Update: Report Generation Delay for CPIDs 2930 and 3232 Health Choice Arizona

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on March 16, 2026.

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

Original notice sent March 27, 2026:

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

Payer(s) impacted:

• CPID 2930 Health Choice Arizona
• CPID 3232 Health Choice Arizona

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10239246.

3/31/2026

---

Resolved: Delay in Electronic Remittance Advice (ERA) for CPID 3510, 1473, 5987, 2436 California Medicaid (Medi-Cal)

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

Original Notify sent March 27, 2026:

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 12, 2026–Present:

• California Medicaid (Medi-Cal)
  • CPIDs 3510, 1473, 5987, 2436

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-000004398.

3/31/2026

---

Resolved: Delay in Electronic Remittance Advice (ERA) for CPID 3510, 1473, 5987, 2436 California Medicaid (Medi-Cal)

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

Original Notify sent March 27, 2026:

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 12, 2026–Present:

• California Medicaid (Medi-Cal)
  • CPIDs 3510, 1473, 5987, 2436

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-000004398.

3/31/2026

---

Resolved: Delay in Electronic Remittance Advice (ERA) for Payer ID MDCAL, California Medicaid (Medi-Cal)

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

Original Notify sent March 27, 2026:

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 12, 2026 – Present.

• California Medicaid (Medi-Cal)
  • Payer ID MDCAL

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-000004398.

3/31/2026

---

Resolved: Delay in Electronic Remittance Advice (ERA) for CPID 5419, 6573 State Farm Insurance (Health)

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

Original notify sent March 26, 2026:

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 13, 2026 - Present.

• State Farm Insurance (Health): CPID 5419, 6573

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-000004387.

3/31/2026

---

835 Delay for UnitedHealthcare Payer ID 87726

Some 835s for UnitedHealthcare payer ID 87726 are delayed at the payer for payment date March 26, 2026. A ticket has been opened with the payer for further research.

• Payer ID 87726 UnitedHealthcare

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004450.

3/31/2026

---

835 Delay for UnitedHealthcare CPID 3429, 3550

Some 835s for UnitedHealthcare CPIDs 3429, 3550 are delayed at the payer for payment date March 26, 2026. A ticket has been opened with the payer for further research.

• CPID 3429 UnitedHealthcare
• CPID 3550 UnitedHealthcare

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004450.

3/31/2026

---

Resolved: Delay in Electronic Remittance Advice (ERA) for Payer ID 31053 State Farm Insurance (Health)

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

Original notify sent March 26, 2026:

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 13, 2026 - Present.

• State Farm Insurance (Health): Payer ID 31053

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-000004387.

3/31/2026

---

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

Due to a processing issue, some Professional and Institutional claims transmitted to the payer listed below between Feb. 28, 2026 and March 11, 2026 were not processed by the payer.

Payer(s) impacted:

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

A resolution has been implemented and the claims were retransmitted to the payer on March 31, 2026.

This delay affected claims released to Optum between 5 a.m. CT on Feb. 27, 2026 and 5 a.m. CT on March 11, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09921247.

3/31/2026

---

Payer Consolidation - Wellcare Health Plans

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

Payer Name: Wellcare of Connecticut
Payer ID: 14164
Claim Type: Institutional

Payer Name: Wellcare Health Plans
Payer ID: 26141, 36406, 48055
Claim Type: Professional

Payer Name: Wellcare Health Plans
Payer ID: 36406, 48055
Claim Type: Institutional

Payer IDs 14164, 26141, 36406, 48055 will be terminated effective April 17, 2026.

Providers must begin using the following ID for electronic claims:

Payer ID: 14163

The following IDs will also be phasing out in the future, so submitters are encouraged to start transitioning to Payer ID 14163.

Payer Name: Wellcare of Connecticut
Payer ID: 14164
Claim Type: Professional

Payer Name: Wellcare Health Plans
Payer ID: 59608
Claim Type: Institutional and Professional

Payer Name: Wellcare Health Plans
Payer ID: WELLC
Claim Type: Professional

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.

3/30/2026

---

Report Generation Delay for CPIDs 5539 and 1419 Magellan Healthcare

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted since March 19, 2026.

Payer impacted:

• CPID 5539 Magellan Healthcare
• CPID 1419 Magellan Healthcare

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 10241520.

3/30/2026

---

Payer Consolidations - Alignment Health Care

Effective April 24, 2026, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: Alignment Health Care
Payer ID: AHCA1
Claim Type: Professional and Institutional

Payer ID AHCA1 will be terminated effective April 24, 2026.

Providers must begin using the following ID for electronic claims:

Payer ID: CCHPC

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.

3/27/2026

---

Payer Consolidations - AmeriHealth New Jersey PPO

Effective April 24, 2026, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: AmeriHealth New Jersey PPO
Payer ID: 12X28
Claim Type: Institutional
Payer ID: SX075
Claim Type: Professional

Payer IDs 12X28 and SX075 will be terminated effective April 24, 2026.

Providers must begin using the following ID for electronic claims:

Payer ID: 60061

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.

3/27/2026

---

Payer Consolidations - Arizona Medicaid

Effective April 24, 2026, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: Arizona Medicaid
Payer ID: SKAZ0;12K02
Claim Type: Institutional
Payer ID: SKAZ0
Claim Type: Professional

Payer IDs SKAZ0 and 12K02 will be terminated effective April 24, 2026.

Providers must begin using the following ID for electronic claims:

Payer ID: AZMCD

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.

3/27/2026

---

Payer Consolidations - Arkansas Medicaid

Effective April 24, 2026, claims currently exchanged with the following payer must use a different payer ID:

Payer Name: Arkansas Medicaid
Payer ID: ARMCD
Claim Type: Institutional
Payer ID: SKAR0;ARMCD
Claim Type: Professional

Payer IDs SKAR0 and ARMCD will be terminated effective April 24, 2026.

Providers must begin using the following ID for electronic claims:

Payer ID: 12023

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.

3/27/2026

---

Electronic Routing Change for Mutual Health Services

Optum is reactivating and changing electronic claims routing for the following payer, effective March 24, 2026:

Payer Name: Mutual Health Services
Payer ID: 34192
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Plans accepted with this connection:

• Antares Management Solutions

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.

Original Notification sent March 10, 2026

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

Payer Name: Mutual Health Services
Payer ID: 34192
Reason: Payer unavailable electronically.

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

3/27/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Lagniappe Advantage
Payer ID: LALA1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Louisiana

Payer Name: PACE Greater New Orleans
Payer ID: R3461
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Louisiana 

Action Required: 

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

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

3/27/2026

---

Remittance Reactivation for CPIDs 5550, 4425 District of Columbia Medicaid

Update:

We have recently been made aware of a new remittance enrollment requirement from the District of Columbia Medicaid. It has been determined that all providers must submit a new enrollment form to receive remittance. All providers who have not received remittance since March 13, 2026, are required to complete a new enrollment form through Enrollment Central.

We apologize for any confusion caused by prior guidance, which indicated that providers currently receiving electronic remittance through Optum were not required to complete a new enrollment form.

Original notice sent March 5, 2026:

Payer Name: District of Columbia Medicaid
Professional CPID: 4425
Institutional CPID: 5550
Payer-assigned Payer ID: 77033
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

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

 Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum do not need to complete a new enrollment form. However, providers who receive an enrollment denial notification must submit a new enrollment through Enrollment Central.
  • New providers must complete a new enrollment form.
  • All providers who have not received remittance since November 25, 2025, will need to complete a new enrollment form.

Report Changes:

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

Additional Changes:

Additional information on this transition can be found on the payer website at https://medicaid.dc.gov

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

• Providers must complete a new enrollment form prior to submitting claims.
• Make any necessary system changes.
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

3/27/2026

---

Remittance Reactivation for CPIDs 5550, 4425 District of Columbia Medicaid

Update:

We have recently been made aware of a new remittance enrollment requirement from the District of Columbia Medicaid. It has been determined that all providers must submit a new enrollment form to receive remittance. All providers who have not received remittance since March 13, 2026, are required to complete a new enrollment form through Enrollment Central.

We apologize for any confusion caused by prior guidance, which indicated that providers currently receiving electronic remittance through Optum were not required to complete a new enrollment form.

Original notice sent March 5, 2026:

Effective March 5, 2026, Optum will reactivate and update electronic claims and remittance routing for the payer listed below. Please note that any claims not processed since February 19, 2026, at 10:00 PM EST will need to be resubmitted.

Payer Name: District of Columbia Medicaid
Professional CPID: 4425
Current Edit Master: PE_D000
Institutional CPID: 5550
Current Edit Master: HE9D000
Payer-assigned Payer ID: 77033
Line of Business Code (LOB): D47
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

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

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum do not need to complete a new enrollment form. However, providers who receive an enrollment denial notification must submit a new enrollment through Enrollment Central.
  • New providers must complete a new enrollment form.
  • All providers who have not received remittance since November 25, 2025, will need to complete a new enrollment form.

Report Changes:

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

Additional Changes:

Additional information on this transition can be found on the payer website at https://medicaid.dc.gov

3/27/2026

---

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective March 26, 2026:

Payer Name: DISTRICT OF COLUMBIA MEDICAID
IMN Real Time ID: SKDC0
Exchange Real Time ID: DCCAID
CPID(s): 4425 (P), 5550 (I)Optum IEDI Real Time ID: DCMCD
Payer Enrollment Required: YES
Connection Type: X12
Fee: $0.0325

Search Options:

Eligibility Subscriber

• Member ID, First Name, Last Name, Date of Birth
• Member ID, Last Name, Date of Birth
• Member ID, First name, Last Name
• First Name, Last Name, Date of Birth
• SSN and DOB

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.

3/27/2026

---

Payer Processing Issue for CPID 2400 Utah Medicaid

Due to a processing issue, some Professional claims transmitted to the payer listed below on March 24, 2026 were not processed by the payer.

Payer impacted:

• CPID 2400 Utah Medicaid

A resolution has been implemented and the claims were retransmitted to the payer on March 27, 2026.

This delay affected claims released to Optum between 2 p.m. CT on March 23, 2026 and 2 p.m. CT on March 24, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 10239744.

3/27/2026

---

Delay in Electronic Remittance Advice (ERA) for CPID 3510, 1473, 5987, 2436 California Medicaid (Medi-Cal)

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 12, 2026–Present:

• California Medicaid (Medi-Cal)
  • CPIDs 3510, 1473, 5987, 2436

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-000004398.

3/27/2026

---

Delay in Electronic Remittance Advice (ERA) for Payer ID MDCAL, California Medicaid (Medi-Cal)

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 12, 2026–present:

• California Medicaid (Medi-Cal)
  • Payer ID MDCAL

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-000004398.

3/27/2026

---

Report Generation Delay for CPID 1086 MDwise Healthy Indiana Plan

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted March 13, 2026.

Payer impacted:

• CPID 1086 MDwise Healthy Indiana 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 10239285.

3/27/2026

---

Report Generation Delay for CPID 2708 StandardHealth with Health Choice (HCS)

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted March 16, 2026.

Payer impacted:

• CPID 2708 StandardHealth with Health Choice (HCS)

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10239324.

3/27/2026

---

Report Generation Delay for CPIDs 2930 and 3232 Health Choice Arizona

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

Payers impacted:

• CPID 2930 Health Choice Arizona
• CPID 3232 Health Choice Arizona

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10239246.

3/27/2026

---

Report Generation Delay for CPID 4246 Capital Health Plan

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted March 13, 2026.

Payer impacted: 

• CPID 4246 Capital 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 10239232.

3/27/2026

---

Delay in Electronic Remittance Advice (ERA) for CPIDs 3807, 1503

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 03/04/2026:

• CPID 3807 CHAMPVA
• CPID 1503 CHAMPVA

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 date above.

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000004346.

3/26/2026

---

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

Update: This issue is still under review with the payer. Additional notifications will be sent as updates become available.

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:

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

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

3/26/2026

---

Report Generation Delay for CPID 5440 Fox Valley Medicine

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since March 12, 2026.

Payer impacted: 

• CPID 5440 Fox Valley Medicine

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10237818.

3/26/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Canopy
Payer ID: CNPY1
Payer Enrollment Required: Yes
Payer Location: California 

Payer Name: American Health Advantage of Pennsylvania
Payer ID: PA901
Payer Enrollment Required: Yes
Payer Location: Pennsylvania 

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. 

3/26/2026

---

Report Generation Delay for CPID 6221 OrthoNet US Family Health

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted Feb. 20, 2026.

Payer impacted:

• CPID 6221 OrthoNet US Family Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10238128.

3/26/2026

---

New Electronic Remittance (ERA) Connections Available on Revenue Performance Advisor

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

Payer ID – Payer name
68011 – Capitol Administrators
CALSC – Calvos SelectCare Health Plans

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.

3/26/2026

---

Reminder: Payer Change for EVV Silver Summit Health Plan Centene

Reminder:
Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by March 31, 2026, 5:00 p.m. CT to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after March 31, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Silver Summit Health Plan
Payer ID: 68069

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

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

3/26/2026

---

Physicians of Southwest Washington Electronic Claims and Remittance Connections No Longer Available

The payer listed below is longer available at Optum for claims and remittance processing, effective immediately.

Payer Name: Physicians of Southwest Washington
Payer ID: 91171
Reason: Payer no longer offers an electronic connection. 

Action Required: None.

Original Notification sent Jan. 2, 2026
Effective Jan. 1, 2026, Physician of Southwest Washington Payer id 91171 is not available at Optum for claims processing. 

Payer Name: Physician of Southwest Washington
Payer ID: 91171 

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

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

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

3/26/2026

---

Update: Report Generation Delay for CPIDs 2824 and 7551 The Health Plan of West Virginia

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted between March 5, 2026 and March 16, 2026.

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

Original notify sent March 13, 2026:

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

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09923855.

3/26/2026

---

Delay in Electronic Remittance Advice (ERA) for Payer ID 31053 State Farm Insurance (Health)

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 13, 2026 - Present.

• State Farm Insurance (Health): Payer ID 31053

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-000004387.

3/26/2026

---

Delay in Electronic Remittance Advice (ERA) for CPID 5419, 6573 State Farm Insurance (Health)

Due to an internal processing issue, there has been a delay in both Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of March 13, 2026 - Present.

• State Farm Insurance (Health): CPID 5419, 6573

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-000004387.

3/26/2026

---

Reminder: Payer Change for CPIDs 1803, 2945 EVV Silver Summit Health Plan Centene

Reminder: Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by 5:00 PM CST on March 31, 2026, to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Professional CPID: 1803Professional Edit Master: PE_T007
Institutional CPID: 2945
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after 5:00 PM CST on March 31, 2026, must begin using the following:

Payer Name: Silver Summit Health Plan
Professional CPID: 1263
Professional Edit Master: PE_T007
Institutional CPID: 5542
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: 68069

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

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.

3/25/2026

---

Reminder: Payer Change for CPIDs 1803, 2945 EVV Silver Summit Health Plan Centene

Reminder: Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by 5:00 PM CST on March 31, 2026, to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Claim CPIDs: 1803, 2945
Payer-assigned Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after 5:00 PM CST on March 31, 2026, must begin using the following:

Payer Name: Silver Summit Health Plan
Professional CPID: 1263
Institutional CPID: 5542
Payer-assigned Payer ID: 68069

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

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

3/25/2026

---

New Electronic Eligibility and Claim Status Connection

Effective March 20, 2026, Optum is pleased to announce the new Real-Time transactions for the payer specified below. Added both Eligibility and Claim Status for this new payer.

Eligibility Inquiry and Response 270/271 with updated Search Options

Real-time Claim Status Inquiry 276/277

Payer Name: S & S Healthcare Strategies dba Reflect Health
Industry Payer ID: 31441
IMN Real Time ID: 31441
Exchange Real Time ID: RFLHL
CPID(s): 2518, 3740
Optum IEDi Real Time ID: 31441
Payer Enrollment Required: No
Connection Type:  X12 5010

Search Options:

Eligibility Subscriber:

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

 Eligibility Dependent

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

  Claim Status Inquiry Subscriber:

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

Optional additional elements:

•   Payer Claim Number
•   Total Submitted Charges

 Claim Status Inquiry Dependent

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

Optional additional elements:

• Payer claim number
• Total submitted charges

Action Required by customer:

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

3/25/2026

---

Electronic Claim Status Connection Suspended

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

Payer Name: USAA-Medicare Supplemental
Industry Payer ID: USAAM
IMN Real Time ID: USAAM
Exchange Real Time ID: n/a
Optum IEDI Real Time ID: USAAM

Action Required: Please refrain from submitting claim status transactions until further notice.

3/25/2026

---

Physicians of Southwest Washington 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: Physicians of Southwest Washington
Claims and Remittance CPIDs: 1136, 8623
Line of Business (LOB) Code: J99
Payer-assigned Payer ID: 91171
Reason: Payer no longer offers an electronic connection.

Action Required: None.

Original Notification sent on 1/2/2026

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

Payer Name: Physician of Southwest Washington
Inst CPID: 8623
Prof CPID: 1136
Payer-assigned Payer ID: 91171 

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

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

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

3/25/2026

---

Physicians of Southwest Washington 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: Physicians of Southwest Washington
Claim and Remittance CPIDs: 1136, 8623
Payer-assigned Payer ID: 91171

Reason: Payer no longer offers an electronic connection. 

Action Required: None.

Original Notification sent on 1/2/2026

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

Payer Name: Physician of Southwest Washington
Inst CPID: 8623
Prof CPID: 1136
Payer-assigned Payer ID: 91171 

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

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

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

3/25/2026

---

Report Generation Delay for CPID 6405 Cigna Health Plans

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on March 21, 2026.

Payer impacted:

• CPID 6405 Cigna 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 10234597.

