999 Payer Batch Rejections for CPID 1782 North American Medical Management (NAMM - N. CA)

Professional claims transmitted to the payer listed below from Optum on Sept. 30, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

• CPID 1782 North American Medical Management (NAMM - N. CA)

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

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09614690.

9/30/2025

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Report Generation Delay for CPID 4423 Medical Mutual of Ohio

A payer is experiencing issues affecting Professional report generation for some claims submitted between Sept. 22, 2025 and Sept. 23, 2025.

Payer impacted:

• CPID 4423 Medical Mutual of Ohio

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 09710703.

9/30/2025

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Report Generation Delay for CPID 1107 Integrated Health Partners (IHP)

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Sept. 17, 2025.

Payer impacted: 

• CPID 1107 Integrated Health Partners (IHP)

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 09710687.

9/30/2025

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Report Generation Delay for CPID 6220 Arizona Priority Care Plus

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Sept. 17, 2025.

Payer impacted: 

• CPID 6220 Arizona Priority Care Plus

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 09710618.

9/30/2025

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Report Generation Delay for CPID 7225 Sharp Community Medical Group

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

Payer impacted: 

• CPID 7225 Sharp Community Medical Group

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 09710815.

9/30/2025

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Report Generation Delay for CPID 2287 Medicare Plus Blue of MI (MAP)

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

Payer impacted: 

• CPID 2287 Medicare Plus Blue of MI(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 09710541.

9/30/2025

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Report Generation Delay for CPID 1421 Blue Cross Blue Shield of Michigan

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

Payer impacted: 

• CPID 1421 Blue Cross Blue Shield of Michigan

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 09710476.

9/30/2025

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Report Generation Delay for CPID 9428 AmeriHealth Caritas Ohio

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

Payer impacted:

• CPID 9428 AmeriHealth Caritas Ohio

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09709232.

9/29/2025

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Report Generation Delay for CPID 3480 ArchCare

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

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 09708768.

9/29/2025

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Update: Report Generation Delay for CPID 3061 Align Senior Care of Michigan

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Aug. 29, 2025.

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

Original notice sent Sept. 9, 2025:

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since Aug. 29, 2025.

Payer impacted: 

• CPID 3061 Align Senior Care of Michigan

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 09677921.

9/29/2025

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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 Sept. 23, 2025:

Payer Name: SOUTH CAROLINA MEDICAID
Industry Payer ID: SCXIX
IMN Real Time ID: SKSC0
Exchange Real Time ID: SCCAID
CPID(s): 1484 / 5540
Optum iEDI Real Time ID: 10179
Payer Enrollment Required: No
Connection Type: X12

Search Options:

• Claim Status Inquiry subscriber
• Member id, first name, last name, date of birth
• Optional additional elements:
• Payer claim number, Total submitted charges

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

9/29/2025

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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 Sept. 12, 2025:

Payer Name: MONTANA MEDICAID
Industry Payer ID: SKMT0
IMN Real Time ID: SKMT0
Exchange Real Time ID: MTCAID
CPID(s): 5586 / 4427
Optum iEDI Real Time ID: MTMCD
Payer Enrollment Required: No
Connection Type: X12
Fee: $.0325

Search Options:

• Claim Status Inquiry subscriber
• Member id, first name, last name, date of birth
• Optional additional elements:
• Payer claim number, Total submitted charges

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

9/29/2025

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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 Sept. 18, 2025:

Payer Name: DELAWARE MEDICAID
Industry Payer ID: SKDE0
IMN Real Time ID: SKDE0
Exchange Real Time ID: DECAID
CPID(s): 1545 / 2726
Optum iEDI Real Time ID: DEMCD
Payer Enrollment Required: No
Connection Type: X12
Fee: $0.065 

Search Options:

• Claim Status Inquiry subscriber
• Member id, first name, last name, date of birth
• Optional additional elements:
• Payer claim number, Total submitted charges

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

9/29/2025

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Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Sept. 17, 2025.

Payer impacted: 

• CPID 6671 HealthSun

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09708811.

9/29/2025

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Updates to EMC Agreements and/or ERA Enrollment forms, Sept. 22, 2025-Sept. 26, 2025

Optum will now be handling many more Dental Claims (837D) and ERAs and they are added as ERA/DENTAL(835D). In IEDI there is a special addition for Dental in the Dropdown choices.

