CPID(s): 5279
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: July 1, 2026

Summit Administration Services
Exchange CPID(s): 1114, 9524
Transaction: Claims – Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

University Health Care Advantage
Exchange CPID(s): 7217, 8634
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

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

6/3/2026

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Electronic Claims Connection Suspended for LifePath Hospice

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

Payer Name: LifePath Hospice
Payer ID: 76870
Reason: Payer unavailable electronically.

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

6/3/2026

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Payer Change for Cigna HealthSpring Tennessee/Alabama

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

Payer Name: Cigna HealthSpring Tennessee/Alabama
Remittance Available: Yes
Payer ID: 63092

Payer ID 63092 Cigna HealthSpring Tennessee/Alabama will be terminated effective July 9, 2026.

Providers must begin using the following ID for electronic claims and remittance:

Current Payer Name: Cigna HealthSpring Maryland/Pennsylvania
New Payer Name: HealthSpring Medicare Advantage
Remittance Available: Yes
Industry Standard Payer ID: 52192

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 Payer ID 52192 HealthSpring Medicare Advantage do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for Payer ID 52192 HealthSpring Medicare Advantage 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 IEDI.

6/3/2026

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Payer Change for Multiple Payers

Effective July 1, 2026, the payers listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by June 30, 2026, 5:00 p.m. CT to ensure final transmission to the payer.

Payer Name: Anthem Blue Cross Blue Shield of Nevada EVV
Payer-assigned Payer ID: NVANT

Payer Name: EVV Health Plan Nevada UHC
Payer-assigned Payer ID: NVHPN

Payer Name: EVV Molina Health Plan Nevada
Payer-assigned Payer ID: NVMOL

Payer Name: EVV State of Nevada
Payer-assigned Payer ID: NVFFS

Reason: Payer IDs no longer supported.

Claims submitted after June 30, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Anthem Blue Cross Blue Shield of Nevada
Payer ID: 00265

Payer Name: Sierra Health and Life
Payer ID: 76342

Payer Name: Molina Healthcare of Nevada
Payer ID: MLNNV

Payer Name: Nevada Medicaid
Standard Payer ID: NVMED

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required for the following payers:
  • Anthem Blue Cross Blue Shield of Nevada
  • Sierra Health and Life
  • Molina Healthcare of Nevada

Payer enrollment for electronic claims is required for the following payer:

• Nevada Medicaid.
  • Providers currently sending electronic claims through Optum for Payer ID NVMED do not need to complete a new enrollment form.
  • New providers must complete a new enrollment form.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for Payer IDs 76342, 00265, MLNNV, and NVMED do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for Payer IDs 76342, 00265, MLNNV, and NVMED must complete a new enrollment form.
  • New providers must complete a new enrollment form.

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

• Modify any bridge routines based on edit masters.

6/3/2026

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Payer Processing Issue for multiple CPIDs

Due to a payer processing issue, some Professional and Institutional claims transmitted to the payers listed below from May 29, 2026-June 2, 2026 were not processed by the payers.

Payers impacted:

• CPID 8561 Avera Health Plans
• CPID 1786 Avera Health Plans
• CPID 9187 Avera-VA Claims
• CPID 6035 Avera-VA Claims

A resolution has been implemented and the claims were retransmitted to the payers June 3, 2026.

This delay affected claims released to Optum May 28, 2026, 11:00-June 2, 2026, 11:00 a.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 10331983.

6/3/2026

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Electronic Routing Change for CPIDs 7757 and 7547 New Jersey Manufacturers

Optum has changed electronic remittance routing for the following payer, effective June 3, 2026:

Payer Name: New Jersey Manufacturers
Professional CPID: 7757
Institutional CPID: 7547
Industry Standard Payer ID: 12122
Payer Remittance Enrollment Required: Yes

Enrollment Requirements:
Remittance:

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

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

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

6/3/2026

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Electronic Routing Change for CPIDs 7757 and 7547 New Jersey Manufacturers

Optum has changed electronic remittance routing for the following payer, effective June 3, 2026:

Payer Name: New Jersey Manufacturers
Professional CPID: 7757
Institutional CPID: 7547
Industry Standard Payer ID: 12122
Line of Business Code (LOB): U9Q
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.

6/3/2026

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Report Generation Delay for CPID 1457 New Mexico Medicare

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

Payer impacted:

• CPID 1457 New Mexico Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10331253.