3/25/2026

---

Resolved: 835 Delay for UnitedHealthcare CPID 3429, 3550

Resolution: All missing 835s for UnitedHealthcare CPID 3429, 3550 with a payment date of March 19, 2026 have been received and processed. Please allow up to 24 hours for posting to complete.

Original Notify sent March 23, 2026:
Some 835s for UnitedHealthcare CPIDs 3429, 3550 are delayed at the payer for payment date of March 19, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs: 3429, 3550

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

3/25/2026

---

Resolved: ERA delay for UHC payer ID 87726 for payment date March 19, 2026

Resolution: All missing 835s for UnitedHealthcare payer ID 87726 with a payment date of March 19, 2026 have been received and processed. Please allow up to 24 hours for posting to complete.

Original Notify sent March 23, 2026:
Due to a delay at the payer, some ERAs (Electronic Remittance advice) for UnitedHealthcare payer ID 87726 are delayed at the payer for payment date March 19, 2026.

Additional updates will be provided as available

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

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

3/25/2026

---

Report Generation Delay for CPID 9743 AdventHealth Transplant Institute

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted March 11, 2026.

Payer impacted:

• CPID 9743 AdventHealth Transplant Institute

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10235801.

3/25/2026

---

New Electronic Claims Connections Available
Optum has new electronic claims connections available:  

Payer Name: PACE Greater New Orleans
Institutional CPID: 9093
Professional CPID: 4121
Payer-assigned Payer ID: R3461
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Louisiana
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. 

3/25/2026

---

Report Generation Delay for CPID 6405 Cigna Health Plans

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted March 23, 2026.

Payer impacted:

• CPID 6405 Cigna Health Plans

The payer intermediary has been unable to generate and deliver the reports for some claims submitted on March 23, 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 10235556.

3/25/2026

---

Edit Master for CPIDs 8061 and 7425 Insurance Services of Lubbock

Optum is changing Edit Masters for the following payer, effective March 25, 2026:

Payer Name: Insurance Services of Lubbock
Professional CPID: 7425
Current Edit Master: PE_C054
New Edit Master: PE_T007
Institutional CPID: 8061
Current Edit Master: HE9C054
New Edit Master: HE9T007
Payer-assigned Payer ID: ISL11 

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. 

3/25/2026

---

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

Deloitte is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 20, 2026.

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10235389.

3/25/2026

---

New Electronic Claims Connections Available
Optum has new electronic claims connections available:

Payer Name: Lagniappe Advantage
Institutional CPID: 9092
Professional CPID: 4109
Payer-assigned Payer ID: LALA1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Louisiana
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.

3/25/2026

---

Report Generation Delay for CPID 6405 Cigna Health Plans

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on March 21, 2026.

Payer impacted:

• CPID 6405 Cigna 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 10234597.

3/25/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Canopy
Institutional CPID: 3790
Professional CPID: 9056
Payer-assigned Payer ID: CNPY1
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California
Payer Name: American Health Advantage of Pennsylvania
Institutional CPID: 5973
Professional CPID: 1887
Payer-assigned Payer ID: PA901
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Pennsylvania 

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. 

3/25/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Canopy
Institutional CPID: 3790
Professional CPID: 9056
Payer-assigned Payer ID: CNPY1
Line of Business (LOB) Code: H97
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California
Payer Name: American Health Advantage of Pennsylvania
Institutional CPID: 5973
Professional CPID: 1887
Payer-assigned Payer ID: PA901
Line of Business (LOB) Code: H8Q
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Pennsylvania 

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. 

3/25/2026

---

Veterans Administration Fee Basis Programs New Real Time Transaction

Optum is pleased to announce the availability of Real-time Authorization Inquiry and Response 278X217 transaction for the below payer, effective March 20, 2026:

Payer Name: Veterans Administration Fee Basis Programs
Payer IDs: 12115

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.

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

3/24/2026

---

Lockard and Williams Electronic Claims and Remittance Connections No Longer Available

Effective March 31, 2026, the payer listed below will no longer be available at Optum for claims and remittance processing.

Payer Name: Lockard and Williams
Claims and Remittance CPIDs: 4661, 6189
Payer-assigned Payer ID: CB752
Reason: Payer no longer in business.

Action Required: None.

3/24/2026

---

Lockard and Williams Electronic Claims and Remittance Connections No Longer Available

Effective March 31, 2026, the payer listed below will no longer be available at Optum for claims and remittance processing.

Payer Name: Lockard and Williams
Claims and Remittance CPIDs: 4661, 6189
Line of Business (LOB) Code: K13
Payer-assigned Payer ID: CB752
Reason: Payer no longer in business.

Payer will no longer accept paper claims.

Action Required: None.

3/24/2026

---

Electronic Routing Change for CPIDs 2290 and 2935 Mutual Health Services

Optum is reactivating and changing electronic claims routing for the following payer, effective March 24, 2026:

Payer Name: Mutual Health Services
Professional CPID: 2290
Institutional CPID: 2935
Payer-assigned Payer ID: 34192
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Plans accepted with this connection:

• Antares Management Solutions

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.

Original Notification sent March 10, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Mutual Health Services
CPID(s): 2290, 2935
Payer ID: 34192
Reason: Payer unavailable electronically.

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

3/24/2026

---

Electronic Routing Change for CPIDs 2290 and 2935 Mutual Health Services

Optum is reactivating and changing electronic claims routing for the following payer, effective March 24, 2026:

Payer Name: Mutual Health Services
Professional CPID: 2290
Institutional CPID: 2935
Payer-assigned Payer ID: 34192
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Plans accepted with this connection:

• Antares Management Solutions

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.

Original Notification sent March 10, 2026
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Mutual Health Services
CPID(s): 2290, 2935
Payer ID: 34192
Reason: Payer unavailable electronically.

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

3/24/2026

---

Automated Benefit Services Electronic Claim Status Connection No Longer Available

Real Time Claim Status Inquiry 276/277 for the payer listed below is no longer available at Optum, effective immediately.

Payer Name: Automated Benefit Services
Industry Payer ID: 38259
Optum iEDI Real Time ID: 10890
Connection Type: X12

Reason: Payer no longer offers an electronic connection.

Action Required: None.

3/24/2026

---

Tips on optimizing 270/271 requests/responses from Cigna Health Plans

Payer id: CIGNA/62308
Payer name: Cigna Health Plans

1. Include Multiple STC Codes in One Submission

• You can include multiple Service Type Codes (STCs) in a single request for the same patient.
• This eliminates the need for sending back-to-back requests for each STC code individually, reducing unnecessary volume.

2. Avoid Redundant STC Requests

• When sending a general STC (e.g., 30) or a grouped STC request, there is no need to also request individual STCs already included in that group.
• Submitting both creates duplication and increases transaction volume.

3. Avoid Duplicate Requests for the Same Patient

• Please wait for the response before submitting another request for the same patient.
• Sending back-to-back requests with different ID, name, or DOB combinations creates unnecessary duplication.
• If the patient is not found in the initial response, then you may try another combination.

4. Send all 4 search criteria

• Submitting a Patient ID Number, Patient Last Name, Patient First Name, and Patient Date of Birth provides you with the best chance of receiving a 271 response back with eligibility and benefits.
• Specifically sending a request that is missing either a Patient ID number or a Patient Date of Birth adds processing time to the 270/271 process in the attempt to identify the patient.
• Increased processing time can result in the 270 request timing out and a AAA 42 being returned.

Action Required by customer:
For assistance with submitting Real-Time transactions, please contact your Practice Management System Vendor or Optum Customer Care Hub ticket.

3/24/2026

---

Report Generation Delay for CPID 7146 Camp Lejeune Family Member Program

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on March 16, 2026.

Payer impacted: 

• CPID 7146 Camp Lejeune Family Member Program

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10134603.

3/24/2026

---

Update: Report Generation Delay for CPID 6405 Cigna Health Plans

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on March 11, 2026.

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

Original notice sent March 12, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on March 11, 2026.

Payer impacted:

• CPID 6405 Cigna 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 09921447.

3/24/2026

---

Electronic Routing Change for Buenaventura Affiliated Physicians

Effective March 23, 2026, Optum will be reactivating and changing electronic claims routing for the following payers:

Payer Name: Buenaventura Affiliated Physicians
Payer ID: BVAP1
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.

Original Suspend Notification sent – 3/2/2026

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

Payer Name: Buenaventura Affiliated Physicians
Payer ID: BVAP1
Reason: Payer unavailable electronically.

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

3/23/2026

---

Payer Change for Presbyterian Health Plan

Effective March 23, 2026, claims that are currently submitted using the payer ID listed below for New Mexico Medicaid Managed Care Organization (MCO) must be submitted using new payer ID.

Payer Name: Presbyterian Health Plan
Remittance Available: Yes
Payer ID: 05003

Effective March 23, 2026, Claims must be submitted using the following:

Payer Name: Presbyterian Health Plan New Mexico Medicaid
Secondary Claims Accepted: Yes
Remittance Available: No
Payer ID: NMPHP

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.
• This only affects claims submitted for New Mexico Medicaid Managed Care Organization (MCO).

3/23/2026

---

MDwise Hoosier Healthwise Electronic Eligibility Connection No Longer Available

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

Payer Name: MDwise Hoosier Healthwise
Industry Payer ID: 3519M
IMN Real Time ID: SKIN0
Exchange Real Time ID: X12-INCAID, Portal-WISE1
CPIDs: 1085, 8112
Optum iEDI Real Time ID: 3519M
Connection Type: X12 and Portal

Reason: Payer no longer offers an electronic connection.

Action Required: None

3/23/2026

---

Payer Processing Issue for CPID 5563 Washington Labor and Industry Workers Compensation

Due to a payer processing issue, some Institutional claims transmitted to the payer listed below on March 16, 2026 were not processed by the payer.

Payer impacted:

• CPID 5563 Washington Labor and Industry Workers Compensation

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

This delay affected claims released to Optum between 3 p.m. CT on March 13, 2026 and 3 p.m. CT on March 16, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09929527.

3/23/3036

---

CMS/HETS Announcement

Centers for Medicare & Medicaid Services (CMS) has recently announced an initiative whereby HETS 270/271 suppliers / providers are required to submit attestation via these websites and use the code: VQAS

1. Durable Medical Equipment Medicare Administrative Contractor (DME MAC) (operated by National Government Services as CEDI) form
2. National Government Services Jurisdiction J6 and Jurisdiction JK form
3. FCSO form
4. Novitas Form
5. Noridian Form
6. Palmetto GBA

JJ Part A

JJ Part B

JM Part A

JM Part B

JM HH&H

7. CGS

Part A

Part B

HH&H

These attestations must be completed by May 11, 2026 to avoid any disruptions to eligibility processing.

3/23/3036

---

Edit Master for CPIDs 2991 and 1758 UMWA H & R Funds

Effective March 24, 2026, Optum will be changing Edit Masters for the following payer:

Payer Name: UMWA H & R Funds
Professional CPID: 1758
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Institutional CPID: 2991
Current Edit Master: HE9C054
New Edit Master:  HE9T007
Payer-assigned Payer ID: 52180 

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. 

3/23/3036

---

Electronic Routing Change for CPIDs 3439 and 8982 Buenaventura Affiliated Physicians

Effective March 23, 2026, Optum will be reactivating and changing electronic claims routing for the following payers:

Payer Name: Buenaventura Affiliated Physicians
Professional CPID: 3439
Institutional CPID: 8982
Payer-assigned Payer ID: BVAP1
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.

Original Suspend Notification sent – 3/2/2026

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

Payer Name: Buenaventura Affiliated Physicians
CPID(s): 3439, 8982
Payer ID: BVAP1
Reason: Payer unavailable electronically.

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

3/23/3036

---

New Real-Time Eligibility Payer Transaction Available

Effective March 18th, 2026, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response (270/271) transactions for the below payer:

Payer Name: Central States Health & Life Co. of Omaha
IMN ID: 13281
Exchange ID: CSHLO
IEDI OPTUM: 13281
Transaction Type: Eligibility

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

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

3/23/2026

---

835 Delay for UnitedHealthcare CPID 3429, 3550

Some 835s for UnitedHealthcare CPIDs 3429, 3550 are delayed at the payer for payment date of March 19, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs: 3429, 3550

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

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

3/23/2026

---

Edit Master for CPID 3465 William C Earhart

Optum will be changing Edit Masters for the following payer, effective March 24, 2026:

Payer Name: William C Earhart
Professional CPID: 3465
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Payer-assigned Payer ID: 93050 

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

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

3/23/2026

---

Edit Master for CPIDs 4970 and 2241 US Benefits

Effective March 24, 2026, Optum will be changing Edit Masters for the following payer:

Payer Name: US Benefits
Professional CPID: 2241
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Institutional CPID: 4970
Current Edit Master: HE9C054
New Edit Master: HE9T007  
Payer-assigned Payer ID: 93092 

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. 

3/23/2026

---

Report Generation Delay for CPID 9057 Sentara PACE

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted March 9, 2026.

Payer impacted:

• CPID 9057 Sentara PACE

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10078949.

3/23/2026

---

Report Generation Delay for CPID 3787 AvMed (Encounters)

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

Payer impacted: 

• CPID 3787 AvMed (Encounters)

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 10043285.

3/23/2026

---

Electronic Routing Change for CPIDs 3439 and 8982 Buenaventura Affiliated Physicians

Optum is reactivating and changing electronic claims routing for the following payer, effective March 23, 2026:

Payer Name: Buenaventura Affiliated Physicians
Professional CPID: 3439
Edit Master: PE_T007
Institutional CPID: 8982
Edit Master: HE9T007
Payer-assigned Payer ID: BVAP1
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:

• 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.

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

Payer Name: Buenaventura Affiliated Physicians
CPID(s): 3439, 8982
Payer ID: BVAP1
Reason: Payer unavailable electronically.

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

3/23/2026

---

Edit Master for CPIDs 6664 and 6768 Health Services Preferred (HSP) Emerald Health

Effective March 24, 2026, Optum will be changing Edit Masters for the following payers:

Payer Name: Health Services Preferred (HSP) Emerald Health
Professional CPID: 6768
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Institutional CPID: 6664
Current Edit Master: HE9C054
New Edit Master:  HE9T007
Payer-assigned Payer ID: 34167 

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.

3/23/2026

---

New Payer Name

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

Previous Payer Name: Guardian Retail
New Payer Name: Guardian Managed DentalGuard
Professional CPID: 3753
Payer ID: GI813
Remit Line of Business (LOB) Code: J35

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

Action Required: No Payer Alias changes are required. Payer name and CPIDs are not changing.

3/23/2026

---

New Payer Name

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

Previous Payer Name: Guardian Retail
New Payer Name: Guardian Managed DentalGuard
Professional CPID: 3753
Payer ID: GI813

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

3/23/2026

---

ERA delay for UHC payer ID 87726 for payment date March 19, 2026

Due to a delay at the payer, some ERAs (Electronic Remittance advice) for UnitedHealthcare payer ID 87726 (CPIDs 3429/3550) are delayed at the payer for payment date March 19, 2026.

Additional updates will be provided as available

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

3/23/2026

---

Report Generation Delay for CPID 3791 Luminare Health AZ, IL, IN, MD, MN, NC, PA

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted March 16, 2026.

Payer impacted: 

• CPID 3791 Luminare Health AZ, IL, IN, MD, MN, NC, PA

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 10043300.

3/23/2026

---

New Electronic Eligibility & Claim Status Connection Available

Optum is pleased to announce the availability of Real-time Eligibility 270/271 & Claim Status Inquiry and Response 276/277 for the below payer, effective March 20, 2026:

Payer Name: Jefferson Health Plans Medicare PPO
Industry Payer ID: RP099
IMN Real Time ID: RP099
Exchange Real Time ID: PRTNRS
CPID(s): 8072 (I), 1705 (P)
IEDI Real Time ID: RP099
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

Claim Status Inquiry subscribe

• Member ID, First name, Last name, date of birth

Optional additional elements:

• Payer claim number, Total submitted charges

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

3/23/2026

---

New Real-Time Eligibility Payer Transaction Available

Effective March 18th, 2026, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response (270/271) transactions for the below payer:

Payer Name: Central States Health & Life Co. of Omaha
IMN ID: 13281
Exchange ID: CSHLO
IEDI OPTUM: 13281
Transaction Type: Eligibility

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

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

3/23/2026

---

Payer Change for CPIDs 5242, 8908 Presbyterian Health Plan

Effective March 23, 2026, claims that are currently submitted using the CPIDs listed below for New Mexico Medicaid Managed Care Organization (MCO) must be submitted using new CPIDs.

Payer Name: Presbyterian Health Plan
Professional CPID: 5242
Institutional CPID: 8908
Remittance Available: Yes
Payer-assigned Payer ID: 05003

Effective March 23, 2026, Claims must be submitted using the following:

Payer Name: Presbyterian Health Plan New Mexico Medicaid
Professional CPID: 1883
Institutional CPID: 4900
Secondary Claims Accepted: Yes
Remittance Available: No
Payer-assigned Payer ID: NMPHP
Claim Fee: $0.10

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.
• This only affects claims submitted for New Mexico Medicaid Managed Care Organization (MCO).
• To access the new enrollment forms, please visit Enrollment Central.

3/23/2026

---

Payer Change for CPIDs 5242, 8908 Presbyterian Health Plan

Medicaid Managed Care Organization (MCO) must be submitted using new CPIDs.

Payer Name: Presbyterian Health Plan
Professional CPID: 5242
Professional Edit Master: PE_B800
Institutional CPID: 8908
Institutional Edit Master: HE9B801
Payer-assigned Payer ID: 05003
Line of Business Code (LOB): U8G

Effective March 23, 2026, Claims must be submitted using the following:

Payer Name: Presbyterian Health Plan New Mexico Medicaid
Professional CPID: 1883
Professional Edit Master: PE_B800
Institutional CPID: 4900
Institutional Edit Master: HE9B801
Secondary Claims Accepted: Yes
Payer-assigned Payer ID: NMPHP
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:

• This only affects claims submitted for New Mexico Medicaid Managed Care Organization (MCO).
• 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.