Note: Optum has added some new payers, and the payer IDs may have 7 digits as well as the payers that have 5 digits.   

Optum has updated the following EMC Agreements and/or ERA Enrollment forms as follows:

Payer/Name: Humana
Payer ID: 61101
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/17/2025

Payer/Name: Wellmark BCBS (Iowa, South Dakota)
Payer ID: 88848
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/17/2025

Payer/Name: Blue Shield of Ohio
Payer ID: OHBLS
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/17/2025

Payer/Name: Indiana Medicaid
Payer ID: INMCD
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/17/2025

Payer/Name: Brown & Toland Medical Group
Payer ID: 94316
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/17/2025

Payer/Name: Veterans Affairs Community Care Network
Payer ID: VACCN
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/22/2025

Payer/Name: VA FEE BASIS PROGRAMS
Payer ID: 12115
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/22/2025

Payer/Name: OLD SURETY LIFE INSURANCE
Payer ID: 29237
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/23/2025

Payer/Name: ATRIO HEALTH PLANS
Payer ID: ATRIO
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/24/2025

Payer/Name: IOWA MEDICAID SNMIS
Payer ID: SNMIS
Payer Type: 837I
Transaction Type: Claims
Updated ERA:
Updated Claim: X
Last Updated: 9/24/2025

Payer/Name: IOWA MEDICAID SNMIS
Payer ID: SNMIS
Payer Type: 837P
Transaction Type: Claims
Updated ERA:
Updated Claim: X
Last Updated: 9/24/2025

Payer/Name: IOWA MEDICAID SNMIS
Payer ID: SNMIS
Payer Type: 835
Transaction Type: ERA
Updated ERA: X
Updated Claim:
Last Updated: 9/24/2025

9/29/2025

---

Report Generation Delay for CPID 7499 Sentara Health Plans

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

Payer impacted: 

• CPID 7499 Sentara Health Plans

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09708668.

9/29/2025

---

Update: Report Generation Delay for CPIDs 7024 and 9409 Align Senior Care of California

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Aug. 29, 2025.

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

Original notice sent Sept. 9, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Aug. 29, 2025.

Payer impacted: 

• CPID 7024 Align Senior Care of California
• CPID 9409 Align Senior Care of California

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 09677876.

9/29/2025

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Report Generation Delay for CPIDs 2839 and 2960 Hometown Health

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

Payer impacted:

• CPID 2839 Hometown Health
• CPID 2960 Hometown Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09708529.

9/29/2025

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Delay in Electronic Remittance Advice (ERA) for CPIDs 2824, 7551 The Health Plan

Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file date of August 18, 2025:

• CPID 2824 The Health Plan
• CPID 7551 The Health Plan

Additional updates will be forwarded as more information becomes available.

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003298.

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

9/29/2025

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Reminder: Payer Change for CPIDs 3430, 2098 Physicians Medical Group of San Jose

Reminder: Effective October 7, 2025, CPIDs 3430 and 2098 Physicians Medical Group of San Jose will be terminated. Claims sent to CPIDs 3430 and 2098 will be rejected. Providers must begin using CPIDs 4730 and 2940 Optum Care Network before the termination date to avoid claim rejections.

Original notify sent September 9, 2025:

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

Payer Name: Physicians Medical Group of San Jose
Professional CPID: 3430
Professional Edit Master: PE_O007
Institutional CPID: 2098
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: EXC01
Line of Business Code (LOB): HC9

Claims must begin using the following:

Payer Name: Optum Care Network
Professional CPID: 4730
Professional Edit Master: PE_O007
Institutional CPID: 2940
Institutional Edit Master: HE9O007
Payer-assigned Payer ID: OCN01
Line of Business Code (LOB): U3H

CPIDs 3430 and 2098 Physicians Medical Group of San Jose will be terminated effective October 7, 2025.

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 4730, 2940 Optum Care Network do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 4730, 2940 Optum Care Network 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 masters.
• 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.

9/26/2025

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Reminder: Payer Change for CPIDs 3430, 2098 Physicians Medical Group of San Jose

Reminder: Effective October 7, 2025, CPIDs 3430 and 2098 Physicians Medical Group of San Jose will be terminated. Claims sent to CPIDs 3430 and 2098 will be rejected. Providers must begin using CPIDs 4730 and 2940 Optum Care Network before the termination date to avoid claim rejections.

