Resolved: Delay in Electronic Remittance Advice (ERA) for multiple CPIDs

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

Original notice sent April 28, 2026:
There has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for check dates since March 24, 2026.

• CPID 3275 Paramount Health
• CPID 5977 Paramount Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10282038.

5/12/2026

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Resolved: 835 Delay for UnitedHealthcare CPIDs 3429, 3550, 1431, 8598, 2240, 3929

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

Original Notice Sent May 11, 2026:
We would like to give you awareness of a payer processing issue that could potentially impact your business.

Some 835s for UnitedHealthcare CPIDs 3429, 3550, 1431, 8598, 2240, 3929 are delayed at the payer for payment date May 7, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs:

• CPID 3429 UnitedHealthcare
• CPID 3550 UnitedHealthcare
• CPID 1431 Medica
• CPID 8598 Medica
• CPID 2240 Preferred Partners
• CPID 3929 Preferred Partners

Action Required: Please be aware of a delay in the delivery of ERA for check dates above. No 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 and reference incident #INC-000004767.

5/12/2026

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Resolved: All missing 835s for UnitedHealthcare payer IDs 87726, 94265, 65088

Resolved: All missing 835s for UnitedHealthcare payer IDs 87726, 94265, 65088 with a payment date of May 7, 2026 have been received and processed. Please allow up to 24 hours for posting to complete.

Original Notice Sent May 11, 2026:
We would like to give you awareness of a payer processing issue that could potentially impact your business.

Some 835s for UnitedHealthcare payer IDs 87726, 94265, 65088 are delayed at the payer for payment date May 7, 2026. A ticket has been opened with the payer for further research.

Affected Payer IDs:

• Payer ID 87726 UnitedHealthcare
• Payer ID 94265 Medica
• Payer ID 65088 Preferred Partners

Action Required: Please be aware of a delay in the delivery of ERA for check dates above. No 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 and reference incident #INC-000004767.

5/12/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: EyeMed Vision Care
Professional CPID: 5817
Industry Standard Payer ID: 31165
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: National

Action Required:

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

Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum.

5/12/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: EyeMed Vision Care
Professional CPID: 5817
Industry Standard Payer ID: 31165
Line of Business (LOB) Code: N19
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.

5/12/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: INDECS, A Homestead Company
Institutional CPID: 1587
Professional CPID: 1264
Industry Standard Payer ID: L0929
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.
• 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.

5/12/2026

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Report Generation Delay for CPID 3706 Cenpatico

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted April 28, 2026.

Payer impacted:

• CPID 3706 Cenpatico

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 10303956.

5/12/2026

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Edit Master for CPIDs 9292 and 7010 Arrowhead Regional Medical Center

Optum is changing Edit Masters for the following payer, effective May 12, 2026:

Payer Name: Arrowhead Regional Medical Center
Professional CPID: 9292
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 7010
Current Edit Master: HE9O007
New Edit Master: HE9T007
Industry Standard Payer ID: ARMC1

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.

5/12/2026

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

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

Payer Name: Imperial Health Holdings Medical Group
Professional CPID: 1296
Institutional CPID: 6560
Industry Standard Payer ID: IHHMG
Line of Business Code (LOB): H9L
Payer Remittance Enrollment Required: Yes

Enrollment Requirements:
Remittance:

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

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

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

5/12/2026

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

Optum is changing electronic Remittance routing for the following payer, effective May 12, 2026:

Payer Name: Imperial Health Holdings Medical Group
Professional CPID: 1296
Institutional CPID: 6560
Industry Standard Payer ID: IHHMG
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.

5/12/2026

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Payer Processing Issue for CPIDs 1474 and 3501 Indiana Medicaid

Due to a payer processing issue, some Professional and Institutional claims transmitted to the payer listed below May 7, 2026 were not processed by the payer.

Payer impacted:

• CPID 1474 Indiana Medicaid
• CPID 3501 Indiana Medicaid

A resolution has been implemented and the claims were retransmitted to the payer May 12, 2026.

This delay affected claims released to Optum May 6, 2026, 2:00 p.m.-May 7, 2026, 2:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 10303607.

5/12/2026

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Payer Processing Issue for CPID 2487 Neighborhood Health Plan of Rhode Island

Due to a payer processing issue, some Professional claims transmitted to the payer listed below May 11, 2026 were not processed by the payer.

Payer impacted:

• CPID 2487 Neighborhood Health Plan of Rhode Island

A resolution has been implemented and the claims were retransmitted to the payer May 12, 2026.

This delay affected claims released to Optum May 8, 2026, 2:00 p.m.-May 11, 2026, 2:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 10303580.

5/12/2026

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Electronic Claims Connection No Longer Available

Effective May 14, 2026, the payer listed below will no longer be available at Optum for claims processing.

Payer Name: Rush Prudential Health Plans (HMO Only)
Industry Standard Payer ID: 36389
Reason: Payer no longer offers an electronic connection.

Payer will no longer accept paper claims.

Action Required: Please make any necessary system changes.

Original notice sent April 10, 2026:

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

Payer Name: Rush Prudential Health Plans (HMO Only)
Industry Standard Payer ID: 36389
Reason: Payer unavailable electronically.

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

5/11/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Harbor Health
Payer ID: HARBR
Payer Enrollment Required: Yes
Payer Location: Texas

Payer Name: RIS Rx
Payer ID: RISRX
Payer Enrollment Required: Yes
Payer Location: California

Action Required:

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

5/11/2026

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New Payer Edit for CPID 1075

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 May 18, 2026:

• IREF02A033: INVALID DOCUMENT CONTROL NUMBER - When entered for an electronic claim, the Document Control Number must be in the following format: 1. First character is the year (X=2024, Y=2025, Z=2026). 2. Next three characters are the current Julian date (001-365). 3. Next is the plan/state (TX, MS, SC, etc.). 4. The seventh character is the format (E = electronic, P or a number is paper). 5. And the last five characters are the claim number. Exception: When the first character is X, 366 is also allowed as a valid Julian date. Note: If this requirement does not apply to your billing situation, you can override the edit within the Error Text. LOOP 2300 REF02

Edit applies to:

• CPID 1075 ALLWELL WESTERN SKY COMM CARE

Action Required: Please be aware of updated edit requirements.