3/23/2026

---

New Electronic Remittance Connections Available

 

Optum has new electronic remittance connections available:  

 

Payer Name: Calvo's SelectCare Health Plans 

Payer ID: CALSC  

Payer Enrollment Required: Yes 

Payer Location: Guam 

 

Payer Name: Denver Health Medical Plan Inc. - Medicare Choice

Payer ID: 84131

Payer Enrollment Required: Yes

Payer Location: Colorado

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.

3/20/2026

---

New Payer ID for United Healthcare New Mexico Medicaid Claims

 

The New Mexico Health Care Authority (HCA) will launch Turquoise Claims, a new Medicaid claims management system, March 23, 2026. Turquoise Claims will replace the current Medicaid claims management system and the New Mexico Medicaid Portal.

Effective March 23,2026, claims that are currently submitted using the payer ID listed below for New Mexico Medicaid Managed Care Organization (MCO) must be submitted using new CPIDs.

Payer Name: UnitedHealthcare

Remittance Available: Yes

Payer ID: 87726

The following new payer will be available for claim submission as of Friday, March 20, 2026.

Payer Name: UnitedHealthcare New Mexico Medicaid

Remittance Available: No

Payer-assigned Payer ID: 87748

Secondary Claims Accepted: 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.
• This only affects claims submitted for New Mexico Medicaid Managed Care Organization (MCO).

3/20/2026

---

Electronic Routing Change for CommuniCare Advantage

 

Optum will be changing electronic claims and remittance routing for the following payer, effective March 17, 2026:

Payer Name: CommuniCare Advantage

Previous Payer ID: 34525

New Payer ID: 70022

Payer Claim Enrollment Required: No

Payer Remittance Enrollment Required: Yes

Secondary Claims Accepted: No

Par Status: Trans

Previous payer ID 34525 will terminate April 24, 2026.

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.

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:

• No Payer Alias changes are required. Payer name and payer ID are not changing.
• When a payer requires enrollment, forms must be submitted and approved from IEDI.

3/20/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

 

Payer Name: PACE of the Triad 

Payer ID: TRIA01 

Payer Enrollment Required: No 

Secondary Claims Accepted: Yes 

Payer Location: North Carolina 

 

Payer Name: AdminOne

Payer ID: 87871

Payer Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: National

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. 

3/20/2026

---

Reminder: Intelligent Medical Network PAR Status Changes

Reminder: Effective 04/01/2026 the PAR Status is changing for the following payer(s):

 

Administrative Concepts

IMN ID: 22384

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Aspirus Medicare Advantage

IMN ID: 36483

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

BayCare Plus Medicare Advantage

IMN ID: 81079

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

CareSource of Georgia

IMN ID: GACS1

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

CareSource of Indiana

IMN ID: INCS1

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Centivo

IMN ID: 45564

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Community Health Choice Medicaid, DSNP, Star+Plus

IMN ID: 48145

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Transitional

 

Community Health First Medicare Advantage

IMN ID: CHFMA

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Cook Childrens Star Plan

IMN ID: CCHP9

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

FirstCare

IMN ID: 94999

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Florida Health Care Plans

IMN ID: 59322

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

GEMCare – Kern County

IMN ID: MCS03

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Gravie Inc.

IMN ID: GRV01

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Great West Healthcare

IMN ID: 80705

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Health Net National

IMN ID: XHNNC

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Healthplans Incorporated

IMN ID: 44273

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Hennepin Health

IMN ID: 60058

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Gateway

 

HMA Hawaii

IMN ID: 86066

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Transitional

 

Hometown Health

IMN ID: HMETH

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Independence Administrators

IMN ID: TA720

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Integrated Mental Health Services

IMN ID: CBHTX

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Kaiser Permanente Southern CA

IMN ID: 94134

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Kempton Group Administrators

IMN ID: 73100

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Key Benefit Administrators

IMN ID: KBKBA

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Lincoln Heritage Life Insurance Company

IMN ID: LCNHG

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

March Vision Care

IMN ID: 52461

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Gateway

 

McLaren Health Care

IMN ID: 38338

Transaction: Eligibility

Old Par Status: Non-Par

New Par Status: Gateway

 

Meritain Health

IMN ID: 41124

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

 

Mountain Health Co-Op

IMN ID: MHC01

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Transitional

 

Mutual of Omaha

IMN ID: 71412

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Par

 

New York Independent Health Assoc (IHA) – Western

IMN ID: SX073

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Passport Health Plan by Molina Healthcare

IMN ID: MLNKY

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Physicians Health Plan of Northern Indiana

IMN ID: 12399

Transaction(s): Eligibility, Claim Status

Old Par Status: Non-Par

New Par Status: Gateway

 

Priority Health

IMN ID: 38217

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Royal Neighbors of America

IMN ID: RYLNB

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Scott & White Health Plan

IMN ID: TH002

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

SelectHealth

IMN ID: SX107

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Senior Whole Health, LLC DBA Molina Healthcare

IMN ID: SWHMA

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Sutter and Aetna Insurance Company

IMN ID: 60624

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

Univera

IMN ID: SX086

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

UPMC Health Plan (Tristate)

IMN ID: 23281

Transaction: Eligibility

Old Par Status: Non-Par

New Par Status: Par

 

Washington National

IMN ID: 70319

Transaction: Eligibility

Old Par Status: Par

New Par Status: Non-Par

 

WellMed

IMN ID: WELM2

Transaction: Claim Status

Old Par Status: Non-Par

New Par Status: Gateway

 

ZING HEALTH

IMN ID: 83248

Transaction(s): Eligibility, Claim Status

Old Par Status: Par

New Par Status: Non-Par

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

3/20/2026

---

Reminder: PAR Status Changes for Real Time Payers

Reminder: Effective 04/01/2026 the PAR Status is changing for the following real time payer(s):

 

Alliant Health Plans

Industry ID: 58234

Exchange CPIDs: 2589, 3793

Exchange RT ID: ALLIHP

Transaction: Eligibility

Old Par Status: Gateway

New Par Status: Transitional

 

COVID19 HRSA Uninsured Testing and Treatment Fund

Industry ID: 95964

Exchange CPIDs: 4019, 8748

Exchange RT ID: COVID

Transaction: Claim Status

Old Par Status: Transitional

New Par Status: Gateway

 

Fallon Community Health Plan

Industry ID: 22254

Exchange CPIDs: 1576, 3801

Exchange RT ID: FALLON

Transaction: Claim Status, Eligibility

Old Par Status: Gateway

New Par Status: Transitional

 

Luminare Health AZ, IL, IN, MD, MN, NC, PA

Industry ID: 48117

Exchange CPIDs: 4568, 5492

Exchange RT ID: CSFMH

Transaction: Claim Status, Eligibility

Old Par Status: Gateway

New Par Status: Transitional

 

Nippon Life Insurance Company of America

Industry ID: 81264

Exchange CPIDs: 6443, 6539

Exchange RT ID: NLICOA

Transaction: Claim Status, Eligibility

Old Par Status: Gateway

New Par Status: Transitional

 

Samaritan Health Plans

Industry ID: CP001

Exchange CPIDs: 2122, 5952

Exchange RT ID: SAMAR

Transaction: Eligibility

Old Par Status: Gateway

New Par Status: Par

 

UnitedHealthcare Secure Horizons Medicare Supplemental

Industry ID: UHSEC

Exchange RT ID: UHSEC

Transaction: Eligibility

New Par Status: Transitional

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

3/20/2026

---

Reminder: PAR Status Changes for Claim Payers

Reminder: Effective 04/01/2026 the PAR Status is changing for the following claim payer(s):

 

National Association of Letter Carriers

Industry ID: 53011

Exchange CPIDs: 7224

Old Par Status: Par

New Par Status: Non Par

 

National Telecommunications Cooperative Association (NTCA Staff)

Industry ID: 52104

Exchange CPIDs: 3944

Old Par Status: Non Par

New Par Status: Par

 

National Telecommunications Cooperative Association (NTCA)

Industry ID: 52103

Exchange CPIDs: 3987

Old Par Status: Non Par

New Par Status: Par

 

Netcare Life and Health Insurance

Industry ID: 66055

Exchange CPIDs: 4915, 7277

Old Par Status: Non Par

New Par Status: Gateway

 

New York State Department of Health Uncompensated Care Program

Industry ID: 14142

Exchange CPIDs: 3665

Old Par Status: Non Par

New Par Status: Gateway

 

Northern Illinois Health Plan

Industry ID: 36347

Exchange CPIDs: 2291, 8969

Old Par Status: Non Par

New Par Status: Par

 

Ohio Health Choice PPO

Industry ID: 34189

Exchange CPIDs: 1860, 7553

Old Par Status: Non Par

New Par Status: Par

 

Partners Health Plan

Industry ID: 14966

Exchange CPIDs: 1111

Old Par Status: Transitional

New Par Status: Non Par

 

Payer Fusion

Industry ID: 27048

Exchange CPIDs: 7636

Old Par Status: Non Par

New Par Status: Gateway

 

Pennsylvania Pace

Industry ID: 20172

Exchange CPIDs: 5603, 6228

Old Par Status: Non Par

New Par Status: Gateway

 

Preferred Benefit Administrators (Longwood, Florida)

Industry ID: 53476

Exchange CPIDs: 1652, 3198

Old Par Status: Transitional

New Par Status: Non Par

 

Priority Health of Michigan

Industry ID: 38217

Exchange CPIDs: 3591

Old Par Status: Non Par

New Par Status: Par

 

Regency Employee Benefits

Industry ID: 38221

Exchange CPIDs: 4668

Old Par Status: Non Par

New Par Status: Gateway

 

Sante Community Physicians Medical Group

Industry ID: SNTMC

Exchange CPIDs: 1134, 1537

Old Par Status: Non Par

New Par Status: Par

 

Selman & Company

Industry ID: 52214

Exchange CPIDs: 2028, 8164

Old Par Status: Non Par

New Par Status: Par

 

South Country Health Alliance

Industry ID: 81600

Exchange CPIDs: 1039, 7868

Old Par Status: Non Par

New Par Status: Par

 

Superior Select Health Plan

Industry ID: 61184

Exchange CPIDs: 1065, 7893

Old Par Status: Non Par

New Par Status: Par

 

Tall Tree Administrators

Industry ID: 88067

Exchange CPIDs: 4935

Old Par Status: Non Par

New Par Status: Par

 

Trusteed Plans Service

Industry ID: 91078

Exchange CPIDs: 2238, 2941

Old Par Status: Non Par

New Par Status: Par

 

U.S. Networks and Administrative Services

Industry ID: USN01

Exchange CPIDs: 4035, 8763

Old Par Status: Non Par

New Par Status: Gateway

 

UMC Health Plan

Industry ID: 75130

Exchange CPIDs: 1670, 5711

Old Par Status: Non Par

New Par Status: Gateway

 

UMWA Health and Retirement Funds

Industry ID: 52180

Exchange CPIDs: 2991

Old Par Status: Transitional

New Par Status: Non Par

 

US Benefits

Industry ID: 93092

Exchange CPIDs: 2241, 4970

Old Par Status: Transitional

New Par Status: Non Par

 

Unified Group Services

Industry ID: 35198

Exchange CPIDs: 4542

Old Par Status: Non Par

New Par Status: Par

 

Unified Health Services

Industry ID: 62170

Exchange CPIDs: 7576

Old Par Status: Non Par

New Par Status: Par

 

UnitedHealthcare Ohio Medicaid

Industry ID: 88337

Exchange CPIDs: 7074, 9465

Old Par Status: Non Par

New Par Status: Gateway

 

University of Illinois at Chicago Division of Specialized Care for Children

Industry ID: 37601

Exchange CPIDs: 8800

Old Par Status: Non Par

New Par Status: Gateway

 

Upper Peninsula Health Group (TPA)

Industry ID: 37324

Exchange CPIDs: 1792, 2686

Old Par Status: Non Par

New Par Status: Gateway

 

Valor Health Plan

Industry ID: 43259

Exchange CPIDs: 2000

Old Par Status: Non Par

New Par Status: Par

 

Wellfleet Group

Industry ID: 87843

Exchange CPIDs: 2670

Old Par Status: Non Par

New Par Status: Gateway

 

Western Growers/Pinnacle

Industry ID: 24735

Exchange CPIDs: 6587

Old Par Status: Non Par

New Par Status: Par

 

Western Health Advantage

Industry ID: 68039

Exchange CPIDs: 6267

Old Par Status: Non Par

New Par Status: Par

 

William C Earhart

Industry ID: 93050

Exchange CPIDs: 3465, 3919

Old Par Status: Transitional

New Par Status: Non Par

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

3/20/2026

---

Reminder: PAR Status Changes for Claim Payers

Reminder: Effective 04/01/2026 the PAR Status is changing for the following claim payer(s):

 

Allegeant, LLC

Industry ID: 52193

Exchange CPIDs: 3691, 5121

Old Par Status: Par

New Par Status: Transitional

 

Anchor Benefit Consulting

Industry ID: 53085

Exchange CPIDs: 4269, 8948

Old Par Status: Transitional

New Par Status: Non Par

 

Avmed Inc Encounters

Industry ID: 59275

Exchange CPIDs: 3787

Old Par Status: Gateway

New Par Status: Non Par

 

Butler Benefit

Industry ID: 42150

Exchange CPIDs: 3250, 8946

Old Par Status: Transitional

New Par Status: Non Par

 

COVID19 HRSA Uninsured Testing and Treatment Fund

Industry ID: 95964

Exchange CPIDs: 6016, 9157

Old Par Status: Non Par

New Par Status: Gateway

 

Claims Development Corporation

Industry ID: 43056

Exchange CPIDs: 7191

Old Par Status: Non Par

New Par Status: Par

 

Colonial Medical Eastern Caribbean

Industry ID: 22287

Exchange CPIDs: 4043, 8772

Old Par Status: Non Par

New Par Status: Gateway

 

Consolidated Associates Railroad

Industry ID: 75284

Exchange CPIDs: 2233, 7967

Old Par Status: Transitional

New Par Status: Non Par

 

Crescent Health Solutions

Industry ID: 56213

Exchange CPIDs: 5664

Old Par Status: Gateway

New Par Status: Transitional

 

EMI-KP Ambulance

Industry ID: 59299

Exchange CPIDs: 8852

Old Par Status: Gateway

New Par Status: Transitional

 

Fringe Benefit Coordinators (Medical and Accident)

Industry ID: 59204

Exchange CPIDs: 5247, 8944

Old Par Status: Transitional

New Par Status: Non Par

 

Global Excel Management

Industry ID: GEM01

Exchange CPIDs: 4658

Old Par Status: Non Par

New Par Status: Par

 

H.E.R.E.I.U. Welfare Pension Plan

Industry ID: 37114

Exchange CPIDs: 2865, 8532

Old Par Status: Non Par

New Par Status: Gateway

 

Health Services Preferred (HSP) Emerald Health

Industry ID: 34167

Exchange CPIDs: 6664, 6768

Old Par Status: Transitional

New Par Status: Non Par

 

HealthCare Solutions Group

Industry ID: 73147

Exchange CPIDs: 3965, 4267

Old Par Status: Transitional

New Par Status: Non Par

 

HealthSmart ACCEL Network

Industry ID: 75237

Exchange CPIDs: 9584

Old Par Status: Transitional

New Par Status: Non Par

 

High Desert Medical Group

Industry ID: 95393

Exchange CPIDs: 3290, 9670

Old Par Status: Par

New Par Status: Non Par

 

Hometown Health

Industry ID: 88023

Exchange CPIDs: 2839, 2960

Old Par Status: Non Par

New Par Status: Gateway

 

ICARE Health Options TPA

Industry ID: 26054

Exchange CPIDs: 5299

Old Par Status: Non Par

New Par Status: Gateway

 

Ingham Health Plan

Industry ID: 38343

Exchange CPIDs: 7252, 8670

Old Par Status: Non Par

New Par Status: Gateway

 

InnovAge

Industry ID: 31182

Exchange CPIDs: 1634

Old Par Status: Non Par

New Par Status: Par

 

Innovante Benefit Administrators

Industry ID: 31172

Exchange CPIDs: 5685

Old Par Status: Transitional

New Par Status: Non Par

 

Insurance TPA.com Administrators

Industry ID: 39182

Exchange CPIDs: 2176, 2688

Old Par Status: Non Par

New Par Status: Par

 

Integra Group

Industry ID: 31127

Exchange CPIDs: 1864, 3955

Old Par Status: Non Par

New Par Status: Par

 

Integrated Medical Solutions

Industry ID: 20050

Exchange CPIDs: 4644, 6163

Old Par Status: Non Par

New Par Status: Par

 

Landmark Healthcare

Industry ID: LNDMK

Exchange CPIDs: 3294

Old Par Status: Par

New Par Status: Non Par

 

Life Trac

Industry ID: 41136

Exchange CPIDs: 3844, 3907

Old Par Status: Non Par

New Par Status: Par

 

MedAdmin Solutions(PHC)

Industry ID: 58204

Exchange CPIDs: 1892

Old Par Status: Non Par

New Par Status: Par

 

MedCom

Industry ID: 59231

Exchange CPIDs: 3271, 4939

Old Par Status: Transitional

New Par Status: Non Par

 

MediView Travis County MAP

Industry ID: TCMAP

Exchange CPIDs: 7891

Old Par Status: Transitional

New Par Status: Non Par

 

Mental Health Consultants Inc

Industry ID: 37050

Exchange CPIDs: 1050, 7878

Old Par Status: Non Par

New Par Status: Gateway

 

Merchants Benefit Administration

Industry ID: 86087

Exchange CPIDs: 1274, 6518

Old Par Status: Non Par

New Par Status: Gateway

 

Mid-America Associates

Industry ID: 37281

Exchange CPIDs: 1613

Old Par Status: Non Par

New Par Status: Gateway

 

Mondial Assistance

Industry ID: 50749

Exchange CPIDs: 1669, 5180

Old Par Status: Non Par

New Par Status: Gateway

 

Municipal Health Benefit Fund

Industry ID: 81883

Exchange CPIDs: 5956

Old Par Status: Non Par

New Par Status: Par

 

My Patient Prepaid

Industry ID: PREPD

Exchange CPIDs: 2737, 7920

Old Par Status: Par

New Par Status: Gateway

 

NAHGA Claim Services

Industry ID: 67788

Exchange CPIDs: 1223, 4520

Old Par Status: Non Par

New Par Status: Gateway

 

NAMCI/Global Care

Industry ID: L0110

Exchange CPIDs: 2076, 8221

Old Par Status: Transitional

New Par Status: Non Par

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

3/20/2026

---

MDwise Healthy Indiana Plan Electronic Eligibility Connection No Longer Available

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

Payer Name: MDwise Healthy Indiana Plan
Industry Payer ID: 3135M
Exchange Real Time ID: INCAID
CPIDs: 1086, 8113
Connection Type: X12- INCAID / Portal- WISE1

Reason: Payer no longer offers an electronic connection

Action Required: None

3/20/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Denver Health Medical Plan Inc. - Medicare Choice
Institutional CPID: 4549
Professional CPID: 1232
Payer-assigned Payer ID: 84131
Line of Business (LOB) Code: E53
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Colorado

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. 