Original notify sent September 9, 2025:                                                                                    

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

Payer Name: Physicians Medical Group of San Jose
Professional CPID: 3430
Institutional CPID: 2098
Payer-assigned Payer ID: EXC01

Claims must begin using the following:

Payer Name: Optum Care Network
Professional CPID: 4730
Institutional CPID: 2940
Payer-assigned Payer ID: OCN01
Claim Fee: N/A

CPIDs 3430 and 2098 Physicians Medical Group of San Jose will be terminated effective October 7, 2025.

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 4730, 2940 Optum Care Network do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 4730, 2940 Optum Care Network 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.

9/26/2025

---

Electronic Claims Connection Suspended

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

Payer Name: Cedars Sinai Medical Center
CPIDs: 6521, 1275
Payer ID: 95164
Reason: Payer unavailable electronically 

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

9/26/2025

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Payer ID Changes for Claim Payers

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

Payer Name: Prospect Medical Systems
Payer ID: IP105, IP056, IP057
NEW PAYER ID: PROSP
Claim Type: Professional

Payer Name: MedStar Family Choice, Inc (MD)
Payer ID: 00243
NEW PAYER ID: RP063
Claim Type: Professional

Payer Name: Imperial Health Holdings Medical Group
Payer ID: 78448
NEW PAYER ID: IHHMG
Claim Type: Institutional

Payer Name: Rehn and Associates
Payer ID: REHNO, REHNA
NEW PAYER ID: REHN
Claim Type: Professional and Institutional 

Please note that Payer IDs IP105, IP056, IP057, 00243, 78448, REHNO, and REHNA will be terminated effective October 17, 2025.

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.

9/26/2025

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Report Generation Delay for CPID 1973 Healthfirst of New York/New Jersey

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

Payer impacted:

• CPID 1973 Healthfirst of New York/New Jersey

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 09700323.

9/26/2025

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Electronic Claims Connection Suspended - Southwest Service Life (37266)

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

Payer Name: Southwest Service Life
Payer ID: 37266
Reason: Payer unavailable electronically 

Action Required: Please refrain from submitting claims electronically until further notice. Claims may be submitted to this payer on paper.

9/26/2025

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Enrollment Form Change

The following payers have changed their Remittance enrollment form: 

• CPID 4282/Payer ID HPSM1/Health Plan of San Mateo
• CPID 5678/Payer ID HPSM1/Health Plan of San Mateo

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

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

9/26/2025

---

UPDATE: Electronic Claims Connection Suspended

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

Is it advised that providers review their Member ID card to make sure that they are sending claims to the correct payer.

Original notification sent July 8, 2025
Effective immediately, the payer listed below has been suspended at Optum for claim processing and removed from the payer list.

Payer Name: Companion Life
CPIDs: 3273, 3989
Payer ID: 37322
Reason: Payer unavailable electronically.

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

9/26/2025

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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: Southwest Service Life
CPIDs: 3244, 3963
Payer ID: 37266
Reason: Payer unavailable electronically 

Action Required: Please refrain from submitting claims electronically until further notice. Claims may be submitted to this payer on paper.

9/26/2025

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New Electronic Claims Connections Available - Fire Department City of New York (FDNYU)

Optum has new electronic claims connections available:

Payer Name: Fire Department City of New York
Payer ID: FDNYU
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: New York

Plans accepted with this connection:

• FDNY World Trade Center Health Plan

Action Required: 

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

9/26/2025

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Electronic Claims Connection Reactivated - Northwestern Medicine Physicians Network (23550)

This payer has been reactivated. Providers may submit claims to this payer.

Payer Name: Northwestern Medicine Physicians Network
Payer ID: 23550
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

9/26/2025

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Report Generation Delay for CPID 1681 International Medical Group

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Sept. 15, 2025.

Payer impacted: 

• CPID 1681 International Medical Group

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 09701840.