5/11/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: RIS Rx
Institutional CPID: 2568
Professional CPID: 1776
Industry Standard Payer ID: RISRX
Line of Business (LOB) Code: U30
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California

Action Required:

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

5/11/2026

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: RIS Rx
Institutional CPID: 2568
Professional CPID: 1776
Industry Standard Payer ID: RISRX
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: California

Action Required:

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

5/11/2026

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Report Generation Delay for CPID 6405 Cigna Health Plans

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on May 8, 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 May 8, 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 10301494.

5/11/2026

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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 April 7, 2026 through April 20, 2026.

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

Original notice sent April 24, 2026:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since April 7, 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 10278551.

5/11/2026

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Payer Processing Issue for CPID 4576 Kaiser Foundation Health Plan

Due to a payer processing issue, some Institutional claims transmitted to the payer listed below May 7, 2026 were not processed by the payer.

Payer impacted:

• CPID 4576 Kaiser Foundation Health Plan of Southern California Region

A resolution has been implemented and the claims were retransmitted to the payer May 11, 2026.

This delay affected claims released to Optum May 6, 2026, 5:00 a.m.-May 7, 2026, 5 a.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 10301455.

5/11/2026

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835 Delay for UnitedHealthcare CPIDs 3429, 3550, 1431, 8598, 2240, 3929

Some 835s for UnitedHealthcare CPID's 3429, 3550, 1431, 8598, 2240, 3929 are delayed at the payer for payment date May 7, 2026. A ticket has been opened with the payer for further research.

Affected CPIDs:

• CPID 3429 UnitedHealthcare
• CPID 3550 UnitedHealthcare
• CPID 1431 Medica
• CPID 8598 Medica
• CPID 2240 Preferred Partners
• CPID 3929 Preferred Partners

Action Required: Please be aware of a delay in the delivery of ERA for check dates above. No 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 and reference incident #INC-000004767.

5/11/2026

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New Clearance Payer Connections May 11, 2026

Optum has new electronic eligibility connections available:

Payer Name: Blue Cross Community Centennial
Connection Type: X12

Payer Name: East West Administrators
Connection Type: X12

Payer Name: Network Administrators
Connection Type: X12

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

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

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

5/11/2026

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New Clearance Payer Connections May 11, 2026

Optum has a new electronic authorization connection available:

Payer Name: Connecticare Medicaid
Connection Type: X12

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

Action Required: If you wish to submit eligibility transactions to the payers above, please take the following actions:

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

5/11/2026

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835 Delay for UnitedHealthcare Payer ID's 87726, 94265, 65088

Some 835s for UnitedHealthcare payer ID 87726, 94265, 65088 are delayed at the payer for payment date May 7, 2026. A ticket has been opened with the payer for further research.

Affected Payer ID:

• Payer ID 87726 UnitedHealthcare
• Payer ID 94265 Medica
• Payer ID 65088 Preferred Partners

Action Required: Please be aware of a delay in the delivery of ERA for check dates above. No 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 and reference incident #INC-000004767.

5/11/2026

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Report Generation Delay for CPID 5676 Alliance Behavioral Healthcare

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted May 1, 2026.

Payer impacted:

• CPID 5676 Alliance Behavioral Healthcare

The payer intermediary has been unable to generate and deliver the reports for some claims submitted May 1, 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 10301391.

5/11/2026

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Report Generation Delay for CPID 5586 Montana Medicaid

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

Payer impacted:

• CPID 5586 Montana Medicaid

The payer intermediary has been unable to generate and deliver the reports for some claims submitted May 6, 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 10301367.

5/11/2026

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Payer Update for Passport Health Plan

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

Payer Name: Passport Health Plan DOS prior to 1/1/21
Professional CPID: 1281
Professional Edit Master: PE_E049
Institutional CPID: 6528
Institutional Edit Master: HE9E049
Industry Standard Payer ID: 61325

Claims sent must begin using the following:

Payer Name: Passport Health Plan by Molina Healthcare
Professional CPID: 8863
Professional Edit Master: PE_C051
Institutional CPID: 5015
Institutional Edit Master: HE9C051
Industry Standard Payer ID: 61325

CPIDs 1281 and 6528 Passport Health Plan DOS prior to 1/1/21 will be terminated effective May 18, 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 for CPIDs 8863, 5015 Passport Health Plan by Molina Healthcare do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs CPIDs 8863, 5015 Passport Health Plan by Molina Healthcare must complete a new enrollment form.
  • New providers must complete a new enrollment form.

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

• Revalidate unreleased claims to edit correctly under new edit master.
• Modify any bridge routines based on edit masters.
• Modify related Payer Alias names to the new CPIDs.
• To access the new enrollment forms, please visit Enrollment Central.

5/8/2026

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Payer Update for Passport Health Plan

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

Payer Name: Passport Health Plan DOS prior to 1/1/21
Professional CPID: 1281
Institutional CPID: 6528
Remittance Available: No
Industry Standard Payer ID: 61325

Claims sent must begin using the following:

Payer Name: Passport Health Plan by Molina Healthcare
Professional CPID: 8863
Institutional CPID: 5015
Remittance Available: Yes
Industry Standard Payer ID: 61325
Claim Fee: NA

CPIDs 1281 and 6528 Passport Health Plan DOS prior to 1/1/21 will be terminated effective May 18, 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 for CPIDs 8863, 5015 Passport Health Plan by Molina Healthcare do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs CPIDs 8863, 5015 Passport Health Plan by Molina Healthcare must complete a new enrollment form.
  • New providers must complete a new enrollment form.

Action Required:

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

5/8/2026

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New Payer Name

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

Previous Payer Name: NHI Billing Services
New Payer Name: Elevate PFS
Industry Standard Payer ID: 14043

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

5/8/2026

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New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: WyoBlue Advantage
Payer ID: WYBA0
Claims Enrollment Required: No
Secondary Claims Accepted: Yes
Remittance Enrollment Required: Yes
Payer Location: Texas

Previously we announced the claims payer ID to be WYBA. That ID will terminated on May 29, 2026. WYBA0 is the go forward Payer ID.