6/3/2026

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Electronic Routing Change for CPIDs 1786 and 8561 Avera Health Plans

Effective June 2, 2026, Optum will be changing electronic claims and remittance routing for the following payer:

Payer Name: Avera Health Plans
Professional CPID: 1786
Institutional CPID: 8561
Industry Standard Payer ID: 46045
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.
  • Providers who have not received remittance since February 28, 2026, will need to complete a new enrollment form.

Report Changes:

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

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

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

6/2/2026

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Electronic Routing Change for CPIDs 1786 and 8561 Avera Health Plans

Effective June 2, 2026, Optum will be changing electronic claims and remittance routing for the following payer:

Payer Name: Avera Health Plans
Professional CPID: 1786
Edit Master: PE_T007
Institutional CPID: 8561
Edit Master: HE9T007
Industry Standard Payer ID: 46045
Line of Business Code (LOB): J84
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.
  • Providers who have not received remittance since February 28, 2026, will need to complete a new enrollment form.

Report Changes:

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

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

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

6/2/2026

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Report Generation Delay for CPID 3509 Ohio Medicaid

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

Payer impacted:

• CPID 3509 Ohio Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10329910.

6/2/2026

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PAR Status change for Claims payers June 2, 2026

The PAR Status will change for the following claim payers:

Affinity Medical Group
iEDI Payer ID: 46594
Transaction: Claims - Institutional
New PAR Status: Non Par
Effective Date: July 1, 2026

Allstate
iEDI Payer ID: C1037
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: July 1, 2026

American Postal Workers Union
iEDI Payer ID: 44444
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

Benefit Coordinators Corporation
iEDI Payer ID: 25145
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: July 1, 2026

Benefit Plan Administrators Roanoke Virginia
iEDI Payer ID: 37118
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

Global Care
iEDI Payer ID: 07689
Transaction: Claims - Prof/Inst
New PAR Status: Gateway
Effective Date: June 1, 2026

iCircle Care of New York
iEDI Payer ID: ICRCL
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

IU Health Transplant
iEDI Payer ID: 47262
Transaction: Claims - Prof/Inst
New PAR Status: Non Par
Effective Date: July 1, 2026

Keystone First CHIP
iEDI Payer ID: 30070
Transaction: Claims - Prof/Inst
New PAR Status: Par
Effective Date: July 1, 2026

Northwest Administrators
iEDI Payer ID: NWADM
Transaction: Claims - Professional
New PAR Status: Transitional
Effective Date: June 1, 2026

ResourceOne Administrators
iEDI Payer ID: 66456
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: July 1, 2026

Santa Clara County IPA HMO
iEDI Payer ID: 10378
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: July 1, 2026

Summit Administration Services
iEDI Payer ID: 86083
Transaction: Claims - Institutional
New PAR Status: Non Par
Effective Date: July 1, 2026

TrueCare Mississippi Medicaid
iEDI Payer ID: MSCS1
Transaction: Claims - Professional
New PAR Status: Non Par
Effective Date: July 1, 2026

University Health Care Advantage
iEDI Payer ID: 46407
Transaction: Claims - Prof/Inst
New PAR Status: Transitional
Effective Date: July 1, 2026

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

6/2/2026

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Edit Master for CPIDs 9456 and 7069 Choice Physicians Network Nivano Physicians

Optum has changed Edit Masters for the following payer, effective June 2, 2026:

Payer Name: Choice Physicians Network Nivano Physicians
Professional CPID: 9456
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 7069
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: CPNNP

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

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

6/2/2026

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New Payer Edit for CPID 7518
The payer listed below has informed Optum of a new edit requirement effective immediately. In order to meet the new requirement, we will add the following edit June 8, 2026:

• ICLM02A009: INVALID TOTAL CLAIM CHARGE AMT - When the Type of Bill is 32x, the Total Claim Charge Amount must be greater than zero. Note: If this requirement does not apply to your billing situation, you can override the edit within the Error Text. LOOP 2300 CLM02

Edit applies to:

• CPID 7518 CareFirst Blue Cross Blue Shield of Maryland

Action Required: Please be aware of updated edit requirements.

6/2/2026

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Delta Dental of Rhode Island Electronic Eligibility Connection No Longer Available

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

Payer Name: Delta Dental of Rhode Island
Industry Payer ID: 05029
IMN Real Time ID: 05029
Optum iEDI Real Time ID: 10734
Connection Type: X12

Reason: Payer no longer offers an electronic connection.

Action Required: None.