9/26/2025

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New Real Time Connections Available on Revenue Performance Advisor

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

20133 – Optimum Healthcare Inc.
85729 – HealthComp West
SB613 – Community Health Plan of Washington (CHPW)

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

23738 – Louisiana Blue Cross Blue Shield
44054 – Govt Employees Hosp Assn (GEHA)
58182 – NaphCare, Inc.
85729 – HealthComp West
PASSE – Summit Community Care
SB613 – Community Health Plan of Washington (CHPW)

9/26/2025

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New Electronic Claims Connections Available on Revenue Performance Advisor

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

Payer ID – Payer name
36481 – Providence Health Plan Powered by Collective Health
61461 – EYLEA4U Commercial Copay Card Program
86083 – Summit Administrators Inc
A0339 – Sonder Health Plans
IHS26 – Network Administrators
M3TPA – M3TPA LLC
NSIPA – Network Solutions IPA
SAMG1 – South Atlantic Medical
UCDMG – UC Davis Medical Group

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

Payer ID – Payer name
36481 – Providence Health Plan Powered by Collective Health
61461– EYLEA4U Commercial Copay Card Program
62350 – Evernorth Care Solutions
86083 – Summit Administrators Inc
A0339 – Sonder Health Plans
DVMC1 – Desert Valley Medical Group
IHS26 – Network Administrators
M3TPA – M3TPA LLC
SAMG1 – South Atlantic Medical
UCDMG – UC Davis Medical Group

9/26/2025

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999 Payer Batch Rejections for CPID 1782 North American Medical Management (NAMM - N. CA)

Professional claims transmitted to the payer listed below from Optum on Sept. 25, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

• CPID 1782 North American Medical Management (NAMM - N. CA)

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

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09614690.

9/26/2025

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Payer Change for Physicians Medical Group of San Jose (EXC01, PMGSJ)

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

Payer Name: Physicians Medical Group of San Jose
Payer-assigned Payer ID: EXC01, PMGSJ

Claims must begin using the following:

Payer Name: Optum Care Network
Payer-assigned Payer ID: OCN01

Payer IDs EXC01 and PMGSJ Physicians Medical Group of San Jose will be terminated effective October 2, 2025.

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for Payer ID OCN01 Optum Care Network do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for Payer ID OCN01 Optum Care Network 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.

9/26/2025

---

Resolved: Claims Rejection Error - Zing Health 83248

Resolved: This issue has been corrected by the trading partner and all affected claims were reprocessed Sept. 18, 2025.

Action Required: None. Please allow time for processing.

Original Notification Sent Sept. 18, 2025:
Due to an external processing issue, claims are rejecting in error for the below payer ID with the following message: Billing Provider NPI isn't registered. Please call Gateway EDI Provider Enrollment at 800.969.3666 x2045.

Payer: Zing Health              
Payer ID: 83248

Additional updates will be forwarded as more information becomes available.

Action Required: None at this time.

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003356.

Action Required: None. Please allow time for processing.

9/25/2025

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Reminder: Payer Change for multiple Cenpatico CPIDs

Reminder: Effective Oct. 29, 2025, providers must begin processing all transactions associated with payer ID 68068, Cenpatico using the following payer information:

Payer name: Cenpatico
Professional CPID: 3706
Institutional CPID: 9026
Remittance Available: Yes
Eligibility payer ID: CENPAT
Claim status payer ID: CENPAT
Payer-assigned Payer ID: 68068

Effective Oct. 29, 2025, the payers listed below will be terminated for claims and remittance.

• CPIDs 4909, 6136 Cenpatico Behavioral Health Arizona
• CPIDs 1630, 2190 Cenpatico Behavioral Health Florida
• CPIDs 3912, 4239 Cenpatico Behavioral Health Georgia
• CPIDs 4663, 6212 Cenpatico Behavioral Health Illinois
• CPIDs 2985, 3236 Cenpatico Behavioral Health Indiana
• CPIDs 3663, 5207 Cenpatico Behavioral Health Kansas
• CPIDs 8959, 3418 Cenpatico Behavioral Health Louisiana
• CPIDs 5638, 6268 Cenpatico Behavioral Health Mississippi
• CPIDs 4692, 6215 Cenpatico Behavioral Health Missouri
• CPIDs 7015, 9297 Cenpatico Behavioral Health Nebraska
• CPIDs 5629, 6263 Cenpatico Behavioral Health New Hampshire
• CPIDs 1660. 2175 Cenpatico Behavioral Health Ohio
• CPIDs 4676, 6205 Cenpatico Behavioral Health South Carolina
• CPIDs 3962, 4746 Cenpatico Behavioral Health Texas
• CPIDs 4927, 3220 Cenpatico Behavioral Health Wisconsin

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for payer ID 68068 do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for payer ID 68068 must complete a new enrollment form for CPIDs 3706, 9026 Cenpatico.
  • New providers must complete a new enrollment form.