Action Required:

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

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

5/8/2026

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: 374 Franciscan CNPT
Payer ID: FRN02
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Indiana, Illinois, Michigan

 

Payer Name: Christian Health Aid
Payer ID: 98628
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National

 

Payer Name: Clinicas Del Camino Real
Payer ID: CDCR1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

 

Payer Name: Employee Benefit Services, Inc
Payer ID: 60221
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National

 

Payer Name: Employer Direct Healthcare
Payer ID: 48888
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National

 

Payer Name: Florida Health Administrators Inc
Payer ID: 86753
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Florida

 

Payer Name: Gemcare IPA
Payer ID: 27133
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

 

Payer Name: Golden Physicians Medical Group
Payer ID: MPM43
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California

 

Payer Name: Gulf Guaranty
Payer ID: 99943
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National

 

Payer Name: Lucent Government Operations
Payer ID: 17380
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National

 

Payer Name: Louisiana Medicaid Long Term Care
Payer ID: SKLA4
Transaction: Institutional
Payer Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Louisiana

 

Payer Name: Merchant Benefit Administration (Repriced Claims Only)
Payer ID: MBAM1
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National

 

Payer Name: New Jersey Charity Care Inpatient
Payer ID: 00012
Transaction: Institutional
Payer Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: New Jersey

 

 

Payer Name: OSU Humana Healthy Horizons
Payer ID: OSUHU
Transaction Type: Professional
Payer Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Oklahoma

 

Payer Name: OSU SoonerCare
Payer ID: 76619
Transaction Type: Professional
Payer Enrollment Required: Yes
Secondary Claims Accepted: No
Payer Location: Oklahoma

 

Payer Name: Physician Healthcare Integration IPA
Payer ID: POP10
Transaction: Professional
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California

 

Payer Name: Redlands Yucaipa Medical Group DOS after 01/01/26
Payer ID: RYMG1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

 

Payer Name: Serendib Healthways
Payer ID: 4YC01
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California

 

Payer Name: SolarteHealth
Payer ID: SLRT1
Transaction Type: Professional
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National

 

Payer Name: Southland San Gabriel Valley Medical Group
Payer ID: PHM11
Transaction Type: Professional
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California

 

Payer Name: Sutter Senior Care
Payer ID: SC028
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

 

Payer Name: TPAC/ USPCPS/ Amerivantage
Payer ID: RP023
Transaction: Professional
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National

 

Payer Name: Torrance Memorial Medical Center
Payer ID: TMMC1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

 

Payer Name: UHP Management
Payer ID: UHP01
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National

 

Payer Name: Verda Healthcare
Payer ID: VERTX
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Texas

Action Required:

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

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

5/8/2026

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Update: Rush Prudential Health Plans (HMO Only) Electronic Claims Connection No Longer Available

Effective May 12, 2026, the payer listed below will no longer be available at Optum for claims processing. 

Payer Name: Rush Prudential Health Plans (HMO Only)
CPIDs: 4144, 7949
Industry Standard Payer ID: 36389
Reason: Payer no longer offers an electronic connection. 

Action Required: Please make any necessary system changes. 

Original notice sent April 10, 2026: 

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

Payer Name: Rush Prudential Health Plans (HMO Only)
CPIDs: 4144, 7949
Industry Standard Payer ID: 36389
Reason: Payer unavailable electronically. 

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

5/8/2026

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Update: Rush Prudential Health Plans (HMO Only) Electronic Claims Connection No Longer Available

Effective May 12, 2026, the payer listed below will no longer be available at Optum for claims processing.

Payer Name: Rush Prudential Health Plans (HMO Only)
CPIDs: 4144, 7949
Industry Standard Payer ID: 36389
Reason: Payer no longer offers an electronic connection.

Payer will no longer accept paper claims.

Action Required: Please make any necessary system changes.

Original notice sent April 10, 2026:

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

Payer Name: Rush Prudential Health Plans (HMO Only)
CPIDs: 4144, 7949
Industry Standard Payer ID: 36389
Reason: Payer unavailable electronically.

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

5/8/2026

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Update: Erisa Administrative Services Electronic Claims Connection No Longer Available

Effective May 12, 2026, the payer listed below will no longer be available at Optum for claims processing. 

Payer Name: Erisa Administrative Services
Claim CPID: 5879
Industry Standard Payer ID: 74234
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: Please make any necessary system changes. 

Original notice sent April 14, 2026:  

Electronic Claims Connection Suspended  

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

Payer Name: Erisa Administrative Services
CPID: 5879
Industry Standard Payer ID: 74234
Reason: Payer unavailable electronically.  

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

5/8/2026

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New Payer Name

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

Previous Payer Name: NHI Billing Services
New Payer Name: Elevate PFS
Professional CPID: 9112
Professional Edit Master: PE_T007
Institutional CPID: 3699
Institutional Edit Master: HE9T007
Industry Standard Payer ID: 14043

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:

• You may choose to update the Payer Alias in your system to accommodate the new payer name.

5/8/2026

---

Update: Erisa Administrative Services Electronic Claims Connection No Longer Available

Effective May 12, 2026, the payer listed below will no longer be available at Optum for claims processing.

Payer Name: Erisa Administrative Services
Claim CPID: 5879
Industry Standard Payer ID: 74234
Reason: Payer no longer offers an electronic connection.

Payer will no longer accept paper claims.

Action Required: Please make any necessary system changes.

Original notice sent April 14, 2026:

Electronic Claims Connection Suspended

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

Payer Name: Erisa Administrative Services
CPID: 5879
Industry Standard Payer ID: 74234
Reason: Payer unavailable electronically.

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

5/8/2026

---

New Payer Name

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

Previous Payer Name: NHI Billing Services
New Payer Name: Elevate PFS
Professional CPID: 9112
Institutional CPID: 3699
Industry Standard Payer ID: 14043

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

5/8/2026

---

Payer Processing Issue for CPID 2554 Louisiana Medicaid Medicare Advantage Crossovers

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

Payer impacted:

• CPID 2554 Louisiana Medicaid Medicare Advantage Crossovers

A resolution has been implemented and the claims were retransmitted to the payer on May 8, 2026.

This delay affected claims released to Optum between 10 a.m. CT on May 5, 2026 and 7 p.m. CT on May 5, 2026.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 10297987.

5/8/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Harbor Health
Institutional CPID: 9058
Professional CPID: 3798
Industry Standard Payer ID: HARBR
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Texas

Action Required:

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

Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum.

5/8/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Harbor Health
Institutional CPID: 9058
Professional CPID: 3798
Industry Standard Payer ID: HARBR
Line of Business (LOB) Code: U2M
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Texas

Action Required:

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

Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum.