6/2/2026

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Eligibility termination for payer ID 90551 on Revenue Performance Advisor

Real Time Eligibility 270/271 and Claim Status Inquiry 276/277 for the payer listed below is no longer available at Optum, on the Revenue Performance Advisor (RPA) system, effective immediately.

Payer Name: Collective Health
RPA Payer ID: 90551

Reason: Payer no longer offers an electronic connection.

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

6/2/2026

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Eligibility Termination for Payer ID 36479 on Revenue Performance Advisor (RPA)

Real Time Eligibility 270/271 and Claim Status Inquiry 276/277 for the payer listed below is no longer available at Optum, on the Revenue Performance Advisor (RPA) system, effective immediately.

Payer Name: Collective Health
RPA Payer ID: 36479
Reason: Payer no longer offers an electronic connection.

Action Required:

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

6/2/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Memorial Medical Center - Non Sutter
Professional CPID: 1760
Institutional CPID: 1614
Industry Standard Payer ID: SC054
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

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.

6/2/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Memorial Medical Center - Non Sutter
Professional CPID: 1760
Institutional CPID: 1614
Industry Standard Payer ID: SC054
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
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.

6/2/2026

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Update: Remittance Changes for CPID 1750 Brown & Toland Physicians

Effective June 17, 2026, remit for CPID 1750 will no longer be processed. 

Reminder: 

Effective June 17, 2206, remit for CPID 1750 will no longer be processed. 

Providers must login to Enrollment Central prior to June 17, 2026, to verify that they are enrolled for Brown & Toland Services, Payer ID BTSH1, CPIDs 6867 7645. 

Original notification sent May 20, 2026

It has come to Optum’s attention that you are receiving electronic remittance for the terminated payer listed below. Effective June 17, 2026, Optum will no longer process electronic remittance for the following payer:

Payer Name: Brown & Toland Physicians
Professional CPID: 1750
Industry Standard Payer ID: BTHS1

In order to continue receiving electronic remittance, providers must login in to Enrollment Central prior to June 17, 2026, to verify they are enrolled with the payer listed below. 

Payer Name: Brown & Toland Health Services
Professional CPID: 6867
Institutional CPID: 7645
Industry Standard Payer ID: BTSH1

Enrollment Requirements: 

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers already enrolled for CPIDs 6867 or 7645 do not need to complete a new enrollment form.
  • Providers who are not enrolled for CPIDs 6867 or 7645 must complete a new enrollment form prior to June 17, 2026. 

Action Required: 

• Please make the necessary enrollment changes, before the effective date, to continue receiving electronic remittance. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

6/1/2026

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Update: Remittance Changes for CPID 1750 Brown & Toland Physicians

Update: 

Effective June 17, 2026, remit for CPID 1750 will no longer be processed. 

Reminder: 

Effective June 17, 2206, remit for CPID 1750 will no longer be processed. 

Providers must login to Enrollment Central prior to June 17, 2026, to verify that they are enrolled for Brown & Toland Services, Payer ID BTSH1, CPIDs 6867 7645. 

Original notification sent May 20, 2026

It has come to Optum’s attention that you are receiving electronic remittance for the terminated payer listed below. Effective June 17, 2026, Optum will no longer process electronic remittance for the following payer:

Payer Name: Brown & Toland Physicians
Professional CPID: 1750
Industry Standard Payer ID: BTHS1
Line of Business Code (LOB): J12

In order to continue receiving electronic remittance, providers must login in to Enrollment Central prior to June 17, 2026, to verify they are enrolled with the payer listed below. 

Payer Name: Brown & Toland Health Services
Professional CPID: 6867
Institutional CPID: 7645
Industry Standard Payer ID: BTSH1
Line of Business Code (LOB): J12

Enrollment Requirements: 

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers already enrolled for CPIDs 6867 or 7645 do not need to complete a new enrollment form.
  • Providers who are not enrolled for CPIDs 6867 or 7645 must complete a new enrollment form prior to June 17, 2026. 

Action Required: 

• Please make the necessary enrollment changes, before the effective date, to continue receiving electronic remittance. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

6/1/2026

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Update: Remittance Changes for CPID 1750 Brown & Toland Physicians

Reminder: 

Effective June 17, 2206, remit for CPID 1750 will no longer be processed. 

Providers must login to Enrollment Central prior to June 17, 2026, to verify that they are enrolled for Brown & Toland Services, Payer ID BTSH1, CPIDs 6867 7645. 