3/20/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Denver Health Medical Plan Inc. - Medicare Choice
Institutional CPID: 4549
Professional CPID: 1232
Payer-assigned Payer ID: 84131
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Colorado

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. 

3/20/2026

---

Update: Report Generation Delay for CPID 3787 AvMed (Encounters)

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Feb. 12, 2026 through March 6, 2026.

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

Original notice sent Feb. 23, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 9, 2026.

Payer impacted: 

• CPID 3787 AvMed (Encounters)

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 09899489.

3/20/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Calvo's SelectCare Health Plans
Institutional CPID: 4094
Professional CPID: 8835
Payer-assigned Payer ID: CALSC
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Guam 

Action Required: 

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

3/20/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Calvo's SelectCare Health Plans
Institutional CPID: 4094
Professional CPID: 8835
Payer-assigned Payer ID: CALSC
Line of Business (LOB) Code: E57
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Guam 

Action Required: 

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

3/20/2026

---

Reports Delay with INS/277 Claim Status Responses

This message is intended for Revenue Performance Advisor customers.

Delay with INS/277 Claim Status responses:

• Claims submitted from March 12th, 2026, through March 19th, 2026, that are missing responses are currently being delivered and should be available by the end of the day Sunday, March 22nd, 2026 due to the sizeable backlog. 

These were delayed due to a processing issue that was found and resolved March 19th, 2026.

We apologize for the inconvenience.

3/20/2026

---

Electronic Routing Change for CPIDs 8889 and 5043 Clear Spring Health

Effective March 20, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: Clear Spring Health
Professional CPID: 8889
Institutional CPID: 5043
Payer-assigned Payer ID: 85468
Line of Business Code (LOB): H3S
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. 

3/20/2026

---

Electronic Routing Change for CPIDs 8889 and 5043 Clear Spring Health

Effective March 20, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: Clear Spring Health
Professional CPID: 8889
Institutional CPID: 5043
Payer-assigned Payer ID: 85468
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. 

3/20/2026

---

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 March 16, 2026:

Payer Name: CareOregon
Industry Payer ID: 93975
IMN Real Time ID: 93975
Exchange Real Time ID: CAREO
CPID(s): 2249 & 2551
Optum IEDi Real Time ID: 93975
Payer Enrollment Required: No
Connection Type: X12

Search Options
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.

3/20/2026

---

Payer Processing Issue for CPIDs 4426 and 5547 Blue Cross Blue Shield of Arizona

Due to a payer processing issue, some Institutional and Professional claims transmitted to the payer listed below March 18, 2026 were not processed by the payer.

Payer impacted:

• CPID 4426 Blue Cross Blue Shield of Arizona
• CPID 5547 Blue Cross Blue Shield of Arizona

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

This delay affected claims released to Optum March 17, 2026, 3:00 p.m.-March 18, 2026, 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 09930669.

3/20/2026

---

Electronic Routing Change for CPIDs 4743 and 5909 Carelon Behavioral Health

Optum is changing electronic remittance routing for the following payer, effective March 20, 2026:

Payer Name: Carelon Behavioral Health
Professional CPID: 4743
Institutional CPID: 5909
Payer-assigned Payer ID: CHCBH
Line of Business Code (LOB): U3B
Payer Remittance Enrollment Required: Yes 

Enrollment Requirements
Remittance:

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

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

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

3/20/2026

---

Electronic Routing Change for CPIDs 4743 and 5909 Carelon Behavioral Health

Optum is changing electronic remittance routing for the following payer, effective March 20, 2026:

Payer Name: Carelon Behavioral Health
Professional CPID: 4743
Institutional CPID: 5909
Payer-assigned Payer ID: CHCBH
Payer Remittance Enrollment Required: Yes 

Enrollment Requirements
Remittance:

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

Action Required: Please 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. 

3/20/2026

---

Report Generation Delay for multiple CPIDs

The following payers are experiencing issues affecting Professional and Institutional report generation for some claims submitted March 14, 2026.

Payers impacted:

• CPID 3971 Loma Linda University Adventist
• CPID 5124 Loma Linda University Adventist
• CPID 6846 Loma Linda University Health Care
• CPID 7628 Loma Linda University Health Care
• CPID 4031 Loma Linda University Medical Center
• CPID 8759 Loma Linda University Medical Center

Optum is working diligently with the payers 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 09930451.

3/20/2026

---

VA payer 835 delay

The VA payer is reporting a delay in processing and delivery of 835 files for check date March 4, 2026 for 84146, 80214, 84147. They have not provided an ETA at this time but are working on the issue.

Please note that research for missing 835s will be held if they are for this check date until the payer has provided the resolution.

3/19/2026

---

Report Generation Delay for CPID 7185 HMC Healthworks

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted on Feb. 2, 2026 and March 4, 2026.

Payer impacted: 

• CPID 7185 HMC Healthworks

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09929693.

3/19/2026

---

New Payer ID for United Healthcare New Mexico Medicaid Claims

The New Mexico Health Care Authority (HCA) will launch Turquoise Claims, a new Medicaid claims management system, March 23, 2026. Turquoise Claims will replace the current Medicaid claims management system and the New Mexico Medicaid Portal.

Effective March 23,2026, claims that are currently submitted using the CPIDs listed below for New Mexico Medicaid Managed Care Organization (MCO) must be submitted using new CPIDs.

Payer Name: UnitedHealthcare
Professional CPID: 3429
Professional Edit Master: PE_U012
Institutional CPID: 3550
Institutional Edit Master: HE9U012
Payer-assigned Payer ID: 87726
Line of Business Code (LOB): U39

The following new payer will be available for claim submission as of Friday, March 20, 2026.

Payer Name: UnitedHealthcare New Mexico Medicaid
Professional CPID: 1856
Professional Edit Master: PE_C009
Institutional CPID: 2690
Institutional Edit Master: HE9C009
Payer-assigned Payer ID: 87748
Secondary Claims Accepted: Yes
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:

• This only affects claims submitted for New Mexico Medicaid Managed Care Organization (MCO).
• 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.

3/19/2026

---

New Payer ID for United Healthcare New Mexico Medicaid Claims

The New Mexico Health Care Authority (HCA) will launch Turquoise Claims, a new Medicaid claims management system, March 23, 2026. Turquoise Claims will replace the current Medicaid claims management system and the New Mexico Medicaid Portal.

Effective March 23,2026, claims that are currently submitted using the CPIDs listed below for New Mexico Medicaid Managed Care Organization (MCO) must be submitted using new CPIDs.

Payer Name: UnitedHealthcare
Professional CPID: 3429
Institutional CPID: 3550
Remittance Available: Yes
Payer-assigned Payer ID: 87726

The following new payer will be available for claim submission as of Friday, March 20, 2026.

Payer Name: UnitedHealthcare New Mexico Medicaid
Professional CPID: 1856
Institutional CPID: 2690
Remittance Available: No
Payer-assigned Payer ID: 87748
Secondary Claims Accepted: Yes
Claim Fee: N/A

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

• Please be aware of the changes above and make any necessary changes in your system.
• This only affects claims submitted for New Mexico Medicaid Managed Care Organization (MCO).

3/19/2026

---

Report Generation Delay for CPIDs 8796 and 4056 Liberty Advantage Health Plan

The payer intermediary listed below is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 2, 2026.

Payer impacted: 

• CPID 8796 Liberty Advantage Health Plan
• CPID 4056 Liberty Advantage 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 09929608.

3/19/2026

---

Electronic Eligibility Connection Suspended

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

Payer Name: Hawaii Medical Assurance Association HMAA
Industry Payer ID: 48330
IMN Real Time ID: 48330
Exchange Real Time ID: HMAASC
Optum IEDI Real Time ID: 11125

Action Required: Please refrain from submitting eligibility transactions until further notice.

3/19/2026

---

Report Generation Delay for CPID 6671 HealthSun

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

Payer impacted: 

• CPID 6671 HealthSun

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09929361.

3/19/2026

---

Enrollment Form Change

The following payers have changed their Remittance enrollment form: 

• CPID 6747 / Payer ID JMH01 John Muir Mt. Diablo Health System
• CPID 7653 / Payer ID JMH01 John Muir Mt. Diablo Health System

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. 

3/19/2026

---

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

Update: This issue is still under review with the payer. Additional notifications will be sent as updates become available.

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:

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

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

3/19/2026

---

Report Generation Delay for CPID 7489 Blue Cross Blue Shield of Wyoming

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

Payer impacted: 

• CPID 7489 Blue Cross Blue Shield of Wyoming

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 09929225.

3/19/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Denver Health Medical Plan
Institutional CPID: 3936
Professional CPID: 4285
Payer-assigned Payer ID: 84135
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Colorado

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.

3/19/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Denver Health Medical Plan
Institutional CPID: 3936
Professional CPID: 4285
Payer-assigned Payer ID: 84135
Line of Business (LOB) Code: E53
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Colorado

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.

3/19/2026

---

Update: Electronic Routing Change for CPIDs 1419 and 5539 Magellan Healthcare

Update: 

Payer Claim Enrollment is not required for this payer. 

Original notice sent March 17, 2026: 

Effective March 19, 2026, Optum will be changing electronic claims routing for the following payer:   

Payer Name: Magellan Healthcare 

Professional CPID: 1419 

Current Edit Master: PE_N000 

New Edit Master: PE_T007 

Institutional CPID: 5539 

Current Edit Master: HE9N000 

New Edit Master: HE9T007 

Payer-assigned Payer ID: 01260 

Payer Claim Enrollment Required: Yes 

Secondary Claims Accepted: Yes 

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required. 

Report Changes:

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

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

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

3/18/2026

---

Tricare For Life, East, and West Real-Time Eligibility and Claim Status Errors

We want to make you aware of a current issue affecting real-time 270/271 eligibility and 276/277 transactions submitted through Optum for Tricare for Life, East, and West.

Some transactions may return the message: "System Not Responding, please resubmit."

This response is due to a temporary system issue on the payer's side. Your transaction was received correctly, and there is no issue with your submission or your connection to Optum.

Payer Name: Tricare East

Payer ID: 99727

Transaction: Real Time Eligibility and Claim Status

Payer Name: Tricare West

Payer ID: 99726

Transaction: Real Time Eligibility and Claim Status

Payer Name: Tricare for Life

Payer ID: TRLIF

Transaction: Real Time Eligibility and Claim Status

What You Should Know:

• The issue is isolated to real-time eligibility and claim status transactions.
• It is being actively investigated and prioritized by the payer.
• There is no estimated time for resolution (ETA) at this moment.

What You Can Do:

• Please wait a few minutes and resubmit the transaction.
• If needed, consider using alternate eligibility verification methods until the issue is resolved.
• No action is needed on your part to correct or troubleshoot the issue.

We understand the importance of timely eligibility and claim status responses. We continue working closely with the payer to support resolution. We will share updates as they become available.

If you have any questions, please contact Customer Support and refer to Global Incident Number INC-000004096.

Thank you for your continued partnership and patience.

3/18/2026

---

Resolved: Monthly Billing Report Delay

Resolved: All missing BD Reports for February 2026 have been processed and delivered. Please allow up to 24 hours for posting to complete.

Original notify sent March 13, 2026:

The delivery of the Optum reports listed below for February transactions were delayed due to a processing issue. Additional updates will be forwarded as more information becomes available.

• Monthly Billing Report (BD)

We apologize for any inconvenience.

Action Required: None. Please be aware of the report delivery delay above.

3/18/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: PACE of the Triad
Institutional CPID: 9083
Professional CPID: 3861
Payer-assigned Payer ID: TRIA01
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: North Carolina
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. 

3/18/2026

---

Enrollment Form Update

The following payers have changed their Remittance/Claims enrollment form estimated turnaround time (TAT) to 30 Days:

• CPID 2872/Payer ID 99727/Tricare East Region
• CPID 5979/Payer ID 99727/Tricare East Region
• CPID 5648/Payer ID 12C01/Tricare West Region
• CPID 6286/Payer ID 99726/Tricare West Region

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

3/18/2026

---

Report Generation Delay for CPID 7241 TransactRX Part D

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since March 12, 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 09927065.

3/18/2026

---

Electronic Claims Connection Suspended

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

Payer Name: GlobalCare
Payer ID: 07689
Reason: Payer unavailable electronically.

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

3/18/2026

---

Update: Invalid Error Message for CPID 2720, 1937 Globalcare

Update: Effective immediately, the payer has been suspended at Optum for claim processing and claims are no longer accepted for below CPID’s.

Action Required: Watch for notifications about new connection availability in the future.

Original notice sent: March 12, 2026:

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

• INVALID OR UNSUPPORTED PAYERID [07689]

This issue began on March 3, 2026 and is being researched at this time.

Payers affected:

• CPID 2720 GlobalCare
• CPID 1937 GlobalCare

Action Required: Please be aware of the error message. We will provide updates as they become available.

3/17/2026

---

Electronic Claims Connection Suspended

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

Payer Name: GlobalCare
CPIDs: 1937, 2720
Payer ID: 07689
Reason: Payer unavailable electronically.

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

3/17/2026

---

Report Generation Delay for CPID 1737 PodAmerica

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

Payer impacted: 

• CPID 1737 PodAmerica

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 09926255.

3/17/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: AdminOne
Institutional CPID: 9091
Professional CPID: 4105
Payer-assigned Payer ID: 87871
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. 

3/17/2026

---

Report Generation Delay for CPID 5909 Carelon Behavioral Health

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted March 2, 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 09925990.

3/17/2026

---

Payer Consolidation - Wellcare Health Plans

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

Payer Name: Wellcare of Connecticut
Payer ID: 14164
Claim Type: Institutional

Payer Name: Wellcare Health Plans
Payer ID: 26141, 36406, 48055
Claim Type: Professional

Payer Name: Wellcare Health Plans
Payer ID: 36406, 48055
Claim Type: Institutional

Payer IDs 14164, 26141, 36406, 48055 will be terminated effective April 17, 2026.

Providers must begin using the following ID for electronic claims:
Payer ID: 14163

The following IDs will also be phasing out in the future, so submitters are encouraged to start transitioning to Payer ID 14163.

Payer Name: Wellcare of Connecticut
Payer ID: 14164
Claim Type: Professional

Payer Name: Wellcare Health Plans
Payer ID: 59608
Claim Type: Institutional and Professional

Payer Name: Wellcare Health Plans
Payer ID: WELLC
Claim Type: Professional

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.

3/17/2026

---

Care N Care Insurance Company Electronic Claims Remittance Connections No Longer Available

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

Payer Name: Care N Care Insurance Company
Payer ID: 66010
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: None.

3/17/2026

---

Reminder: Payer Change for EVV Silver Summit Health Plan Centene

Reminder: Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by March 31, 2026, 5:00 p.m. CT, to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after March 31, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Silver Summit Health Plan
Payer ID: 68069

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

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

3/17/2026

---

Electronic Remittance Connections No Longer Available (multiple payers)

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

Payer Name: Affinity Medical Group
Payer-assigned Payer ID: 46594
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Payer Name: Carolina Behavioral Health Alliance
Payer-assigned Payer ID: 56215
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Payer Name: Employee Plans LLC
Payer-assigned Payer ID: 35112
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Payer Name: Preferred Medical Claims Services
Payer-assigned Payer ID: 21524
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None. 

3/17/2026

---

New Payer Name

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

Previous Payer Name: Carolina Summit Healthcare
New Payer Name: American Trust Administrators, Inc.
Payer ID: 56195

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

3/17/2026

---

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 16, 2026.

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

Original notice sent March 2, 2026:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 16, 2026.

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 09907096.

3/17/2026

---

PAR Status Change for Real-time Payers

The PAR Status is changing for the following payer(s):

Harvard Pilgrim Health Care
Transaction: Eligibility
Payer ID: HPHCS
New PAR Status: Non Par
Effective Date: 04/01/2026

Surest
Transaction: Eligibility
Payer ID: 25463
New PAR Status: Gateway
Effective Date: 03/01/2026

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

3/17/2026

---

Electronic Routing Change for CPIDs 1419 and 5539 Magellan Healthcare

Effective March 19, 2026, Optum will be changing electronic claims routing for the following payer:   

Payer Name: Magellan Healthcare
Professional CPID: 1419
Current Edit Master: PE_N000
New Edit Master: PE_T007
Institutional CPID: 5539
Current Edit Master: HE9N000
New Edit Master: HE9T007
Payer-assigned Payer ID: 01260
Payer Claim Enrollment Required: Yes
Secondary Claims Accepted: Yes 

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required. 