5/8/2026

---

New Electronic Remittance (ERA) Connections Available on RPA

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

12B60 – Highmark Blue Cross Blue Shield of Western Pennsylvania

PSN22 – Paysign

SNMIS – Iowa Medicaid SNMIS

WYBAX – WyoBlue Advantage

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

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

5/8/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Cannon Cochran Management Services (CCMSI Workers Comp)
Payer ID: WR322
Payer Enrollment Required: Yes
Payer Location: National

 

Payer Name: Capital Health LIFE
Payer ID: R3473
Payer Enrollment Required: Yes
Payer Location: New Jersey

 

Payer Name: Exceedent
Payer ID: 22344
Payer Enrollment Required: Yes
Payer Location: National

 

Payer Name: Liberty HealthShare
Payer ID: 90753
Payer Enrollment Required: Yes
Payer Location: National

 

Payer Name: Paysign
Payer ID: PSN22
Payer Enrollment Required: Yes
Payer Location: National

 

Payer Name: Southland Benefit Solutions
Payer ID: SBS01
Payer Enrollment Required: Yes
Payer Location: Alabama

 

Payer Name: The Hanover Insurance Company
Payer ID: WP927
Payer Enrollment Required: Yes
Payer Location: National

 

Payer Name: Western Health Advantage
Payer ID: 68039
Payer Enrollment Required: Yes
Payer Location: California

 

Payer Name: WyoBlue Advantage
Industry Standard Payer ID: WYBA0
Payer Enrollment Required: Yes
Payer Location: Wyoming

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.

5/8/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Exceedent
Institutional CPID: 9681
Professional CPID: 7732
Industry Standard Payer ID: 22344
Line of Business (LOB) Code: H05
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.

5/8/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Exceedent
Institutional CPID: 9681
Professional CPID: 7732
Industry Standard Payer ID: 22344
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.

5/8/2026

---

Payer Change for CPID 4705 Sutter Connect - East Bay Medical Foundation

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

Payer Name: Sutter Connect - East Bay Medical Foundation
Professional CPID: 4705
Remittance Available: No
Industry Standard Payer ID: 94269

Claims must begin using the following:

Payer Name: Sutter Connect - East Bay Medical Foundation
Professional CPID: 4274
Remittance Available: No
Industry Standard Payer ID: 94269
Claim Fee: N/A

CPID 4705 will be terminated effective May 21, 2026.

Enrollment Requirements:

Claims:

Payer enrollment for electronic claims is not required.

Action Required:

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

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

5/8/2026

---

Update: Blue Cross Community Centennial Real Time Transactions

Effective May 7, 2026, Optum is pleased to announce that clients may resume sending Real-Time Eligibility Inquiry and Response (270/271) and Claim Status Inquiry and Response (276/277) transactions for the following payer:

BLUE CROSS COMMUNITY CENTENNIAL

Transaction types: Eligibility, Claims Status

IMN: MC721
IEDI: 14296
Exchange: 4570, 1243

Action Required by customer:

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

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

Customer Care Hub Portal: Submit a ticket through the Customer Care Hub at https://customercare.optum.com/public/home.html

Please note: If you are not currently registered, you will need to complete the registration process before submitting a ticket.

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

5/8/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Sutter Senior Care
Institutional CPID: 1552
Industry Standard Payer ID: SC028
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

Action Required:

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

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

5/8/2026

---

Update: The payer has advised that the impacted claims will be reprocessed within 1 business day and a new updated status will be sent. 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:

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

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

5/7/2026

---

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

Update: The payer has advised that the impacted claims will be reprocessed within 1 business day and a new updated status will be sent. 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.

5/7/2026

---

Reminder: Electronic Payer ID Change for High Desert PACE

Optum changed electronic claims payer ID and routing for the following payer, effective April 27, 2026.

Payer Name: High Desert PACE
Current Payer ID: R3467
New Payer ID: HDP01
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Payer ID R3467 will be terminated effective May 22, 2026.

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required.

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

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

• Make any necessary system changes.

5/7/2026

---

Electronic Claims Connection Suspended

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

Payer Name: Emanate Health Center - EHIPA/NMM
CPID(s): 1752, 1952
Industry Standard Payer ID: MPM65
Reason: Payer unavailable electronically.

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

5/7/2026

---

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 May 1, 2026:

Payer Name: WESTERN SOUTHERN FINANCIAL GROUP
Industry Payer ID: 31048
IMN Real Time ID: 31048
Exchange Real Time ID: WSTSL
CPID(s): 3979 (I), 5415 (P)
Optum IEDI Real Time ID: 31048
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.

5/7/2026

---

Report Generation Delay for CPIDs 5596 and 2416 Blue Cross Blue Shield of Arkansas

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

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10296849.

5/7/2026

---

Routing Change Sutter Senior Care

Optum will be changing electronic claims routing for the following payer, effective May 11, 2026:

Payer Name: Sutter Senior Care
Professional CPID: 6813
Current Edit Master: PE_O007
New Edit Master: PE_T007
Industry Standard Payer ID: SC028
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 is not changing.
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

5/7/2026

---

Report Generation Delay for CPID 4110 Bollinger Inc

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

Payer impacted:

• CPID 4110 Bollinger Inc

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10296102.

5/7/2026

---

Update: Report Generation Delay for CPID 3089 Allstate

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted April 21, 2026 and April 24, 2026.

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

Original notice sent April 27, 2026:
A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since April 13, 2026.

Payer impacted:

• CPID 3089 Allstate

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 10280085.

5/7/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Liberty HealthShare
Institutional CPID: 9614
Professional CPID: 7291
Industry Standard Payer ID: 90753
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.

5/7/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Liberty HealthShare
Institutional CPID: 9614
Professional CPID: 7291
Industry Standard Payer ID: 90753
Line of Business (LOB) Code: N44
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.

5/7/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: 374 Franciscan CNPT
Institutional CPID: 1535
Professional CPID: 1235
Industry Standard Payer ID: FRN02
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Indiana, Illinois, Michigan

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.

5/7/2026

---

New Payer Edit for CPID 8637

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 May 13, 2026:

• IPRV03A000: MISSING BILL PROV TAXONOMY CODE - When the Attending Provider Taxonomy Code is not present, the Billing Provider Taxonomy Code is required. LOOP 2000A PRV03

Edit applies to:  

• CPID 8637 AETNA BETTER HEALTH MICHIGAN

Action Required: Please be aware of updated edit requirements.