Original notification sent May 20, 2026

It has come to Optum’s attention that you are receiving electronic remittance for the terminated payer listed below. Effective June 17, 2026, Optum will no longer process electronic remittance for the following payer:

Payer Name: Brown & Toland Physicians
Professional CPID: 1750
Industry Standard Payer ID: BTHS1
Line of Business Code (LOB): J12

In order to continue receiving electronic remittance, providers must login in to Enrollment Central prior to June 17, 2026, to verify they are enrolled with the payer listed below. 

Payer Name: Brown & Toland Health Services
Professional CPID: 6867
Institutional CPID: 7645
Industry Standard Payer ID: BTSH1
Line of Business Code (LOB): J12

Enrollment Requirements: 

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers already enrolled for CPIDs 6867 or 7645 do not need to complete a new enrollment form.
  • Providers who are not enrolled for CPIDs 6867 or 7645 must complete a new enrollment form prior to June 12, 2026. 

Action Required: 

• Please make the necessary enrollment changes, before the effective date, to continue receiving electronic remittance. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

6/1/2026

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Update: Remittance Changes for CPID 1750 Brown & Toland Physicians

Reminder: 

Effective June 17, 2206, remit for CPID 1750 will no longer be processed. 

Providers must login to Enrollment Central prior to June 17, 2026, to verify that they are enrolled for Brown & Toland Services, Payer ID BTSH1, CPIDs 6867 7645. 

Original notification sent May 20, 2026

It has come to Optum’s attention that you are receiving electronic remittance for the terminated payer listed below. Effective June 17, 2026, Optum will no longer process electronic remittance for the following payer:

Payer Name: Brown & Toland Physicians
Professional CPID: 1750
Industry Standard Payer ID: BTHS1

In order to continue receiving electronic remittance, providers must login in to Enrollment Central prior to June 17, 2026, to verify they are enrolled with the payer listed below. 

Payer Name: Brown & Toland Health Services
Professional CPID: 6867
Institutional CPID: 7645
Industry Standard Payer ID: BTSH1

Enrollment Requirements:
Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers already enrolled for CPIDs 6867 or 7645 do not need to complete a new enrollment form.
  • Providers who are not enrolled for CPIDs 6867 or 7645 must complete a new enrollment form prior to June 12, 2026. 

Action Required: 

• Please make the necessary enrollment changes, before the effective date, to continue receiving electronic remittance. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

6/1/2026

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New Real Time Eligibility 270/271 Connection Available

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

Payer Name: Johns Hopkins US Family Health Plan
Industry Payer ID: 52123
IMN Real Time ID: JHFHP
Exchange Real Time ID: JHFHP
CPID(s): 4959 & 4750
Optum IEDi Real Time ID: JHFHP
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Subscriber

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

Dependent

• Member ID, Dependent First Name, Dependent Last Name

Action Required by customer:

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

6/1/2026

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Resolved: Invalid Error Message for Payer ID BCBSAZ, 53589, Blue Cross Blue Shield of Arizona

Resolved: This issue is now resolved. All affected claims have processed at the payer.

Original notify sent on: March 27, 2025

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

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

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

Payers affected:

• Payer ID BCBSAZ Blue Cross Blue Shield of Arizona
• Payer ID 53589 Blue Cross Blue Shield of Arizona

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

6/1/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: Choice Physicians Net First Choice
Professional CPID: 1794
Industry Standard Payer ID: CPNFC
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California 

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.

6/1/2026

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Edit Master for CPIDs 6852 and 7635 Clinicas Del Camino Real

Optum is changing Edit Masters for the following payer, effective June 1, 2026:

Payer Name: Clinicas Del Camino Real
Professional CPID: 6852
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 7635
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: CDCR1

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

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

6/1/2026

---

New Real Time Eligibility 270/271 Connection Available

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

Payer Name: Johns Hopkins US Family Health Plan
Industry Payer ID: 52123
IMN Real Time ID: JHFHP
Exchange Real Time ID: JHFHP
CPID(s): 4959 & 4750
Optum IEDi Real Time ID: JHFHP
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Subscriber

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

Dependent

• Member ID, Dependent First Name, Dependent Last Name

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

6/1/2026

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

Resolved: This issue is now resolved. All affected claims have processed at the payer.