Report Changes:

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

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

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

3/17/2026

---

Enrollment Form Change

The following payers have changed their Remittance enrollment form:

• CPID 1484/Payer ID SCXIX/South Carolina Medicaid
• CPID 5540/ Payer ID SCXIX/South Carolina Medicaid

If providers are not currently receiving remittance, the updated enrollment form should be completed. 

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

3/17/2026

---

Update: Report Generation Delay for CPIDs 1573 and 3802 AvMed

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Feb. 4, 2026-Feb. 27, 2026.

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

Original notice sent Feb. 16, 2026:
A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Feb. 4, 2026.

Payer impacted: 

• CPID 1573 AvMed
• CPID 3802 AvMed

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 09891641.

3/17/2026

---

Electronic Routing Change for CPIDs 1419 and 5539 Magellan Healthcare

Optum will be changing electronic claims routing for the following payer, effective March 19, 2026:

Payer Name: Magellan Healthcare
Professional CPID: 1419
Institutional CPID: 5539
Payer-assigned Payer ID: 01260
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 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. 

3/17/2026

---

PAR Status Change for Real Time Payers

The PAR Status is changing for the following payers:

Alliant Health Plans
Transaction: Claim Status
Industry ID: 58234
Exchange CPIDs: 2589, 3793
Exchange RT ID: ALLIHP
New PAR Status: Transitional
Effective Date: March 1, 2026

FirstCarolinaCare
Transactions: Eligibility, Claim Status
Industry ID: FCC01
Exchange CPIDs: 4077, 8821
Exchange RT ID: FCACAR
New PAR Status: Transitional
Effective Date: March 1, 2026

Harvard Pilgrim Health Care
Transaction: Eligibility
Industry ID: 04271
Exchange CPIDs: 6512, 2742
Exchange RT ID: HRVPGM
New PAR Status: Non Par
Effective Date: April 1, 2026

Surest
Transaction: Eligibility
Industry ID: 25463
Exchange CPIDs: 2007, 8139
Exchange RT ID: BIND
New PAR Status: Gateway
Effective Date: March 1, 2026

3/17/2026

---

Payer Name Change

Optum has new electronic eligibility connections available:

Payer Name: Standard Life and Accident Ins Co
Connection Type: X12
Payer Enrollment Required: No

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.

3/16/2026

---

Multiple payers Electronic Remittance Connections No Longer Available

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

Payer Name: Affinity Medical Group
Remittance CPIDs: 5217, 9683
Line of Business (LOB) Code: N20
Payer-assigned Payer ID: 46594 

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

Payer Name: Carolina Behavioral Health Alliance
Remittance CPIDs: 5195, 7964
Line of Business (LOB) Code: N11
Payer-assigned Payer ID: 56215 

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

Payer Name: Employee Plans LLC
Remittance CPIDs: 1834, 8548
Line of Business (LOB) Code: J6I
Payer-assigned Payer ID: 35112 

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

Payer Name: Preferred Medical Claims Services
Remittance CPIDs: 7833, 1009
Line of Business (LOB) Code: H99
Payer-assigned Payer ID: 21524 

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

Action Required: None. 

3/16/2026

---

Multiple payers Electronic Remittance Connections No Longer Available

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

Payer Name: Affinity Medical Group
Remittance CPIDs: 5217, 9683
Payer-assigned Payer ID: 46594 

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

Payer Name: Carolina Behavioral Health Alliance
Remittance CPIDs: 5195, 7964
Payer-assigned Payer ID: 56215 

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

Payer Name: Employee Plans LLC
Remittance CPIDs: 1834, 8548
Payer-assigned Payer ID: 35112 

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

Payer Name: Preferred Medical Claims Services
Remittance CPIDs: 7833, 1009
Payer-assigned Payer ID: 21524 

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

Action Required: None. 

3/16/2026

---

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 Feb. 27, 2026.

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 09925144.

3/16/2026

---

Edit Master for CPIDs 6555 and 5422 Klais and Company

Effective March 17, 2026, Optum will be changing Edit Masters for the following payer:

Payer Name: Klais and Company
Professional CPID: 5422
Current Edit Master: PE_C054
New Edit Master: PE_T007  
Institutional CPID: 6555
Current Edit Master: HE9C054
New Edit Master: HE9T007
Payer-assigned Payer ID: 34145 

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. 

3/16/2026

---

Report Generation Delay for CPID 1258 Global Healthcare Alliance

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

Payer impacted: 

• CPID 1258 Global Healthcare Alliance

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09925094.

3/16/2026

---

Update: Report Generation Delay for CPID 2872 TRICARE East Region

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

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

Original notice sent March 5, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 24, 2026.

Payer impacted:

• CPID 2872 TRICARE East Region

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09913063.

3/16/2026

---

New Payer Name

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

Previous Payer Name: Carolina Summit Healthcare
New Payer Name: American Trust Administrators, Inc.
Professional CPID: 5466
Professional Edit Master: PE_T007
Institutional CPID: 3695
Institutional Edit Master: HE9T007
Payer ID: 56195

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

Action Required: No Payer Alias changes are required. Payer name and CPIDs are not changing.

3/16/2026

---

New Payer Name

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

Previous Payer Name: Carolina Summit Healthcare
New Payer Name: American Trust Administrators, Inc.
Professional CPID: 5466
Institutional CPID: 3695
Payer ID: 56195

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

3/16/2026

---

Update: Report Generation Delay for CPID 3488 TrueCare Mississippi Medicaid

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 14, 2026 and Feb. 16, 2026.

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

Original notice sent March 2, 2026:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 14, 2026.

Payer impacted:

• CPID 3488 TrueCare Mississippi 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 09907038.

3/16/2026

---

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Feb. 19, 2026 through Feb. 27, 2026.

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

Original notice sent Feb. 26, 2026:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 12, 2026.

Payer impacted: 

• CPID 1913 Michigan Medicare Plus Blue (MAP)
• CPID 2287 Michigan Medicare Plus Blue (MAP)

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09903805.

3/16/2026

---

Report Generation Delay for CPID 7576 Unified Health Services

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted March 4, 2026.

Payer impacted: 

• CPID 7576 Unified Health Services 

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09924828.

3/16/2026

---

Update: Report Generation Delay for CPID 7489 Blue Cross Blue Shield of Wyoming

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Feb. 11, 2026 -Feb. 17, 2026.

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

Original notice sent Feb. 25, 2026:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 11, 2026.

Payer impacted: 

• CPID 7489 Blue Cross Blue Shield of Wyoming

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 09901765.

3/16/2026

---

Edit Master for CPIDs 1517 and 2724 HealthSmart Preferred Care

Optum will be changing Edit Masters for the following payer, effective March 17, 2026:

Payer Name: HealthSmart Preferred Care
Professional CPID: 2724
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Institutional CPID: 1517
Current Edit Master: HE9C054
New Edit Master: HE9T007  
Payer-assigned Payer ID: 75250 

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. 

3/16/2026

---

Report Generation Delay for CPID 9053 AvMed (Encounters)

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since March 2, 2026.

Payer impacted: 

• CPID 9053 AvMed (Encounters)

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 09924724.

3/16/2026

---

Edit Master for CPIDs 9584 and 5280 HealthSmart ACCEL Network

Optum will be changing Edit Masters for the following payer, effective March 17, 2026:

Payer Name: HealthSmart ACCEL Network
Professional CPID: 5280
Current Edit Master: PE_C054
New Edit Master:  PE_T007
Institutional CPID: 9584
Current Edit Master: HE9C054
New Edit Master:  HE9T007
Payer-assigned Payer ID: 75237 

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. 

3/16/2026

---

PAR Status Change for Real Time Payers

Please note the PAR Status is changing for the following payers:

Alliant Health Plans
Transaction: Eligibility, Claim Status
IMN ID: 58234
Effective Date: March 1, 2026
New Par Status: Transitional

Delta Dental of California AARP
Transaction: Eligibility
IMN ID: AARP1
Effective Date: April 1, 2026
New Par Status: Non Par

DeltaCare USA
Transaction: Eligibility
IMN ID: DDCA2
Effective Date: April 1, 2026
New Par Status: Non Par

FirstCarolinaCare
Transaction: Eligibility, Claim Status
IMN ID: FCC01
Effective Date: March 1, 2026
New Par Status: Transitional

Harvard Pilgrim Health Care
Transaction: Eligibility
IMN ID: 04271
Effective Date: April 1, 2026
New Par Status: Non Par

Surest
Transaction: Eligibility
IMN ID: 25463
Effective Date: March 1, 2026
New Par Status: Gateway

Action Required: Please be aware of the upcoming changes.

3/16/2026

---

Care N Care Insurance Company Electronic Claim /Remittance Connections No Longer Available

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

Payer Name: Care N Care Insurance Company
Claims and Remittance CPIDs: 8146, 2013
Line of Business (LOB) Code: H7I
Payer-assigned Payer ID: 66010
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: None.

3/16/2026

---

Care N Care Insurance Company Electronic Claims Remittance Connections No Longer Available

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

Payer Name: Care N Care Insurance Company
Claim and Remittance CPIDs: 8146, 2013
Payer-assigned Payer ID: 66010
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

3/16/2026

---

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:

Payer ID – Payer name

27154 – Arizona Priority Care Plus
VNSPC – Volunteers of America National Services

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.

3/16/2026

---

New Real Time Connections Available on RPA

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

07205 – HealthComp South

10750 – State Mutual Med Supp

10752 – Shenandoah Life Insurance Company

11043 – Public Employee Benefit Authority

11050 – Public Employees Health Program - CHIP

11162 – SBLI USA Life Insurance Company, Inc

11163 – S. USA Life Insurance Company, Inc.

11216 – Universal American

14298 – United Insurance Company of America (Kemper)

31481 – AmeriHealth Caritas VIP Care – North Carolina HIDE SNP

37135 – Consociate

73575 – AmeriHealth Caritas VIP Care – Louisiana HIDE SNP

75066 – AmeriHealth Caritas Next, A Product of AmeriHealth Caritas Louisiana

90689 – AmeriHealth Caritas VIP Care – Michigan HIDE SNP

99320 – Benefit and Risk Management

A0339 – Sonder Health Plans

A5420 – AmeriHealth Caritas District of Columbia - Healthy DC Plan

COCHA – Colorado Community Health Alliance

DCRSS – Clearwater

IHS29 – Point C

MLNIA – Molina Healthcare of Iowa

XHNNC – Health Net National

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

07205 – HealthComp South

11315 – Fidelis Care

31481 – AmeriHealth Caritas VIP Care – North Carolina HIDE SNP

59322 – Florida Health Care Plans

66170 – Community Health Group

73575 – AmeriHealth Caritas VIP Care – Louisiana HIDE SNP

75066 – AmeriHealth Caritas Next, A Product of AmeriHealth Caritas Louisiana

90689 – AmeriHealth Caritas VIP Care – Michigan HIDE SNP

A5420 – AmeriHealth Caritas District of Columbia - Healthy DC Plan

COCHA – Colorado Community Health Alliance

ECLLS – Excellus Blue Cross Blue Shield

SKPA0 – Pennsylvania Medicaid

SKWA0 – Washington Medicaid

3/16/2026

---

Reminder: Payer Change for CPIDs 1803, 2945 EVV Silver Summit Health Plan Centene

Reminder:
Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by March 31, 2026, 5:00 p.m. CT on to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Professional CPID: 1803
Professional Edit Master: PE_T007
Institutional CPID: 2945
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after March 31, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Silver Summit Health Plan
Professional CPID: 1263
Professional Edit Master: PE_T007
Institutional CPID: 5542
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: 68069

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required.

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.

3/16/2026

---

Reminder: Payer Change for CPIDs 1803, 2945 EVV Silver Summit Health Plan Centene

Reminder:
Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by March 31, 2026, 5:00 p.m. CT, to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Claim CPIDs: 1803, 2945
Payer-assigned Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after March 31, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Silver Summit Health Plan
Professional CPID: 1263
Institutional CPID: 5542
Payer-assigned Payer ID: 68069

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

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

3/16/2026

---

Teamsters Medicare Trust for Retired Employees Electronic Claims Connection No Longer Available

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

Payer Name: Teamsters Medicare Trust for Retired Employees
Payer ID: 43619
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

3/13/2026

---

New Electronic Eligibility Connection Available

Optum has new electronic claims connections available:

 

Payer Name: Central Valley Medical Group (CVMG)

Payer ID: CVH01

Payer Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: California

 

Payer Name: American Collective LP

Payer ID: 29084

Payer Enrollment Required: No

Secondary Claims Accepted: No

Payer Location: National

 

Payer Name: Captrue Benefits

Payer ID: 34242

Payer Enrollment Required: No

Secondary Claims Accepted: No

Payer Location: National

 

Payer Name: Tres Health, Inc.

Payer ID: 32396

Payer Enrollment Required: No

Secondary Claims Accepted: No

Payer Location: National

 Action Required: 

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

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

3/13/2026

---

Electronic Routing Change for CPIDs 5095 and 9144 CommuniCare Advantage

Optum will be changing electronic claims and remittance routing for the following payer, effective March 17, 2026:

Payer Name: CommuniCare Advantage
Professional CPID: 9144
Current Edit Master: PE_C051
New Edit Master: PE_T007
Institutional CPID: 5095
Current Edit Master: HE9C051
New Edit Master: HE9T007
Previous Payer ID: 34525
New Payer ID: 70022
Line of Business Code (LOB): K45
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers.

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.

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.

3/13/2026

---

Electronic Routing Change for CPIDs 5095 and 9144 CommuniCare Advantage

Optum will be changing electronic claims and remittance routing for the following payer, effective March 17, 2026:

Payer Name: CommuniCare Advantage
Professional CPID: 9144
Institutional CPID: 5095
Previous Payer ID: 34525
New Payer ID: 70022
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No

Providers only need to include the CPID (not Payer ID) in the claim. Optum will manage the Payer ID changes for our customers

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.

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.

3/13/2026

---

Claims and Remittance Reactivation for District of Columbia Medicaid

Update: Effective March 5, 2026, Optum is reactivating and updating electronic claims and remittance routing for the payer listed below. Please note that any claims not processed since Feb. 19, 2026, 10:00 p.m. ET will need to be resubmitted. 

Payer Name: District of Columbia Medicaid
Payer ID: 77033, DCMCD, SKDC0, 12001
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes 

Enrollment Requirements
Claims:

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

Remittance:

• Payer enrollment for electronic remittance is required. 
• Providers currently receiving electronic remittance through Optum do not need to complete a new enrollment form. However, providers who receive an enrollment denial notification must submit a new enrollment through Enrollment Central. 
• New providers must complete a new enrollment form. 
• All providers who have not received remittance since Nov. 25, 2025, will need to complete a new enrollment form. 

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

Additional Changes:
Additional information on this transition can be found on the payer website at https://medicaid.dc.gov  

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

• Providers must complete a new enrollment form prior to submitting claims. 
• 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 IEDI. 

Original notice sent Feb. 23, 2026:
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: District of Columbia Medicaid
Payer ID: 77033, DCMCD, SKDC0, 12001
Reason: Effective March 2, 2026, DHCF will transition to a new Medicaid Management Information System (MMIS) and all fiscal agent services will transition to Gainwell.

Starting Feb. 20, 2026, 4:00 p.m. ET, the web portal will be available in an INQUIRY ONLY mode through Feb. 28, 2026, and will no longer allow Claim or Prior Authorization submissions.

Additional information on this transition will be provided by Gainwell/DHCF as the transition date approaches. You can also visit https://medicaid.dc.gov for more information.

NOTE: Claims submitted after Feb. 19, 2026, 10:00 PM ET will not be eligible for processing by the payer.

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

3/13/2026

---

Update: Electronic Claims Connection Suspended

Update: Optum has reactivated and changed electronic claims routing for the following payer: 

Payer Name: PHCS Multiplan - Group Resources
Payer ID: 28680
Payer Claim Enrollment Required: N
Secondary Claims Accepted: Yes 

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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 payer IDs are not changing. 

Original notice sent Jan. 9, 2026:
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list. 

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

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

3/13/2026

---

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

Deloitte is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 6, 2026.

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09923866.

3/13/2026

---

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

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

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09923855.

3/13/2026

---

Enrollment Form Change

The following payer has changed their Remittance enrollment form:

• CPID 5299/Payer ID 26054/ICARE Health Options TPA

If providers are not currently receiving remittance the updated enrollment form should be completed.

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

3/13/2026

---

Teamsters Medicare Trust for Retired Employees Electronic Claims Connection No Longer Available

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

Payer Name: Teamsters Medicare Trust for Retired Employees
Claim CPIDs: 1271, 6508
Payer-assigned Payer ID: 43619
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

3/13/2026

---

Payer Processing Issue for CPID 3801 Fallon Community Health Plan

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

Payer impacted:

• CPID 3801 Fallon Community Health Plan

A resolution has been implemented and the claims were retransmitted to the payer March 13, 2026.

This delay affected claims released to Optum March 9, 2026, 8:00 p.m.-March 10, 2026, 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 09922304.

3/13/2026

---

Update: Electronic Routing Change for CPIDs 6797 and 6693 Lucent Health

Update: Edit master updates have been delayed and will now be effective March 17, 2026. Please note the new date and complete your system updates at that time.