5/6/2026

---

Claim Submission for AARP CPIDs 5271/8940

We have been informed the payers listed below have been receiving a high volume of paper claims. As an electronic submission option is available for this payer, we encourage all future claims are submitted electronically.

Payers Affected:

• CPID 5271 AARP
• CPID 8940 AARP

Action Required: If possible, please ensure that claims are submitted electronically to these payers.

If you have any questions, please contact Customer Support.

5/6/2026

---

Correction Exch PAR Status Changes May 5, 2026

UPDATE: Please note the corrections below for the notification originally sent April 30, 2026. We apologize for any confusion or inconvenience this may have caused.

Effective June 1, 2026 the PAR Status will change for the following payers:

Payer Name: Aetna Better Health of Illinois Medicaid (no longer an active real time connection)
Industry ID: 68024
Exchange CPID(s): 5013, 8861
Exchange Real Time ID: ABHILL
Transactions: Eligibility, Claim Status
New PAR Status: Non Par

Payer Name: Alliant Health Plans
Industry ID: 58234
Exchange CPID(s): 2589, 3793
Exchange Real Time ID: ALLIHP
Transactions: Eligibility only
New PAR Status: Non Par

Payer Name: Aspire Health Plan
Industry ID: 46156
Exchange CPID(s): 2507, 1163
Exchange Real Time ID: ASPHPL
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Curative Health Plan
Industry ID: CURTV
Exchange CPID(s): 8055, 9774
Transactions: Claims
New PAR Status: Transitional

Payer Name: Farm Bureau Health Plans
Industry ID: 62045
Exchange CPID(s): 3096, 1151
Exchange Real Time ID: FRMBHP
Transactions: Eligibility only
New PAR Status: Transitional

Payer Name: Farm Bureau Health Plans MAPD
Industry ID: RP061
Exchange CPID(s): 8015, 9733
Exchange Real Time ID: FMBHP
Transactions: Eligibility, Claim Status
New PAR Status: Transitional

Payer Name: Las Vegas Firefighters Health and Welfare Trust
Industry ID: 77684
Exchange CPID(s): 6017, 9164
Transactions: Claims
New PAR Status: Non Par

Payer Name: Luminare Health Kansas City
Industry ID: 48117
Exchange CPID(s): 4568, 5492
Exchange Real Time ID: CSFMH
Transactions: Eligibility, Claim Status
New PAR Status: Gateway

Payer Name: Nippon Life Insurance Company of America
Industry ID: 81264
Exchange CPID(s): 6539, 6443
Exchange Real Time ID: NLICOA
Transactions: Eligibility, Claim Status
New PAR Status: Gateway

Payer Name: WeShare Legacy
Industry ID: UHSM1
Exchange CPID(s): 9001, 3450
Exchange Real Time ID: UHSMN
Transactions: Eligibility
New PAR Status: Gateway

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

5/6/2026

---

Update: Real Time Payer BLUE CROSS COMMUNITY CENTENNIAL

This message serves as an update to a previous communication regarding BLUE CROSS COMMUNITY CENTENNIAL Eligibility and Claim Status transactions.

Please disregard the prior notification related to this payer’s Real-Time transactions. A revised notice will be distributed within the next 24–48 hours. Thank you for your attention to this update.

5/6/2026

---

Friday Health Plans Electronic Eligibility Connection No Longer Available

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

Payer Name: Friday Health Plans
Industry Payer ID: H0657
IMN Real Time ID: COCHP
Exchange Real Time ID: COCHP, COCHP1, COCHP2
CPIDs: 7634, 6851
Connection Type: X12 and Portal

Reason: Payer no longer offers an electronic connection.

Action Required: None.

5/5/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name: Redlands Yucaipa Medical Group DOS after 01/01/26
Institutional CPID: 1926
Professional CPID: 2794
Industry Standard Payer ID: RYMG1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: CA

Action Required:

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

5/5/2026

---

Electronic Routing Change for CPIDs 6163 and 4644 Integrated Medical Solutions

Effective May 5, 2026, Optum will be changing electronic claims routing for the following payer:   

Payer Name: Integrated Medical Solutions
Professional CPID: 6163
Institutional CPID: 4644
Industry Standard Payer ID: 20050
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. 

5/5/2026

---

Electronic Routing Change for CPIDs 6163 and 4644 Integrated Medical Solutions

Optum is changing electronic claims routing for the following payer, effective May 5, 2026:

Payer Name: Integrated Medical Solutions
Professional CPID: 6163
Edit Master: PE_C051
Institutional CPID: 4644
Edit Master: HE9C051
Industry Standard Payer ID: 20050
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.

5/5/2026

---

New Electronic Claims and Remittance Connections Available Iowa Medicaid SNMIS

Optum has new electronic claims and remittance connections available:

Payer Name: Iowa Medicaid SNMIS
Payer ID: SNMIS
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Iowa

Action Required:

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

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

5/5/2026

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: Choice Physicians Network - Live Well
Payer ID: CPNLW
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California 

Payer Name: WeShare
Payer ID: WESHR
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National

Payer Name: Access IPA
Payer ID: ACC01
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

Payer Name: AdventHealth Transplant Institute
Payer ID: RP090
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Florida

Payer Name: Adventist Health Hanford AHP
Payer ID: MPM36
Transaction Type: Institutional
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California

Payer Name: Adventist Health Plan
Payer ID: MPM37
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California

Payer Name: Adventist White Memorial - Crown City Medical Group
Payer ID: MPM33
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California

Payer Name: Aligned Community Physicians
Payer ID: ACP17
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California

Payer Name: Allstate
Payer ID: C1037
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: National

Payer Name: Always Care Benefits
Payer ID: STR01
Transaction Type: Professional
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Louisiana

Payer Name: VitalCore Millette
Payer ID: MAI58
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. 
• When a payer requires claims enrollment, forms must be submitted and approved to begin submitting transactions. 

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

5/5/2026

---

New Real-time Eligibility and Claim Status Transactions Available

Effective May 1, 2026, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response and Claim Status Inquiry and Response transactions for the below payer:

Payer name: BLUE CROSS COMMUNITY CENTENNIAL
Transaction types: Eligibility, Claims Status
IMN: 14296
IEDI: 14296
Exchange: BCCCS

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

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

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

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

5/5/2026

---

Spohn Health Electronic Claims Connection No Longer Available

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

Payer Name: Spohn Health
Claims CPID: 3991
Industry Standard Payer ID: 12T63
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: Please make any necessary system changes.