Original notify sent March 27, 2025
Due to a payer processing issue, Professional and Institutional claims for the payer listed below may have received the following invalid error message on the Payer Claim Data Report (SR), Payer Claim Data Report (SE), Payer Report Data File (SF):

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

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

Payers affected:

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

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

6/1/2026

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Edit Master for Children's Physicians Medical Group and Children's Specialists of San Diego

Optum is changing Edit Masters for the following payers, effective June 1, 2026:

Payer Name: Children's Physicians Medical Group
Professional CPID: 1145
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: RCHN1

Payer Name: Children's Specialists of San Diego
Professional CPID: 1197
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: CSSD2

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

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

6/1/2026

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Edit Master for CPIDs 5914 and 4221 CalOptima Direct

Optum is changing Edit Masters for the following payer, effective June 2, 2026:

Payer Name: CalOptima Direct
Professional CPID: 4221
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 5914
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: CALOP

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

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

6/1/2026

---

Payer Change for Multiple Payers

Effective July 1, 2026, the payers listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by June 30, 2026, 5:00 p.m. CT to ensure final transmission to the payer.

Payer Name: Anthem Blue Cross Blue Shield of Nevada EVV
Professional CPID: 1801
Professional Edit Master: PE_B143
Institutional CPID: 2944
Institutional Edit Master: HE9B143
Payer-assigned Payer ID: NVANT

Payer Name: EVV Health Plan Nevada UHC
Professional CPID: 1800
Professional Edit Master: PE_T007
Institutional CPID: 2925
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: NVHPN

Payer Name: EVV Molina Health Plan Nevada
Professional CPID: 1799
Professional Edit Master: PE_T007
Institutional CPID: 2922
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: NVMOL

Payer Name: EVV State of Nevada
Professional CPID: 1798
Professional Edit Master: PE_F014
Institutional CPID: 2916
Institutional Edit Master: HE9F014
Payer-assigned Payer ID: NVFFS

Reason: Payer IDs no longer supported.

Claims submitted after June 30, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Anthem Blue Cross Blue Shield of Nevada
Professional CPID: 7496
Professional Edit Master: PE_B143
Institutional CPID: 2906
Institutional Edit Master: HE9B143
Industry Standard Payer ID: 00265
Line of Business Code (LOB): X68

Payer Name: Sierra Health and Life
Professional CPID: 3880
Professional Edit Master: PE_N000
Institutional CPID: 1994
Institutional Edit Master: HE9N000
Industry Standard Payer ID: 76342
Line of Business Code (LOB): U56

Payer Name: Molina Healthcare of Nevada
Professional CPID: 9247
Professional Edit Master: PE_C051
Institutional CPID: 6086
Institutional Edit Master: HE9C051
Industry Standard Payer ID: MLNNV
Line of Business Code (LOB): U21

Payer Name: Nevada Medicaid
Professional CPID: 7495
Professional Edit Master: PE_F014
Institutional CPID: 2907
Institutional Edit Master: HE9F014
Industry Standard Payer ID: NVMED
Line of Business Code (LOB): D31

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required for the following payers:
• 7496, 2906 Anthem Blue Cross Blue Shield of Nevada
• 3880, 1994 Sierra Health and Life
• 9247, 6086 Molina Healthcare of Nevada

Payer enrollment for electronic claims is required for the following payer:

• 7495, 2907 Nevada Medicaid.
• Providers currently sending electronic claims through Optum for CPIDs 7495 and 2907 do not need to complete a new enrollment form.
• New providers must complete a new enrollment form.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 1994, 2906, 2907, 3880, 6086, 7495, 7496, and 9247 do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 1994, 2906, 2907, 3880, 6086, 7495, 7496, and 9247 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.

6/1/2026

---

Payer Change for Multiple Payers

Effective July 1, 2026, the payers listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by June 30, 2026, 5:00 p.m. CT to ensure final transmission to the payer.

Payer Name: Anthem Blue Cross Blue Shield of Nevada EVV
Claim CPIDs: 1801, 2944
Industry Standard Payer ID: NVANT

Payer Name: EVV Health Plan Nevada UHC
Claim CPIDs: 1800, 2925
Industry Standard Payer ID: NVHPN

Payer Name: EVV Molina Health Plan Nevada
Claim CPIDs: 1799, 2922
Industry Standard Payer ID: NVMOL

Payer Name: EVV State of Nevada
Claim CPIDs: 1798, 2916
Industry Standard Payer ID: NVFFS

Reason: Payer IDs no longer supported.