Original sent March 11, 2026:
Effective March 13, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: Lucent Health
Professional CPID: 6797
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 6693
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 88056
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

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

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

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

3/13/2026

---

New Electronic Eligibility and Claim Status Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 and Claim Status Inquiry and Response 276/277 for the below payer, effective March 12, 2026:

Payer Name: SKAI Blue Cross Blue Shield
Industry Payer ID: BSKAI
IMN Real Time ID: BSKAI
Exchange Real Time ID: BSKAI
Optum IEDI Real Time ID: BSKAI
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

Eligibility Dependent

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

Claim Status Inquiry Subscriber

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

Claim Status Inquiry Dependent

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

3/13/2026

---

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective March 12, 2026:

Payer Name: Standard Life and Accident Insurance Company
Industry Payer ID: 73099
IMN Real Time ID: SLAIC
Exchange Real Time ID: SLAICO
Optum IEDI Real Time ID: 73099
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

Eligibility Dependent

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

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

3/13/2026

---

Invalid Error Message for CPID 2720, 1937 Globalcare

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

• INVALID OR UNSUPPORTED PAYERID [07689]

This issue began on March 3, 2026 and is being researched at this time.

Payers affected:

• CPID 2720 GlobalCare
• CPID 1937 GlobalCare

Action Required: Please be aware of the error message. We will provide updates as they become available.

3/13/2026

---

New Payer Edit for 5596 ARKANSAS BLUE CROSS

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 on March 17th, 2026:

• ISV202B112: MISSING HCPCS/CPT-4 CODE – When the following conditions are present, the HCPCS/CPT-4 Code is required.

1. The Type of Bill is 13x, 14x, or 85x; and
2. The associated Revenue Code is in the following list:

250-259    290-294
270-274    631-637
276-277    94x
279

Notes:

1. If this requirement does not apply to your billing situation, you can override the edit within the Error Text.
2. Edit is based on AR BCBS Provider News, page 5, June 2025, page 9, December 2025.

LINK: https://www.arkansasbluecross.com/providers/medical-providers/providers-news

LINK: https://www.blueadvantagearkansas.com/docs/librariesprovider9/providers-news/00292-08-06-abcbs-providers-news-dec-2025-v2.pdf

LOOP 2400 SV202-2 

 Edit applies to: 

• CPID 5596 ARKANSAS BLUE CROSS 

Action Required: Please be aware of updated edit requirements. 

3/13/2026

---

Update: Report Generation Delay for CPID 5440 Fox Valley Medicine

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Feb. 5, 2026 through Feb. 21, 2026.

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

Original notice sent Feb. 19, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 5, 2026.

Payer impacted: 

• CPID 5440 Fox Valley Medicine

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09895920.

3/13/2026

---

Electronic Routing Change for Ameritas Life Insurance Company (47009)

Optum is changing electronic remittance routing for the following payer, effective March 12, 2025:

Payer Name: Ameritas Life Insurance Company
Payer ID: 47009
Payer Remittance Enrollment Required: Yes
Payer Type: Trans

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 Payer ID are not changing. 
• When a payer requires enrollment, forms must be submitted and approved from IEDI. 

3/12/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Gulf Quest Renaissance
Payer ID: RENGQ
Reason: Payer unavailable electronically.

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

3/12/2026

---

Electronic Routing Change for Capitol Administrators (68011)

Optum is changing electronic remittance routing for the following payer, effective March 12, 2026:

Payer Name: Capitol Administrators
Payer ID: 68011
Payer Remittance Enrollment Required: Yes
Payer Type: Trans

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 IEDI. 

3/12/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Gulf Quest Renaissance
CPID(s): 3463
Payer ID: RENGQ 
Reason: Payer unavailable electronically.

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

3/12/2026

---

Electronic Routing Change for CPID 9402 Ameritas Life Insurance Company

Effective March 12, 2025, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: Ameritas Life Insurance Company
Professional CPID: 9402
Payer-assigned Payer ID: 47009
Line of Business Code (LOB): K1K
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 CPID are not changing. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central. 

3/12/2026

---

Electronic Routing Change for CPID 9402 Ameritas Life Insurance Company

Effective March 12, 2025, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: Ameritas Life Insurance Company
Professional CPID: 9402
Payer-assigned Payer ID: 47009
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. 

3/12/2026

---

Electronic Routing Change for CPIDs 2810 and 2989 Capitol Administrators

Effective March 12, 2026, Optum will be changing electronic remittance routing for the following payer:   

Payer Name: Capitol Administrators
Professional CPID: 2810
Institutional CPID: 2989
Payer-assigned Payer ID: 68011
Line of Business Code (LOB): J7Y
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. 

3/12/2026

---

Electronic Routing Change for CPIDs 2810 and 2989 Capitol Administrators

Effective March 12, 2026, Optum will be changing electronic remittance routing for the following payer: 

Payer Name: Capitol Administrators
Professional CPID: 2810
Institutional CPID: 2989
Payer-assigned Payer ID: 68011
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. 

3/12/2026

---

Report Generation Delay for CPID 3509 Ohio Medicaid

Deloitte is experiencing issues affecting Institutional report generation for some claims submitted on March 4, 2026.

Payer impacted:

• CPID 3509 Ohio Medicaid

Deloitte 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 09920067.

3/12/2026

---

Report Generation Delay for CPID 6405 Cigna Health Plans

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted March 11, 2026.

Payer impacted:

• CPID 6405 Cigna 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 09921447.

3/12/2026

---

Electronic Claims Connection Suspended

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

Payer Name: 21ST CENTURY INSURANCE AND FINANCIAL SERVICES
Payer ID: 51028
Reason: Payer unavailable electronically.

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

3/12/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Mutual Health Services
Payer ID: 34192
Reason: Payer unavailable electronically.

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

3/12/2026

---

Farm Bureau Health Plans MAPD Electronic Claims Connection No Longer Available

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

Payer Name: Farm Bureau Health Plans MAPD
Payer ID: RP061
Reason: Payer no longer supports Payer ID RP061 and requested deactivation.  

Action Required: None. 

3/12/2026

---

Upcoming Payer Edit Change for CPIDs 1149, 1581 Children's Community Health Plan

Optum has been informed that coverage has ended  effective  Jan. 1, 2026.  Children's Community Health Plan is operating on a standard runout period for claims with 2025 dates of service. Optum is implementing the following edits for date of service effective March 11, 2026.

• PDTP03C450: INVALID STATEMENT FROM DATE - This payer is not accepting claims with a Service Line From Date on or after 01/01/2026. LOOP 2400 DTP03 
• INVALID STATEMENT FROM DATE - This Payer is not accepting claims with Statement From Date on or after 01/01/2026. LOOP 2300 DTP03 

The date of service edits will be applied for:
Payer Name: Children's Community Health Plan
Claim CPIDs: 1149, 1581
Payer-assigned Payer ID: 251CC 

Providers must be aware that claims with date of service on or after Jan. 1, 2026, will be rejected.  

Action Required: Providers should be aware of the date of service edit implementation.  

3/11/2026

---

Report Generation Delay for CPID 3509 Ohio Medicaid

Deloitte is experiencing issues affecting Institutional report generation for some claims submitted on March 4, 2026.

Payer impacted:

• CPID 3509 Ohio Medicaid

Deloitte 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 09920067.

3/11/2026

---

Electronic Routing Change for CPIDs 6797 and 6693 Lucent Health

Effective March 13, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: Lucent Health
Professional CPID: 6797
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 6693
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 88056
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

3/11/2026

---

Electronic Routing Change for CPIDs 6797 and 6693 Lucent Health

Effective March 13, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: Lucent Health
Professional CPID: 6797
Institutional CPID: 6693
Payer-assigned Payer ID: 88056
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

3/11/2026

---

Electronic Claims Connection Suspended

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

Payer Name: 21ST CENTURY INSURANCE AND FINANCIAL SERVICES
CPID(s): 2170
Payer ID: 51028
Reason: Payer unavailable electronically.

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

3/11/2026

---

Payer Fee Change for 1145 Children's Physicians Medical Group

Please be aware of the following payer claim fee change: 

Payer Name: Children's Physicians Medical Group
CPID: 1145
Payer ID: RCHN1
Current Fee: $0.00
New Fee: $0.10
Effective Date: 03/10/2026 

Action Required: Please be aware the payer above has modified their claim fee. 

3/10/2026

---

Report Generation Delay for CPID 2593 QualChoice of Arkansas

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since Feb. 24, 2026.

Payer impacted: 

• CPID 2593 QualChoice of Arkansas

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09918368.

3/10/2026

---

New Clearance Payer Connections
Optum has new electronic eligibility connections available:

Payer Name: CareFirst BCBS Medicare Advantage
Connection Type: X12

Payer Name: Corporate Benefit Services
Connection Type: X12

Payer Name: Lagniappe Advantage
Connection Type: X12

Payer Name: Lumico Life Insurance
Connection Type: X12

Payer Name: International Benefit Administrators TPA
Connection Type: Portal

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.

3/10/2026

---

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

Update: This issue is still under review with the payer. Additional notifications will be sent as updates become available.

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.

3/10/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Mutual Health Services
CPID(s): 2290, 2935
Payer ID: 34192
Reason: Payer unavailable electronically.

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

3/10/2026

---

Electronic Routing Change for CPIDs 4480 and 1532 SelectHealth

Optum is changing electronic remittance routing for the following payer, effective March 10, 2026:

Payer Name: SelectHealth
Professional CPID: 4480
Institutional CPID: 1532
Payer-assigned Payer ID: SX107
Line of Business Code (LOB): U3P
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. 

3/10/2026

---

Electronic Routing Change for CPIDs 4480 and 1532 SelectHealth

Optum is changing electronic remittance routing for the following payer, effective March 10, 2026:

Payer Name: SelectHealth
Professional CPID: 4480
Institutional CPID: 1532
Payer-assigned Payer ID: SX107
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. 

3/10/2026

---

Farm Bureau Health Plans MAPD Electronic Claims Connection No Longer Available

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

Payer Name: Farm Bureau Health Plans MAPD
Claim CPIDs: 8015, 9733
Payer-assigned Payer ID: RP061 

Reason: Payer no longer supports Payer ID RP061 and requested deactivation.  

Action Required: None. 

3/10/2026

---

Farm Bureau Health Plans MAPD Electronic Claims Connection No Longer Available

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

Payer Name: Farm Bureau Health Plans MAPD
Claims CPIDs: 8015, 9733
RTE Payer ID: FMBHP
Payer-assigned Payer ID: RP061
Reason: Payer no longer supports Payer ID RP061 and requested deactivation. 

Action Required: None. 

3/10/2026

---

Real Time Eligibility 270/271 Payer Termination

Effective April 1, 2026, Real Time Eligibility 270/271 for the payer listed below will no longer be available at Optum.

Payer Name: Health Alliance Plans of Illinois
Industry Payer ID: 77950
IMN Real Time ID: HALLS
Exchange Real Time ID: HLTAIL
CPID(s): 2509, 2494
Optum IEDi Real Time ID: 77950Connection Type: X12 and Portal

Reason: The runout period has ended. Payer will no longer offer an electronic connection.

Action Required: Providers should be aware Real Time Eligibility transactions will terminate on April 1, 2026.

3/10/2026

---

Claim Status Inquiry 276/277 Payer Termination

Effective April 1, 2026, Claim Status Inquiry 276/277 for the payer listed below will no longer be available at Optum.

Payer Name: Health Alliance Plans of Illinois
Industry Payer ID: 77950
IMN Real Time ID: HALLS
Exchange Real Time ID: HLTAIL
CPID(s): 2509, 2494
Optum IEDi Real Time ID: 10871
Connection Type: X12

Reason: The runout period has ended. Payer will no longer offer an electronic connection.

Action Required: Providers should be aware Real Time Claim Status transactions will terminate on April 1, 2026.

3/10/2026

---

Electronic Routing Change for CPIDs 4480 and 1532 SelectHealth

Optum is changing electronic remittance routing for the following payer, effective March 10, 2026:

Payer Name: SelectHealth
Professional CPID: 4480
Institutional CPID: 1532
Payer-assigned Payer ID: SX107
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. 

3/10/2026

---

Payer Processing Issue for CPID 5560 Alabama Medicaid Inpatient

Due to a payer processing issue, some Institutional claims transmitted to the payer listed below March 5, 2026 were not processed by the payer.

Payer impacted:

• CPID 5560 Alabama Medicaid Inpatient

A resolution has been implemented and the claims were retransmitted to the payer March 10, 2026.

This delay affected claims released to Optum March 4, 2026, 3:00 p.m.-March 5, 2026, 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 09917716.

3/10/2026

---

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum March 6, 2026 were not processed by the payer due to a 999 Batch Rejection. 

• CPID 1844 Wellcare Health Plans

A resolution has been implemented and the claims were retransmitted to the payer March 9, 2026.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09916483.

3/10/2026

---

Report Generation Delay for CPID 7136 Benefit and Risk Management Services

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

Payer impacted:

• CPID 7136 Benefit and Risk Management Services

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09917717.

3/10/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Tres Health, Inc.
Institutional CPID: 2673
Professional CPID: 1789
Payer-assigned Payer ID: 32396
Payer Enrollment Required: No
Secondary Claims Accepted: No
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.

3/9/2026

---

Electronic Routing Change for Brio Living Services – multiple CPIDs

Effective March 9, 2026, Optum is changing electronic claims and remittance routing for the following payers:

Payer Name: Huron Valley PACE
Professional CPID: 7463
Institutional CPID: 9634
Payer-assigned Payer ID: 54750
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No
Claims Fee: N/A
Remittance Fee: N/A 

Payer Name: LifeCircles PACE
Professional CPID: 7866
Institutional CPID: 1037
Payer-assigned Payer ID: 71498
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No
Claims Fee: N/A
Remittance Fee: N/A 

Payer Name: The Cascade PACE Inc. DBA Thome PACE
Professional CPID: 9418
Institutional CPID: 7034
Payer-assigned Payer ID: RP044
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No
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 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. 

3/9/2026

---

Electronic Routing Change for Brio Living Services – multiple CPIDs

Effective March 9, 2026, Optum is changing electronic claims and remittance routing for the following payers:   

Payer Name: Huron Valley PACE
Professional CPID: 7463
Edit Master: PE_T007
Institutional CPID: 9634
Edit Master: HE9T007
Payer-assigned Payer ID: 54750
Line of Business Code (LOB): H2M
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No 

Payer Name: LifeCircles PACE
Professional CPID: 7866
Edit Master: PE_T007
Institutional CPID: 1037
Edit Master: HE9T007
Payer-assigned Payer ID: 71498
Line of Business Code (LOB): H4M
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No 

Payer Name: The Cascade PACE Inc. DBA Thome PACE
Professional CPID: 9418
Edit Master: PE_T007
Institutional CPID: 7034
Edit Master: HE9T007
Payer-assigned Payer ID: RP044
Line of Business Code (LOB): H07
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No 

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

3/9/2026

---

PAR Status Change for Claim/ERA payers

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

Element Care
Industry ID: 04326
Exchange CPIDs: 6977, 6811
Transaction: Claims, Remittance
New PAR Status: Par

Kaiser Foundation Health Plan of Colorado
Industry ID: RH003
Exchange CPIDs: 1931, 2439
Transaction: Remittance
New PAR Status: Non Par

Kaiser Foundation Health Plan of Northern California Region
Industry ID: RH009
Exchange CPIDs: 2582, 3781
Transaction: Remittance
New PAR Status: Non Par

Kaiser Foundation Health Plan of Southern California Region
Industry ID: 94134
Exchange CPIDs: 4576, 1703
Transaction: Remittance
New PAR Status: Non Par

Kaiser Foundation Health Plan of the Mid‑Atlantic States
Industry ID: RH010
Exchange CPIDs: 7506, 2819
Transaction: Remittance
New PAR Status: Non Par

Kaiser Foundation Health Plan of the Northwest
Industry ID: RH002
Exchange CPIDs: 1544, 2266
Transaction: Remittance
New PAR Status: Non Par

Kaiser Permanente Hawaii
Industry ID: 94123
Exchange CPIDs: 5925, 6772
Transaction: Remittance
New PAR Status: Non Par

Veteran Affairs Community Care Network Region 1, 2, 3
Industry ID: VACCN
Exchange CPIDs: 3009, 8257
Transaction: Claims
New PAR Status: Transitional

Yale University Health Plan
Industry ID: 60646
Exchange CPIDs: 5972, 9166
Transaction: Claims
New PAR Status: Par

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

3/9/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

 

Payer Name: WyoBlue Advantage

Payer ID: WYBA

Payer Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: Wyoming

 

Payer Name: Pomona Valley Hospital Medical Center

Payer ID: PVHMC

Payer Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: California

 

Payer Name: Bay Area Care Partners

Payer ID: NMM11

Payer Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: California

 

Payer Name: ViCare Health

Payer ID: VCH01

Payer Enrollment Required: No

Secondary Claims Accepted: Yes

Payer Location: National

Action Required: 

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

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

3/9/2026

---

New Electronic Claims Connections Available - Arizona Priority Care Plus

Optum has new electronic claims connections available:

Payer Name: Arizona Priority Care Plus
Payer ID: 27154
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Arizona

Plan accepted with this connection:

• Arizona Priority Care

Action Required: 

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

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

3/9/2026

---

Payer Change for Village Practice Management Company (36477)

Effective immediately, claims submitted to the payer listed below with Dates of Service on or after Nov. 1, 2025, will be rejected. The payer has also informed us that they will discontinue all claims and remittance activity effective May 1, 2026.

Payer Name: Village Practice Management Company
Payer ID: 36477

Action Required: Be sure to follow the dates outlined above when submitting claims.

3/9/2026

---

California Department of Corrections Electronic Claims Connection No Longer Available

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

Payer Name: California Department of Corrections
Payer ID: MCS04
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

3/9/2026

---

Claims Payer Enrollment No Longer Required

Optum has received notification that Claims enrollment forms are no longer required for the following payer:

• Washington Medicaid – Payer ID - 77045

Action Required: None.