5/5/2026

---

PAR Status change for Real Time payers

Effective June 1, 2026, the PAR Status will change for the following real time payers:

Independence Administrators
iEDI ID: 10417
Transaction: Eligibility
New PAR Status: Non Par

Integrated Mental Health Services
iEDI ID: 10585
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

JAI Medical Systems
iEDI ID: 11147
Transaction: Eligibility
New PAR Status: Non Par

JVHL Priority Health
iEDI ID: PRHTH
Transaction: Eligibility
New PAR Status: Non Par

Kempton Group Administrators
iEDI ID: 73100
Transaction: Eligibility
New PAR Status: Non Par

Lincoln Heritage Life Insurance Company
iEDI ID: 10749
Transaction: Eligibility
New PAR Status: Non Par

Luminare Health Kansas City
iEDI ID: 48117
Transaction: Eligibility, Claim Status
New PAR Status: Gateway

Medstar Family Choice District of Columbia
iEDI ID: 10844
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

New York Independent Health Assoc (IHA) – Western
iEDI ID: 10536
Transaction: Eligibility
New PAR Status: Non Par

Nippon Life Insurance Company of America
iEDI ID: 81264
Transaction: Eligibility, Claim Status
New PAR Status: Gateway

Royal Neighbors of America
iEDI ID: 10751
Transaction: Eligibility
New PAR Status: Non Par

San Francisco Health Plan
iEDI ID: 10849
Transaction: Eligibility
New PAR Status: Non Par

Self Insured Services Company (SISCO)
iEDI ID: 11129
Transaction: Eligibility
New PAR Status: Non Par

Senior Whole Health, LLC DBA Molina Healthcare
iEDI ID: 10962
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Shared Health Mississippi
iEDI ID: 14435
Transaction: Eligibility
New PAR Status: Non Par

Sutter and Aetna Insurance Company
iEDI ID: 60624
Transaction: Eligibility
New PAR Status: Non Par

Univera
iEDI ID: 10535
Transaction: Eligibility
New PAR Status: Non Par

Washington National Insurance Company
iEDI ID: 10853
Transaction: Eligibility
New PAR Status: Non Par

WeShare Legacy
iEDI ID: UHSM1
Transaction: Eligibility
New PAR Status: Gateway

Zing Health
iEDI ID: 83248
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

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

5/4/2026

---

PAR Status change for Real Time payers

Effective June 1, 2026, the PAR Status will change for the following real time payers:

Administrative Concepts
iEDI ID: 22384
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Aetna Better Health of Illinois – Medicaid
iEDI ID: 10892
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Alliant Health Plans
iEDI ID: 58234
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Aspire Health Plan
iEDI ID: 46156
Transaction: Eligibility
New PAR Status: Non Par

Aspirus Medicare Advantage
iEDI ID: 36483
Transaction: Eligibility
New PAR Status: Non Par

BayCare Plus Medicare Advantage
iEDI ID: 81079
Transaction: Eligibility
New PAR Status: Non Par

CareSource of Georgia
iEDI ID: GACS1
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

CareSource of Indiana
iEDI ID: INCS1
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Centivo
iEDI ID: 45564
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Christus Health Plan Health Insurance Exchange
iEDI ID: CHPTX
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Community Health First Medicare Advantage
iEDI ID: 10421
Transaction: Eligibility
New PAR Status: Non Par

Cook Childrens Star Plan
iEDI ID: 10610
Transaction: Eligibility
New PAR Status: Non Par

Farm Bureau Health Plans
iEDI ID: 62045
Transaction: Eligibility, Claim Status
New PAR Status: Transitional

Farm Bureau Health Plans MAPD
iEDI ID: RP061
Transaction: Eligibility, Claim Status
New PAR Status: Transitional

FirstCare Health Plans
iEDI ID: 10870
Transaction: Eligibility
New PAR Status: Non Par

GEMCare – Kern County
iEDI ID: 11065
Transaction: Eligibility
New PAR Status: Non Par

Great American Life Insurance Medicare Supplement
iEDI ID: 80705
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Health Choice Pathway
iEDI ID: 62180
Transaction: Eligibility, Claim Status
New PAR Status: Non Par

Health Plans, Inc.
iEDI ID: 10802
Transaction: Eligibility
New PAR Status: Non Par

Hometown Health
iEDI ID: 10335
Transaction: Eligibility
New PAR Status: Non Par

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

5/4/2026

---

PAR Status change for Claim payers

Effective June 1, 2026, the PAR Status will change for the following claim payers:

Curative Health Plan
iEDI ID: CURTV
Transaction: Claims - Prof/Inst
New PAR Status: Transitional

Las Vegas Firefighters Health and Welfare Trust
iEDI ID: 77684
Transaction: Claims - Prof/Inst
New PAR Status: Non Par

Cigna Health Plans
iEDI ID: 62308
Transaction: Claims – Dental
New PAR Status: Non Par

Guardian Life
iEDI ID: 64246
Transaction: Claims – Dental
New PAR Status: Non Par

Kaiser Foundation Health Plan of the Northwest
iEDI ID: RP073
Transaction: Claims – Dental
New PAR Status: Non Par

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

5/4/2026

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: Iowa Medicaid SNMIS
Institutional CPID: 9027
Professional CPID: 3707
Industry Standard Payer ID: SNMIS
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Iowa
Claims Fee: N/A
Remittance Fee: N/A

Action Required:

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

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

5/4/2026

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: Iowa Medicaid SNMIS
Institutional CPID: 9027
Professional CPID: 3707
Industry Standard Payer ID: SNMIS
Line of Business (LOB) Code: D28
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Iowa
Remittance Fee: N/A

Action Required:

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

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

5/4/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: WyoBlue Advantage
Institutional CPID: 9085
Professional CPID: 3870
Industry Standard Payer ID: WYBA
Line of Business (LOB) Code: H4B
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Wyoming

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.

5/4/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: WyoBlue Advantage
Institutional CPID: 9085
Professional CPID: 3870
Industry Standard Payer ID: WYBA
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Wyoming

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.