Claims submitted after June 30, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Anthem Blue Cross Blue Shield of Nevada
Professional CPID: 7496
Institutional CPID: 2906
Remittance Available: Yes
Industry Standard Payer ID: 00265
Claim Fee: No

Payer Name: Sierra Health and Life
Additional Plan: Health Plan of Nevada
Professional CPID: 3880
Institutional CPID: 1994
Remittance Available: Yes
Industry Standard Payer ID: 76342
Claim Fee: No

Payer Name: Molina Healthcare of Nevada
Professional CPID: 9247
Institutional CPID: 6086
Remittance Available: Yes
Industry Standard Payer ID: MLNNV
Claim Fee: No

Payer Name: Nevada Medicaid
Professional CPID: 7495
Institutional CPID: 2907
Remittance Available: Yes
Industry Standard Payer ID: NVMED
Claim Fee: No

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required for the following payers:
• 7496, 2906 Anthem Blue Cross Blue Shield of Nevada
• 3880, 1994 Sierra Health and Life
• 9247, 6086 Molina Healthcare of Nevada

Payer enrollment for electronic claims is required for the following payer:

• 7495, 2907 Nevada Medicaid.
• Providers currently sending electronic claims through Optum for CPIDs 7495 and 2907 do not need to complete a new enrollment form.
• New providers must complete a new enrollment form.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 1994, 2906, 2907, 3880, 6086, 7495, 7496, and 9247 do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 1994, 2906, 2907, 3880, 6086, 7495, 7496, and 9247 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 updates in your system.

6/1/2026

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Report Generation Delay for CPID 5909 Carelon Behavioral Health

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

Payer impacted:

• CPID 5909 Carelon Behavioral Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10326616.

6/1/2026

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Report Generation Delay for CPID 7241 TransactRX Part D

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on May 25, 2026.

Payer impacted:

• CPID 7241 TransactRX Part D

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10327954.

6/1/2026

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Report Generation Delay for CPID 1558 Oklahoma Medicare

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

Payer impacted:

• CPID 1558 Oklahoma Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10326515.

6/1/2026

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Payer Change for Multiple payers

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

Payer Name: Cigna HealthSpring Tennessee/Alabama
Professional CPID: 2795
Institutional CPID: 1556
Remittance Available: Yes
Industry Standard Payer ID: 63092

Payer Name: Cigna Medicare
Professional CPID: 4742
Institutional CPID: 5694
Remittance Available: Yes
Industry Standard Payer ID: 52192

CPIDs 1556 and 2795 Cigna HealthSpring Tennessee/Alabama and CPIDs 5694 and 4742 Cigna Medicare will be terminated effective July 9, 2026. 

Providers must begin using the following ID for electronic claims and remittance:

Current Payer Name: Cigna HealthSpring Maryland/Pennsylvania
New Payer Name: HealthSpring Medicare Advantage
Professional CPID: 3839
Institutional CPID: 1978
Remittance Available: Yes
Industry Standard Payer ID: 52192
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 3839, 1978 HealthSpring Medicare Advantage do not need to complete a new enrollment form. 
  • Providers not receiving electronic remittance through Optum for CPIDs 3839, 1978 HealthSpring Medicare Advantage 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.

6/1/2026

---

Payer Change for Multiple payers

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

Payer Name: Cigna HealthSpring Tennessee/Alabama
Professional CPID: 2795
Professional Edit Master: PE_T007
Institutional CPID: 1556
Institutional Edit Master: HE9T007
RTE Payer ID: HSPRNG
Industry Standard Payer ID: 63092
Line of Business Code (LOB): U1F

Payer Name: Cigna Medicare
Professional CPID: 4742
Professional Edit Master: PE_B800
Institutional CPID: 5694
Institutional Edit Master: HE9B801
RTE Payer ID: HSPRNG
Industry Standard Payer ID: 52192
Line of Business Code (LOB): U1F

CPIDs 1556 and 2795 Cigna HealthSpring Tennessee/Alabama and CPIDs 5694 and 4742 Cigna Medicare will be terminated effective July 9, 2026. 

Providers must begin using the following ID for electronic claims, remittance and eligibility:

Current Payer Name: Cigna HealthSpring Maryland/Pennsylvania
New Payer Name: HealthSpring Medicare Advantage
Professional CPID: 3839
Professional Edit Master: PE_T007
Institutional CPID: 1978
Institutional Edit Master: HE9T007
RTE Payer ID: ELDRHL
Industry Standard Payer ID: 52192
Line of Business Code (LOB): U1F

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 3839, 1978 HealthSpring Medicare Advantage do not need to complete a new enrollment form. 
  • Providers not receiving electronic remittance through Optum for CPIDs 3839, 1978 HealthSpring Medicare Advantage 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.

6/1/2026