3/9/2026

---

Payer Change for EVV Silver Summit Health Plan Centene (NVSIL)

Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by March 31, 2026, 5:00 p.m. CT to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after March 31, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Silver Summit Health Plan
Payer ID: 68069

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

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

3/9/2026

---

Update: Payer Reactivation - Yuzu Health

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

Payer Name: Yuzu Health
Payer ID: IHS15
Payer Claim Enrollment Required: No
Secondary claims accepted: Yes

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

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

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

3/9/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Optum San Diego Public Sector CFWB
Payer ID: CFWB1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

Payer Name: Optum San Diego Public Sector CFWB Medi-Cal
Payer ID: CFWMC
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.

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

3/9/2026

---

California Department of Corrections Electronic Claims Connection No Longer Available

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

Payer Name: California Department of Corrections
Claim CPID: 7222
Payer-assigned Payer ID: MCS04
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

3/6/2026

---

Report Generation Delay for CPID 4438 Evolutions Healthcare Systems

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted Jan. 30, 2026.

Payer impacted:  

• CPID 4438 Evolutions Healthcare Systems

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09914653.

3/6/2026

---

Report Generation Delay for CPID 2960 Hometown Health

The payer listed below is experiencing issues affecting Institutional report generation for some claims submitted Feb. 19, 2026 and Feb. 20, 2026.

Payer impacted: 

• CPID 2960 Hometown Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09914608.

3/6/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: American Collective LP
Institutional CPID: 9088
Professional CPID: 3882
Payer-assigned Payer ID: 29084
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National
Claims Fee: N/A

Payer Name: Captrue Benefits
Institutional CPID: 9089
Professional CPID: 3884
Payer-assigned Payer ID: 34242
Payer Enrollment Required: No
Secondary Claims Accepted: No
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.

3/6/2026

---

Follow up CSA for Eligibility Connection

Follow‑up to the previous CSA, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective March 3, 2026. Additionally, please be advised that the Payer ID previously published for Exchange RT ID TXCPL was incorrect. The accurate Payer ID is TXCHIP.

Payer Name: Texas Children’s Health Plan - CHIP
Industry Payer ID: 76408
IMN Real Time ID: 76408
Exchange Real Time ID: TXCHIP
Optum IEDI Real Time ID: 76408
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.

3/6/2026

---

Claims Payer Enrollment No Longer Required

Optum has received notification that Claims enrollment forms are no longer required for the following payers:

• CPID 5523 - Washington Medicaid – Payer ID - 77045
• CPID 1482 - Washington Medicaid - Payer ID - 77045
• CPID 6553 - Washington Medicaid - Payer ID - 77045
• CPID 2432 - Washington Medicaid – Payer ID - 77045

Action Required: None.

3/6/2026

---

Report Generation Delay for CPID 5865 Indian Health Services

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 20, 2026.

Payer impacted: 

• CPID 5865 Indian Health Services

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09914208.

3/6/2026

---

Payer Change for CPIDs 1803, 2945 EVV Silver Summit Health Plan Centene

Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by March 31, 2026, 5:00 p.m. CT to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Professional CPID: 1803
Professional Edit Master: PE_T007
Institutional CPID: 2945
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after March 31, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Silver Summit Health Plan
Professional CPID: 1263
Professional Edit Master: PE_T007
Institutional CPID: 5542
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: 68069

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

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.

3/6/2026

---

Payer Change for CPIDs 1803, 2945 EVV Silver Summit Health Plan Centene

Effective April 1, 2026, the payer listed below will no longer be available at Optum for claims processing. Claims must be submitted to Optum by March 31, 2026, 5:00 p.m. CT to ensure final transmission to the payer.

Payer Name: EVV Summit Health Plan Centene
Claim CPIDs: 1803, 2945
Payer-assigned Payer ID: NVSIL
Reason: Payer ID no longer supported.

Claims submitted after March 31, 2026, 5:00 p.m. CT must begin using the following:

Payer Name: Silver Summit Health Plan
Professional CPID: 1263
Institutional CPID: 5542
Payer-assigned Payer ID: 68069

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

Action Required:

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

3/6/2026

---

New Electronic Remittance (ERA) Connections Available on Revenue Performance Advisor

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

Payer ID – Payer name
BSKAI – SKAI Blue Cross Blue Shield
IHS15 – Yuzu Health

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.

3/6/2026

---

Electronic Routing Change for CPID 1561 Children's Physicians Medical Group

Effective March 5, 2026, Optum is reactivating and changing electronic claims routing for the following payer:   

Payer Name: Children's Physicians Medical Group
Institutional CPID: 1561
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: RCHN1
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 CPID are not changing. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central. 

3/5/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Central Valley Medical Group (CVMG)
Institutional CPID: 3683
Professional CPID: 1882
Payer-assigned Payer ID: CVH01
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
Claims Fee: N/A

Action Required: 

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

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

3/5/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Optum San Diego Public Sector CFWB
Professional CPID: 3872
Payer-assigned Payer ID: CFWB1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
Claims Fee: N/A

Payer Name: Optum San Diego Public Sector CFWB Medi-Cal
Professional CPID: 3873
Payer-assigned Payer ID: CFWMC
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
Claims Fee: N/A

Action Required: 

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

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

3/5/2026

---

Update: Claims and Remittance Reactivation for CPIDs 5550, 4425 District of Columbia Medicaid

Update:
Effective March 5, 2026, Optum is reactivating and updating electronic claims and remittance routing for the payer listed below. Please note that any claims not processed since February 19, 2026, 10:00 p.m. ET will need to be resubmitted. 

Payer Name: District of Columbia Medicaid
Professional CPID: 4425
Institutional CPID: 5550
Payer-assigned Payer ID: 77033
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes 

Enrollment Requirements
Claims:

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

Remittance:

• Payer enrollment for electronic remittance is required. 
• Providers currently receiving electronic remittance through Optum do not need to complete a new enrollment form. However, providers who receive an enrollment denial notification must submit a new enrollment through Enrollment Central. 
• New providers must complete a new enrollment form. 
• All providers who have not received remittance since November 25, 2025, will need to complete a new enrollment form. 

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

Additional Changes:
Additional information on this transition can be found on the payer website at https://medicaid.dc.gov

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

• Providers must complete a new enrollment form prior to submitting claims. 
• Make any necessary system changes. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central. 

Original notice sent Feb. 20, 2026:
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.  

Payer Name: District of Columbia Medicaid
CPID(s): 5550, 4425
Payer ID: 77033
Reason:

Effective March 2, 2026, DHCF will transition to a new Medicaid Management Information System (MMIS) and all fiscal agent services will transition to Gainwell. As of Feb. 20, 2026, 4:00 PM ET, the web portal no longer allows Claim or Prior Authorization submissions.  

Additional information on this transition will be provided by Gainwell/DHCF as the transition date approaches. You can also visit https://medicaid.dc.gov for more information.  

NOTE: Claims submitted after Feb. 19, 2026, 10:00 PM ET will not be eligible for processing by the payer.  

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

3/5/2026

---

Update: Claims and Remittance Reactivation for CPIDs 5550, 4425 District of Columbia Medicaid

Update: Effective March 5, 2026, Optum is reactivating and updating electronic claims and remittance routing for the payer listed below. Please note that any claims not processed since February 19, 2026, 10:00 p.m. ET will need to be resubmitted. 

Payer Name: District of Columbia Medicaid
Professional CPID: 4425
Current Edit Master: PE_D000
Institutional CPID: 5550
Current Edit Master: HE9D000
Payer-assigned Payer ID: 77033
Line of Business Code (LOB): D47
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes 

Enrollment Requirements
Claims:

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

Remittance:

• Payer enrollment for electronic remittance is required. 
• Providers currently receiving electronic remittance through Optum do not need to complete a new enrollment form. However, providers who receive an enrollment denial notification must submit a new enrollment through Enrollment Central. 
• New providers must complete a new enrollment form. 
• All providers who have not received remittance since November 25, 2025, will need to complete a new enrollment form. 

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

Additional Changes:
Additional information on this transition can be found on the payer website at https://medicaid.dc.gov  

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

• Providers must complete a new enrollment form prior to submitting claims. 
• 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. 

Original notice sent Feb. 20, 2026:
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.  

Payer Name: District of Columbia Medicaid
CPID(s): 5550, 4425
Payer ID: 77033
Reason:

Effective March 2, 2026, DHCF will transition to a new Medicaid Management Information System (MMIS) and all fiscal agent services will transition to Gainwell. As of Feb. 20, 2026, 4:00 PM ET, the web portal no longer allows Claim or Prior Authorization submissions.   

Additional information on this transition will be provided by Gainwell/DHCF as the transition date approaches. You can also visit https://medicaid.dc.gov for more information.  

NOTE: Claims submitted after Feb. 19, 2026, 10:00 PM ET will not be eligible for processing by the payer.  

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

3/5/2026

---

Claim processing issue

Some claims processed Feb. 10-Feb. 27, 2026 for the below payers may have rejected in error for Duplicate Claim. 

Payer Name(s): Scripps Coastal Medical Group & Scripps Health Plan MSO
CPID(s) 7102, 6624, 1199, 2653
Payer ID(s) SHPS1 & 33099

Action Needed: None. These claims also received an Acceptance, so the Duplicate rejection message should be ignored.

3/5/2026

---

Report Generation Delay for CPID 2872 TRICARE East Region

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 17, 2026.

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

Original notice sent Feb. 27, 2026:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 17, 2026.

Payer impacted: 

• CPID 2872 TRICARE East Region

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09905538.

3/5/2026

---

Report Generation Delay for CPID 2872 TRICARE East Region

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 24, 2026.

Payer impacted:

• CPID 2872 TRICARE East Region

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09913063.

3/5/2026

---

Electronic Routing Change for CPID 1561 Children's Physicians Medical Group

Effective March 5, 2026, Optum is reactivating and changing electronic claims routing for the following payer: 

Payer Name: Children's Physicians Medical Group
Institutional CPID: 1561
Payer-assigned Payer ID: RCHN1
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: $0.10 

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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

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

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

3/5/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Delta Dental of Colorado
Payer ID: 10178
Payer Enrollment Required: Yes
Payer Location: Colorado

Payer Name: Volunteers of America National Services
Payer ID: VNSPC
Payer Enrollment Required: Yes
Payer Location: National

Payer Name: Arizona Priority Care Plus
Payer ID: 27154
Payer Enrollment Required: Yes
Payer Location: Arizona

Action Required:

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

3/5/2026

---

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective March 3, 2026:

Payer Name: Texas Children’s Health Plan - CHIP
Industry Payer ID: 76408
IMN Real Time ID: 76408
Exchange Real Time ID: TXCPL
Optum IEDI Real Time ID: 76408
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.

3/5/2026

---

Update: Electronic Claims Connection Suspended

Update: Optum has reactivated and changed electronic claims routing for the following payer: 

Payer Name: PHCS Multiplan - Group Resources
Professional CPID: 8192
Institutional CPID: 2053
Payer-assigned Payer ID: 28680
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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

• Make any necessary system changes. 

Original notice sent Jan. 9, 2026:
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list. 

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

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

3/5/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Arizona Priority Care Plus
Institutional CPID: 4695
Professional CPID: 6220
Payer-assigned Payer ID: 27154
Line of Business (LOB) Code: E51
Payer Enrollment Required: Yes
Payer Location: Arizona

Action Required:

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

3/5/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Arizona Priority Care Plus
Institutional CPID: 4695
Professional CPID: 6220
Payer-assigned Payer ID: 27154
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Arizona

Action Required:

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

3/5/2026

---

Report Generation Delay for multiple CPIDs

Deloitte is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 3, 2026.

Payers impacted:

• CPID 2481 Ohio Medicaid
• CPID 3509 Ohio Medicaid
• CPID 3813 Next Generation MyCare Anthem Blue Cross Blue Shield
• CPID 3817 Next Generation MyCare Buckeye Community Health Plan
• CPID 3819 Next Generation MyCare CareSource
• CPID 3821 Next Generation MyCare Molina Healthcare of Ohio Inc
• CPID 7045 AmeriHealth Caritas Ohio
• CPID 7052 OhioRISE - Aetna Better Health of Ohio
• CPID 7067 Molina Ohio Medicaid Vision
• CPID 7068 Ohio Medicaid Buckeye Community Health Plan
• CPID 7070 CareSource Ohio Medicaid
• CPID 7071 Anthem Ohio Medicaid
• CPID 7072 Molina Ohio Medicaid
• CPID 7073 Humana Ohio Medicaid
• CPID 7074 UnitedHealthcare Ohio Medicaid
• CPID 7086 Anthem Ohio Medicaid Vision
• CPID 7088 Humana Ohio Medicaid Vision
• CPID 7091 Ohio Medicaid Buckeye Vision
• CPID 7093 UnitedHealthcare Ohio Medicaid Vision
• CPID 7094 CareSource Ohio Medicaid Vision
• CPID 9061 Next Generation MyCare Anthem Blue Cross Blue Shield
• CPID 9062 Next Generation MyCare Buckeye Community Health Plan
• CPID 9063 Next Generation MyCare CareSource
• CPID 9064 Next Generation MyCare Molina Healthcare of Ohio Inc
• CPID 9428 AmeriHealth Caritas Ohio
• CPID 9435 OhioRISE - Aetna Better Health of Ohio
• CPID 9455 Molina Ohio Medicaid Vision
• CPID 9457 Ohio Medicaid Buckeye Community Health Plan
• CPID 9458 CareSource Ohio Medicaid
• CPID 9461 Anthem Ohio Medicaid
• CPID 9462 Molina Ohio Medicaid
• CPID 9463 Humana Ohio Medicaid
• CPID 9465 UnitedHealthcare Ohio Medicaid
• CPID 9493 Anthem Ohio Medicaid Vision
• CPID 9701 Humana Ohio Medicaid Vision
• CPID 9704 Ohio Medicaid Buckeye Vision
• CPID 9706 UnitedHealthcare Ohio Medicaid Vision
• CPID 9708 CareSource Ohio Medicaid Vision

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09911100.

3/5/2026

---

Electronic Routing Change for Multiple Payers

Effective March 5, 2026, Optumis changing electronic remittance routing for the following payers: 

Payer Name: CALMED Global
Professional CPID: 7806
Institutional CPID: 8580
Payer-assigned Payer ID: MPM27
Payer Remittance Enrollment Required: Yes 

Payer Name: Dignity HCLA
Professional CPID: 7797
Institutional CPID: 8557
Payer-assigned Payer ID: MPM28
Payer Remittance Enrollment Required: Yes 

Enrollment Requirements
Remittance:

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

Action Required: Please 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. 

3/5/2026

---

Electronic Routing Change for Multiple Payers

Effective March 5, 2026, Optum is changing electronic remittance routing for the following payers:   

Payer Name: CALMED Global
Professional CPID: 7806
Institutional CPID: 8580
Payer-assigned Payer ID: MPM27
Line of Business Code (LOB): U16
Payer Remittance Enrollment Required: Yes 

Payer Name: Dignity HCLA
Professional CPID: 7797
Institutional CPID: 8557
Payer-assigned Payer ID: MPM28
Line of Business Code (LOB): J29
Payer Remittance Enrollment Required: Yes 

Enrollment Requirements
Remittance:

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

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

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

3/5/2026

---

Electronic Routing Change for CPIDs 2895 and 1553 American Republic Insurance Company

Effective March 5, 2026, Optum is changing electronic remittance routing for the following payer: 

Payer Name: American Republic Insurance Company
Professional CPID: 2895
Institutional CPID: 1553
Payer-assigned Payer ID: 42011
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. 

3/5/2026

---

Electronic Routing Change for CPIDs 2895 and 1553 American Republic Insurance Company

Effective March 5, 2026, Optum is changing electronic remittance routing for the following payer:   

Payer Name: American Republic Insurance Company
Professional CPID: 2895
Institutional CPID: 1553
Payer-assigned Payer ID: 42011
Line of Business Code (LOB): H58
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. 

3/5/2026

---

Electronic Routing Change for Multiple Payers

Effective March 5, 2026, Optumis changing electronic remittance routing for the following payers: 

Payer Name: CALMED Global
Professional CPID: 7806
Institutional CPID: 8580
Payer-assigned Payer ID: MPM27
Payer Remittance Enrollment Required: Yes 

Payer Name: Dignity HCLA
Professional CPID: 7797
Institutional CPID: 8557
Payer-assigned Payer ID: MPM28
Payer Remittance Enrollment Required: Yes 

Enrollment Requirements
Remittance:

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

Action Required: Please 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. 

3/5/2026

---

Electronic Routing Change for CPIDs 7138 Sierra Medical Group

Effective March 4, 2026, Optum is reactivating and changing electronic claims routing for the following payer:   

Payer Name: Sierra Medical Group  
Professional CPID: 7138
Current Edit Master: PE_T007
New Edit Master: PE_B800
Payer-assigned Payer ID: 30891
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 CPID are not changing. 
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central. 

3/4/2026

---

Electronic Routing Change for CPIDs 7138 Sierra Medical Group

Effective March 4, 2026, Optum is reactivating and changing electronic claims routing for the following payer: 

Payer Name: Sierra Medical Group
Professional CPID: 7138
Payer-assigned Payer ID: 30891
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: $0.10 

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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

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

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

3/4/2026

---

CountyCare Illinois (Payer ID 06541) 277 Payer Response

Optum Intelligent EDI would like to inform you of a recent update related to CountyCare Illinois.

On Feb. 23, 2026, Optum Intelligent EDI processed payer responses that had not previously been processed for CountyCare Illinois.

Payer Impacted: Payer ID 06541 CountyCare Illinois

These responses were initially received Jan. 1, 2026-February 23, 2026.

Action Required: None. Please be aware of delays for the time frames above.

If you have questions regarding this notice or need additional assistance, please contact Optum Intelligent EDI Support.

3/4/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Arizona Priority Care Plus
Institutional CPID: 4695
Payer-assigned Payer ID: 27154
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Arizona
Claims Fee: N/A

Plan accepted with this connection:

• Arizona Priority Care

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. 