5/4/2026

---

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 April 28, 2026:

Payer Name: Network Administrators
IMN Real Time ID: IHS26
iEDI Real Time ID: IHS26
Exchange Real Time ID: NETAD
CPID(s): 3659 (I), 1839 (P)
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Subscriber

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

Dependent

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

5/4/2026

---

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 April 28, 2026:

Payer Name: East West Administrators
IMN Real Time ID: EWACA
iEDI Real Time ID: EWACA
Exchange Real Time ID: EWACA
CPID(s): 3659 (I), 1839 (P)
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Subscriber

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

Dependent

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

Action Required by customer:

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

5/4/2026

---

Report Generation Delay for CPID 9057 Sentara PACE

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since April 20, 2026.

Payer impacted:

• CPID 9057 Sentara PACE

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10291564.

5/4/2026

---

Multiple Payers Electronic Eligibility Connections No Longer Available

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

Payer Name: Christian Care Ministries
Industry Payer ID: 59355
Exchange Real Time ID: CCMIN1
CPIDs: 8638, 7154
Connection Type: Portal

Payer Name: Clover Health
Industry Payer ID: 13285
Exchange Real Time ID: CLOVE1
CPIDs: 5666, 6433
Connection Type: Portal

Payer Name: Common Ground Healthcare Cooperative
Industry Payer ID: 77170
Exchange Real Time ID: CGHC1
CPIDs: 6674, 6778
Connection Type: Portal

Reason: Payer no longer offers an electronic connection.

Action Required: None.

5/4/2026

---

Update: Report Generation Delay for multiple CPIDs

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

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

Original notice sent April 17, 2026:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted April 3, 2026.

Payers impacted: 

• CPID 4272 Absolute Total Care
• CPID 7776 Allwell from Buckeye Health Plan
• CPID 7769 Allwell from Peach State Health Plan
• CPID 7785 Allwell from Superior Health Plan
• CPID 6755 Ambetter from Sunshine Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 10268517.

5/4/2026

---

21st Century Insurance and Financial Services Electronic Claims Connection No Longer Available

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

Payer Name: 21st Century Insurance and Financial Services
Claims CPIDs: 9094, 2170
Industry Standard Payer ID: 51028
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

5/4/2026

---

21st Century Insurance and Financial Services Electronic Claims Connection No Longer Available

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

Payer Name: 21st Century Insurance and Financial Services
Claims CPIDs: 9094, 2170
Industry Standard Payer ID: 51028
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: None.

5/4/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Southland Benefit Solutions
Professional CPID: 9265
Industry Standard Payer ID: SBS01
Line of Business (LOB) Code: H3F
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Alabama

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.

5/4/2026

---

Brand New Day Electronic Eligibility Connection No Longer Available

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

Payer Name: Brand New Day
Industry Payer ID: UC001
Exchange Real Time ID: BRAND1
CPIDs: 1044, 7871
Connection Type: Portal

Reason: Payer no longer offers an electronic connection.

Action Required: None.

5/4/2026

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Southland Benefit Solutions
Professional CPID: 9265
Industry Standard Payer ID: SBS01
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Alabama

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.

5/4/2026

---

Update: Multiple Payers Electronic Claims and Remittance Connections No Longer Available

Update:
Optum has confirmed that the payers listed below will continue to accept claims electronically.

• In-network claims: Timely filing is 90 days from the date of service for dates prior to Jan. 1, 2026.
• Out-of-network claims: Timely filing is 180 days from the date of service for dates prior to Jan. 1, 2026.

Please be aware that for any claims submitted on or after Jan. 1, 2026, claims that exceed these timely filing limits may be rejected.

Optum has reconnected the claim connections so providers may continue sending claims.

Action Required

• Review all pending and future claims to ensure they meet applicable timely filing requirements.

Original notice sent April 23, 2026:
Effective April 30, 2026, the payers listed below will no longer be available at Optum for claims and remittance processing.

Optum received information that, effective Jan. 1, 2026, MDwise no longer serves as a managed care health plan for Indiana Medicaid’s Healthy Indiana Plan and Hoosier Healthwise programs. Members had the opportunity to select a new health plan by Dec. 24, 2025.

Payer Name: MDwise Hoosier Healthwise
Payer IDs: 3519M, 35191
Reason: Payer no longer in business effective April 30, 2026.

Payer Name: MDwise Healthy Indiana Plan
Payer IDs: 3135M, 31354
Reason: Payer no longer in business effective April 30, 2026.

Payers will no longer accept paper claims.

A payer notification was sent to providers announcing this change. Additional information can be found on their website https://www.mdwise.org/mdwise/mdwise-for-providers

Action Required: Please make any necessary system changes.

5/1/2026

---

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

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

68039 – Western Health Advantage
FRN01 – Franciscan Health Hammond
R3473 – Capital Health LIFE

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.

5/1/2026

---

Update: Multiple Payers Electronic Claims and Remittance Connections No Longer Available

Update: Optum has confirmed that the payers listed below will continue to accept claims electronically.

• In-network claims: Timely filing is 90 days from the date of service for dates prior to Jan. 1, 2026.
• Out-of-network claims: Timely filing is 180 days from the date of service for dates prior to Jan. 1, 2026.

Please be aware that for any claims submitted on or after Jan. 1, 2026, claims that exceed these timely filing limits may be rejected.

Optum will reconnect the claim connections May 4, 2026. Providers may resume sending claims effective May 5, 2026.

Action Required

• Review all pending and future claims to ensure they meet applicable timely filing requirements.

Original notice sent April 23, 2026:
Effective April 30, 2026, the payers listed below will no longer be available at Optum for claims and remittance processing.

Optum received information that effective Jan. 1, 2026, MDwise no longer serves as a managed care health plan for Indiana Medicaid’s Healthy Indiana Plan and Hoosier Healthwise programs. Members had the opportunity to select a new health plan by Dec. 24, 2025.

Payer Name: MDwise Hoosier Healthwise
Claims and Remittance CPIDs: 8112, 1085
Line of Business (LOB) Code: H1L
Industry Standard Payer ID: 3519M
Reason: Payer no longer in business effective April 30, 2026

Payer Name: MDwise Healthy Indiana Plan
Claims and Remittance CPIDs: 8113, 1086
Line of Business (LOB) Code: H1N
Industry Standard Payer ID: 3135M
Reason: Payer no longer in business effective April 30, 2026.

Payers will no longer accept paper claims.

A payer notification was sent to providers announcing this change. Additional information can be found on their website https://www.mdwise.org/mdwise/mdwise-for-providers

Action Required: Please make any necessary system changes.

5/1/2026

---

Update: Multiple Payers Electronic Claims and Remittance Connections No Longer Available

Update: Optum has confirmed that the payers listed below will continue to accept claims electronically.

• In-network claims: Timely filing is 90 days from the date of service for dates prior to Jan. 1, 2026.
• Out-of-network claims: Timely filing is 180 days from the date of service for dates prior to Jan. 1, 2026.

Please be aware that for any claims submitted on or after Jan. 1, 2026, claims that exceed these timely filing limits may be rejected.

Optum will reconnect the claim connections May 4, 2026. Providers may resume sending claims effective May 5, 2026

Action Required

• Review all pending and future claims to ensure they meet applicable timely filing requirements.

Original notice sent April 23, 2026:
Effective April 30, 2026, the payers listed below will no longer be available at Optum for claims and remittance processing.

Optum received information that Effective Jan. 1, 2026, MDwise no longer serves as a managed care health plan for Indiana Medicaid’s Healthy Indiana Plan and Hoosier Healthwise programs. Members had the opportunity to select a new health plan by Dec. 24, 2025.

Payer Name: MDwise Hoosier Healthwise
Claims and Remittance CPIDs: 8112, 1085
Industry Standard Payer ID: 3519M
Reason: Payer no longer in business effective April 30, 2026.

Payer Name: MDwise Healthy Indiana Plan
Claims and Remittance CPIDs: 8113, 1086
Industry Standard Payer ID: 3135M
Reason: Payer no longer in business effective April 30, 2026.

Payers will no longer accept paper claims.

A payer notification was sent to providers announcing this change. Additional information can be found on their website https://www.mdwise.org/mdwise/mdwise-for-providers

Action Required: Please make any necessary system changes.

5/1/2026

---

PAR Status Changes Effective June 1, 2026

Effective June 1, 2026, the PAR Status will change for the following real time payer(s):

Payer Name: Integrated Mental Health Services
IMN ID: CBHTX
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: JAI Medical Systems
IMN ID: JAI01
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Kempton Group Administrators
IMN ID: 73100
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Kempton Group Administrators
IMN ID: 73100
Transactions: Eligibility, Claim Status
New PAR Status: Non Par

Payer Name: Lincoln Heritage Life Insurance Company
IMN ID: LCNHG
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Luminare Health AZ, IL, IN, MD, MN, NC, PA
IMN ID: 48117
Transactions: Claim Status, Eligibility
New PAR Status: Gateway

Payer Name: Manhattan Life
IMN ID: MNHTN
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Medstar Family Choice District of Columbia
IMN ID: RP062
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Medstar Family Choice District of Columbia
IMN ID: RP062
Transactions: Eligibility, Claim Status
New PAR Status: Non Par

Payer Name: New York Independent Health Assoc (IHA) - Western
IMN ID: SX073
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Nippon Life Insurance Company of America
IMN ID: 81264
Transactions: Claim Status, Eligibility
New PAR Status: Gateway

Payer Name: Priority Health of Michigan
IMN ID: 38217
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Royal Neighbors of America
IMN ID: RYLNB
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: San Francisco Health Plan
IMN ID: SFHP1
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Secure Health Plans of Georgia
IMN ID: 28530
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Self Insured Services Company (SISCO)
IMN ID: SISCO
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Senior Whole Health, LLC DBA Molina Healthcare
IMN ID: SWHMA
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Shared Health Mississippi
IMN ID: SHMS1
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Sutter and Aetna Insurance Company
IMN ID: 60624
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Thrivent Financial
IMN ID: THRIV
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Triple-S Advantage
IMN ID: 973MA
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Univera
IMN ID: SX086
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Washington National Insurance Company
IMN ID: 70319
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: WeShare Legacy
IMN ID: UHSM1
Transactions: Eligibility
New PAR Status: Gateway

Payer Name: Yamhill County CCO Physical Health
IMN ID: 77946
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Zing Health
IMN ID: 83248
Transactions: Claim Status, Eligibility
New PAR Status: Non Par
Message Verbiage Plain Text

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

5/1/2026

---

PAR Status Changes Effective June 1, 2026

Effective June 1, 2026, the PAR Status will change for the following real time payer(s):

Payer Name: Administrative Concepts
IMN ID: 22384
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Aetna Better Health of Illinois - Medicaid
IMN ID: 26337
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Allied Benefit Systems
IMN ID: 37308
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Alliant Health Plans
IMN ID: 58234
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Aspire Health Plan
IMN ID: 46156
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Aspirus Medicare Advantage
IMN ID: 36483
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: BayCare Plus Medicare Advantage
IMN ID: 81079
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: CareSource of Georgia
IMN ID: GACS1
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: CareSource of Indiana
IMN ID: INCS1
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Centivo
IMN ID: 45564
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Christus Health Plan Health Insurance Exchange
IMN ID: CHPTX
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Cigna Select Great-West Healthcare
IMN ID: 80705
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Community Health First Medicare Advantage
IMN ID: CHFMA
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: CompBenefits
IMN ID: CX021
Transactions: Claim Inquiry, Eligibility
New PAR Status: Non Par

Payer Name: Cook Childrens Star Plan
IMN ID: CCHP9
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Farm Bureau Health Plans
IMN ID: 62045
Transactions: Claim Status, Eligibility
New PAR Status: Transitional

Payer Name: Farm Bureau Health Plans MAPD
IMN ID: RP061
Transactions: Claim Status, Eligibility
New PAR Status: Transitional

Payer Name: First United American Insurance Company
IMN ID: FUNAI
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: FirstCare Health Plans
IMN ID: 94999
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: GEMCare - Kern County
IMN ID: MCS03
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Health Choice Pathway
IMN ID: HCGEN
Transactions: Claim Status, Eligibility
New PAR Status: Non Par

Payer Name: Health Plans, Inc.
IMN ID: 44273
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Hometown Health
IMN ID: HMETH
Transactions: Eligibility
New PAR Status: Non Par

Payer Name: Independence Administrators
IMN ID: TA720
Transactions: Eligibility
New PAR Status: Non Par

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

5/1/2026