3/4/2026

---

Electronic Routing Change for CPID 6220 Arizona Priority Care

Effective March 4, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: Arizona Priority Care Plus
Professional CPID: 6220
Current Edit Master: PE_B800
New Edit Master: PE_T007
Payer-assigned Payer ID: 27154
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

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

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

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

3/4/2026

---

Electronic Routing Change for CPID 6220 Arizona Priority Care

Effective March 4, 2026, Optum is changing electronic claims routing for the following payer:

Payer Name: Arizona Priority Care Plus
Professional CPID: 6220
Payer-assigned Payer ID: 27154
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Plans accepted with this connection:

• Arizona Priority Care

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.

3/4/2026

---

Report Generation Delay for Multiple CPIDs

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Feb. 20, 2026.

Payers impacted:  

• CPID 1029 Physician Health Associates/Midland Mgmt
• CPID 3770 Physician Health Associates/Midland Mgmt
• CPID 1851 Lake County Physicians Association
• CPID 3017 Gonzaba Medical Group
• CPID 8266 Gonzaba Medical Group
• CPID 3026 Essential Health Partners
• CPID 8275 Essential Health Partners
• CPID 3088 Lake County Physicians Association
• CPID 6137 West Suburban Health Providers
• CPID 7245 Oak West Physician Association
• CPID 8664 Oak West Physician Association

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 09910873.

3/4/2026

---

New Payer Edit for CPID 5634

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 March 18, 2026:

• INM10900NM: INVALID SUBSCRIBER MEMBER ID - When entered, the Active Subscriber Member ID must be 11 numeric characters. Exception: When the CPID is 4973, 5552, or 5937, the Active Subscriber Member ID must not be all zeros or all nines. Note: If this requirement does not apply to your billing situation, you can override the edit in the Edit/Error Severity application or within the Error Text. LOOP 2010BA NM109

Edit applies to: 

• CPID 5634 WESTERN HEALTH ADVANTAGE

Action Required: Please be aware of updated edit requirements.

3/4/2026

---

Electronic Routing Change for CPID 7485 HealthNow Blue Cross Blue Shield of New York

Effective March 5, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: HealthNow Blue Cross Blue Shield of New York
Professional CPID: 7485
Edit Master: PE_T007
Payer-assigned Payer ID: 55204
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

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

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

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

3/4/2026

---

Electronic Routing Change for CPID 7485 HealthNow Blue Cross Blue Shield of New York

Effective March 5, 2026, Optum will be changing electronic claims routing for the following payer:

Payer Name: HealthNow Blue Cross Blue Shield of New York
Professional CPID: 7485
Payer-assigned Payer ID: 55204
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

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

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

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

3/4/2026

---

PAR Status Change for Claim/ERA payers

The PAR Status is changing for the following payers:

Harvard Pilgrim Health Care
Transaction: Claims, Remittance
Industry ID: 04271
Exchange CPIDs: 6512, 2742
New Par Status: Non Par
Effective Date: April 1, 2026

Health Choice Arizona
Transaction: Claims
Industry ID: 62179
Exchange CPIDs: 2930, 3232
New Par Status: Gateway
Effective Date: March 1, 2026

Health Choice Pathway
Transaction: Claims
Industry ID: 62180
Exchange CPIDs: 8985, 4878
New Par Status: Gateway
Effective Date: March 1, 2026

StandardHealth with Health Choice
Industry ID: RP105
Exchange CPIDs: 7595, 2708
New Par Status: Gateway
Effective Date: March 1, 2026

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

3/4/2026

---

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective March 2, 2026:

Payer Name: Lagniappe Advantage
Industry Payer ID: LALA1
IMN Real Time ID: LALA1
Exchange Real Time ID: LADLA
CPID(s): N/A
Optum IEDi Real Time ID: LALA1
Payer Enrollment Required: No
Connection Type: X12 5010

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.

3/4/2026

---

New Electronic Claim Status Connection Available

Optum is pleased to announce the availability of Real-time Claim Status Inquiry and Response 276/277 for the below payer, effective Feb. 27, 2026:

Payer Name: Welfare Pension Administration Services (WPAS)
Industry Payer ID: 91136
IMN Real Time ID: 91136
Exchange Real Time ID: WPADM
CPID(s): 6591, 1744
Optum IEDi Real Time ID: 91136
Payer Enrollment Required: No
Connection Type: X12 5010

Search Options
Claim Status 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.

3/4/2026

---

Update: Report Generation Delay for CPIDs 7743 and 6589 Inland Empire Health Plan

Update: The payer has been unable to generate and deliver some reports for some claims submitted Feb. 26, 2026.

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

Original notice sent March 3, 2026:
A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted Feb. 26, 2026.

Payer impacted:

• CPID 7743 Inland Empire Health Plan
• CPID 6589 Inland Empire 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 09908319.

3/4/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Volunteers of America National Services
Institutional CPID: 7916
Professional CPID: 2735
Payer-assigned Payer ID: VNSPC
Line of Business (LOB) Code: E55
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.

3/4/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Volunteers of America National Services
Institutional CPID: 7916
Professional CPID: 2735
Payer-assigned Payer ID: VNSPC
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. 

3/4/2026

---

Resolved: Healthgram Processing Issue

Resolved: Impacted claims have been processed and delivered as expected.

Original issue: Some claims are delayed for Healthgram for some providers Feb. 12, 2026-March 3, 2026.

Payer ID: 56144
CPID 6595
CPID 1757

The claims are being reviewed to ensure they are processed and distributed to the payer as expected.

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

If you have any questions, please contact Customer Support and refer to INC-000004124.

3/4/2026

---

Report Generation Delay for multiple CPIDs

Deloitte is experiencing issues affecting Professional and Institutional report generation for some claims submitted Feb. 25, 2026.

Payers impacted:

• CPID 7070 CareSource Ohio Medicaid
• CPID 9458 CareSource Ohio Medicaid
• CPID 9463 Humana Ohio Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09910090.

3/4/2026

---

Tricare For Life, East, and West Real-Time Eligibility and Claim Status Errors

We want to make you aware of a current issue affecting real-time 270/271 eligibility and 276/277 transactions submitted through Optum for Tricare for Life, East, and West.

Some transactions may return the message: "System Not Responding, please resubmit."

This response is due to a temporary system issue on the payer's side. Your transaction was received correctly, and there is no issue with your submission or your connection to Optum.

Payer Name: Tricare East
Payer ID: 99727
Transaction: Real Time Eligibility and Claim Status

Payer Name: Tricare West
Payer ID: 99726
Transaction: Real Time Eligibility and Claim Status

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

What You Should Know:

• The issue is isolated to real-time eligibility and claim status transactions.
• It is being actively investigated and prioritized by the payer.
• There is no estimated time for resolution (ETA) at this moment.

What You Can Do:

• Please wait a few minutes and resubmit the transaction.
• If needed, consider using alternate eligibility verification methods until the issue is resolved.
• No action is needed on your part to correct or troubleshoot the issue.

We understand the importance of timely eligibility and claim status responses. We continue working closely with the payer to support resolution. We will share updates as they become available.

If you have any questions, please contact Customer Support and refer to Global Incident Number INC-000004096.

Thank you for your continued partnership and patience.

3/4/2026

---

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

Update: This issue is still under review with the payer. Additional notifications will be sent as updates become available.

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.

3/4/2026

---

Real Time Eligibility payer no longer available

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

Payer Name: ComPsych
Industry Payer ID: 37363
IMN Real Time ID: 37363
Exchange Real Time ID: CMPSY
CPID(s): 6644, 6206
Connection Type: X12
Reason: Payer no longer offers an electronic connection.

Action Required: None.

3/4/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Delta Dental of Colorado
Professional CPID: 3897
Payer-assigned Payer ID: 10718
Line of Business (LOB) Code: E56
Payer Enrollment Required: Yes
Payer Location: Colorado

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. 

3/3/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Delta Dental of Colorado
Professional CPID: 3897
Payer-assigned Payer ID: 10178
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Colorado

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.

3/3/2026

---

Report Generation Delay for CPID 6284 Trillium Health Resources

The payer listed below is experiencing issues affecting Professional report generation for some claims submitted Nov. 12, 2025 and Nov. 18, 2025.

Payer impacted:

• CPID 6284 Trillium Health Resources

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09803220.

3/3/2026

---

Care N Care Insurance Company Eligibility and Claim Status No Longer Available

Effective immediately, Real Time Eligibility 270/271 and Claim Status Inquiry 276/277 for the payer listed below will no longer be available at Optum.

Payer Name: Care N Care Insurance Company
Industry Payer ID: 66010
IMN Real Time ID: 66010
Exchange Real Time ID: CAREN
CPIDs: 8146, 2013
Optum IEDi Real Time IDs: 14335, 66010
Connection Type: X12

Reason: Payer no longer offers an electronic connection.

Action Required: None.

3/3/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Buenaventura Affiliated Physicians
Payer ID: BVAP1
Reason: Payer unavailable electronically.

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

3/3/2026

---

Life Pittsburgh Electronic Claims and Remittance Connection No Longer Available

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

Payer Name: Life Pittsburgh
Payer ID: 25181
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

3/3/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: SKAI Blue Cross Blue Shield
Payer ID: BSKAI
Payer Enrollment Required: Yes
Payer Location: Arkansas

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.

3/3/2026

---

Claims Reactivation for Leon Medical Center Health Plan (37316)

Optum recently restored electronic claims connectivity for the following payer:

Payer Name: Leon Medical Center Health Plan
Payer ID: 37316

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

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

• Make any necessary system changes.

3/3/2026

---

Report Generation Delay for CPIDs 7743 and 6589 Inland Empire Health Plan

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

Payer impacted:

• CPID 7743 Inland Empire Health Plan
• CPID 6589 Inland Empire 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 09908319.

3/3/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: ViCare Health
Institutional CPID: 9087
Professional CPID: 3881
Payer-assigned Payer ID: VCH01
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. 

3/3/2026

---

New Electronic Eligibility Connection Available

Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 for the below payer, effective Feb. 27, 2026:

Payer Name: Lumico Life Insurance
Industry Payer ID: 11236
IMN Real Time ID: 11236
Exchange Real Time ID: LMLCO
CPID(s): N/A
Optum IEDi Real Time ID: 11236
Payer Enrollment Required: No
Connection Type:  X12 5010

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.

3/3/2026

---

Blue Cross Blue Shield Washington and Alaska New Real Time Payer Transaction

Optum is pleased to announce the availability of Real-time Claim Status inquiry and Response 276/277 transactions for the below payer, effective Feb. 25, 2026.

Payer Name: Blue Cross Blue Shield Washington and Alaska
IMN Payer id: SB930
Exchange: 5522 & 7445
IEDI: 10326

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.

Updated Payer Lists may be obtained from your software vendor or Payer Lists | Change Healthcare

3/3/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Bay Area Care Partners
Institutional CPID: 9086
Professional CPID: 3876
Payer-assigned Payer ID: NMM11
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
Claims Fee: N/A

Action Required: 

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

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

3/2/2026

---

Report Generation Delay for CPID 3480 ArchCare

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 17, 2026.

Payer impacted: 

• CPID 3480 ArchCare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09907712.

3/2/2026

---

Mid American Benefits Clearance Payer Consolidation

Effective Feb. 24, 2026, Clearance transactions for the following payer must be submitted to a different Optum payer name to avoid rejections. Any customers currently using the old payer connection have already been migrated to the new payer connection.

Current Payer Name: Mid American Benefits
New Payer Name: Point C Health
Enrollment required: No

Action Required: None. Please be aware of the new payer name.

If you wish to start submitting 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.

3/2/2026

---

Edit Master for CPIDs 4919 and 5853 GMS Insurance

Effective March 3, 2026, Optum will be changing Edit Masters for the following payer:

Payer Name: GMS Insurance
Professional CPID: 5853
Current Edit Master: PE_C054
New Edit Master: PE_B800  
Institutional CPID: 4919
Current Edit Master: HE9C054
New Edit Master: HE9B801
Payer-assigned Payer ID: 47083 

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. 

3/2/2026

---

Report Generation Delay for CPIDs 8508 and 4448 HealthLink PPO

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

Payer impacted: 

• CPID 8508 HealthLink PPO
• CPID 4448 HealthLink PPO

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 09907647.

3/2/2026

---

Electronic Routing Change for CPID 1137 South Florida Musculoskeletal Care

Effective March 2, 2026, Optum is reactivating and changing electronic claims routing for the following payer:   

Payer Name: South Florida Musculoskeletal Care
Professional CPID: 1137
Current Edit Master: PE_E049
New Edit Master: PE_T007
Payer-assigned Payer ID: 06294
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No 

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is no] required. 

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

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

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

3/2/2026

---

Electronic Routing Change for CPID 1137 South Florida Musculoskeletal Care

Effective March 2, 2026, Optum is reactivating and changing electronic claims routing for the following payer:

Payer Name: South Florida Musculoskeletal Care
Professional CPID: 1137
Payer-assigned Payer ID: 06294
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: N/A 

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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

3/2/2026

---

Clearance New Payer Connections

Optum has new electronic eligibility connections available:

Payer Name: Direct Care Administrators
Payer Enrollment Required: No
Connection Type: X12

Payer Name: Partners Insurance Company of New Jersey Inc
Payer Enrollment Required: No
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 action: 

• 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).

3/2/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: SKAI Blue Cross Blue Shield
Institutional CPID: 9075
Professional CPID: 3843
Payer-assigned Payer ID: BSKAI
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Arkansas

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.

3/2/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: SKAI Blue Cross Blue Shield
Institutional CPID: 9075
Professional CPID: 3843
Payer-assigned Payer ID: BSKAI
Line of Business (LOB) Code: E54
Payer Enrollment Required: Yes
Payer Location: Arkansas

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. 

3/2/2026

---

Report Generation Delay for CPID 3757 IMAGINE360 ADMINISTRATORS (GPA)

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 16, 2026.

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 09907096.

3/2/2026

---

Resolved: 835 Delay for UnitedHealthcare CPID 3429, 3550

Resolved: All missing 835s for UnitedHealthcare CPID 3429 & 3550 with a payment date of Feb. 24, 2026 have been received and processed. Please allow up to 24 hours for posting to complete.

Original Notify sent March 2, 2026:
Some 835s for UnitedHealthcare CPID 3429 & 3550 are delayed at the payer for payment date Feb. 24, 2026. A ticket has been opened with the payer for further research.

Affected Payer IDs: 3429, 3550

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

3/2/2026

---

Resolved: 835 Delay for UnitedHealthcare payer ID 87726

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

Original Notify sent March 2, 2026:
Some 835s for UnitedHealthcare payer ID 87726 are delayed at the payer for payment date Feb. 24, 2026. A ticket has been opened with the payer for further research.

Affected Payer ID: 87726

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

3/2/2026

---

Report Generation Delay for CPID 3488 TrueCare Mississippi Medicaid

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

Payer impacted: 

• CPID 3488 TrueCare Mississippi 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 09907038.

3/2/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Buenaventura Affiliated Physicians
CPID(s): 3439, 8982
Payer ID: BVAP1
Reason: Payer unavailable electronically.

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

3/2/2026

---

AmericasHealth Plan Electronic Claims Connection No Longer Available

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

Payer Name: AmericasHealth Plan
Payer ID: AHP01
Reason: Payer no longer in business.

Action Required: None.

3/2/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Esperanza IPA
Payer ID: EIPA8
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

Payer Name: Rincol Health Network
Payer ID: RHN01
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

Payer Name: SGRX Health
Payer ID: 29094
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Michigan

Payer Name: Optum San Diego Public Sector County
Payer ID: CNTY1
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California

Payer Name: Optum San Diego Skilled Nursing Facilities
Payer ID: COSNF
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

Payer Name: Optum San Diego County Funded Hospital
Payer ID: COHOSP
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

Payer Name: Manhattan Life Insurance and Annuity Company
Payer ID: 28148
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National

Action Required:  

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

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

3/2/2026

---

Electronic Eligibility Connections Partially Terminated

Effective Feb. 27. 2026, electronic Eligibility for CPIDs 5904 and 2275 for the payer specified below is no longer available at Optum.

Payer Name: Blue Cross Blue Shield Arizona Advantage
IMN ID: 77078
Exchange ID: MDSUN
CPID(s): 5904, 2275
Industry Payer ID: 77078
Connection Type: X12
Reason: CPIDs 5904 and 2275 for MDSUN have been terminated.

Action Required: Please update your system immediately for the payer specified above.

3/2/2026

---

Report Generation Delay for CPID 7543 UPMC Health Plan

The payer listed below is experiencing issues affecting Institutional report generation for some claims submitted Feb. 18, 2026.

Payer impacted: 

• CPID 7543 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 09906661.

3/2/2026

---

Electronic Eligibility Connections Partially Terminated

Effective Feb. 27, 2026, electronic Eligibility and Claim Status Institutional CPID 7587 for the payer specified below is no longer available at Optum.

Payer Name: Iron Road Healthcare
IMN ID: 87042
Exchange ID: UPREHS
CPID(s): 7587
Industry Payer ID: 87042
IEDI ID: 87042
Connection Type: X12
Reason: Institutional CPID 7587 for UPREHS has been Terminated.

Action Required: Please update your system immediately for the payer specified above.

3/2/2026

---

835 Delay for UnitedHealthcare CPID 3429, 3550

Some 835s for UnitedHealthcare CPID 3429 & 3550 are delayed at the payer for payment date Feb. 24, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs: 3429, 3550

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

3/2/2026

---

835 Delay for UnitedHealthcare payer ID 87726

Some 835s for UnitedHealthcare payer ID 87726 are delayed at the payer for payment date Feb. 24, 2026. A ticket has been opened with the payer for further research.

Affected Payer ID: 87726

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

3/2/2026