Eligibility:

• Payer enrollment for eligibility is not required.

Claim status:

• Payer enrollment for claims status 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.

9/25/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Huron Valley PACE
Institutional CPID: 9634
Professional CPID: 7463
Payer-assigned Payer ID: 54750
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Michigan 

Payer Name: LifeCircles PACE
Institutional CPID: 1037
Professional CPID: 7866
Payer-assigned Payer ID: 71498
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Michigan 

Payer Name: The Cascade PACE, Inc., DBA Thome PACE
Institutional CPID: 7034
Professional CPID: 9418
Payer-assigned Payer ID: RP044
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Michigan 

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. 

9/25/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Huron Valley PACE
Institutional CPID: 9634
Professional CPID: 7463
Payer-assigned Payer ID: 54750
Line of Business (LOB) Code: H2M
Payer Enrollment Required: Yes
Payer Location: Michigan 

Payer Name: LifeCircles PACE
Institutional CPID: 1037
Professional CPID: 7866
Payer-assigned Payer ID: 71498
Line of Business (LOB) Code: H4M
Payer Enrollment Required: Yes
Payer Location: Michigan 

Payer Name: The Cascade PACE, Inc., DBA Thome PACE
Institutional CPID: 7034
Professional CPID: 9418
Payer-assigned Payer ID: RP044
Line of Business (LOB) Code: H07
Payer Enrollment Required: Yes
Payer Location: Michigan 

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. 

9/25/2025

---

Reminder: Payer Change for multiple Cenpatico CPIDs

Reminder: Effective Oct. 29, 2025, providers must begin processing all transactions associated with payer ID 68068, Cenpatico using the following payer information.

Payer name: Cenpatico
Professional CPID: 3706
Professional Edit Master: PE_B800
Institutional CPID: 9026
Institutional Edit Master: HE9B801
RTE Payer ID: CENPAT
Claim status payer ID: CENPAT
Payer-assigned Payer ID: 68068
Line of Business Code (LOB): E04

Effective Oct. 29, 2025, the payers listed below will be terminated for claims and remittance.

• CPIDs 4909, 6136 Cenpatico Behavioral Health Arizona
• CPIDs 1630, 2190 Cenpatico Behavioral Health Florida
• CPIDs 3912, 4239 Cenpatico Behavioral Health Georgia
• CPIDs 4663, 6212 Cenpatico Behavioral Health Illinois
• CPIDs 2985, 3236 Cenpatico Behavioral Health Indiana
• CPIDs 3663, 5207 Cenpatico Behavioral Health Kansas
• CPIDs 8959, 3418 Cenpatico Behavioral Health Louisiana
• CPIDs 5638, 6268 Cenpatico Behavioral Health Mississippi
• CPIDs 4692, 6215 Cenpatico Behavioral Health Missouri
• CPIDs 7015, 9297 Cenpatico Behavioral Health Nebraska
• CPIDs 5629, 6263 Cenpatico Behavioral Health New Hampshire
• CPIDs 1660. 2175 Cenpatico Behavioral Health Ohio
• CPIDs 4676, 6205 Cenpatico Behavioral Health South Carolina
• CPIDs 3962, 4746 Cenpatico Behavioral Health Texas
• CPIDs 4927, 3220 Cenpatico Behavioral Health Wisconsin

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for payer ID 68068 do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for payer ID 68068 must complete a new enrollment form for CPIDs 3706, 9026 Cenpatico.
  • New providers must complete a new enrollment form.

Eligibility:

• Payer enrollment for eligibility is not required.

Claim status:

• Payer enrollment for claims status is not required.

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

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

9/25/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Show Me Health Administrators
Institutional CPID: 9032
Professional CPID: 3722
Payer-assigned Payer ID: 98578
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.

9/25/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: High Desert PACE
Institutional CPID: 9031
Professional CPID: 3717
Payer-assigned Payer ID: R3467
Payer Enrollment Required: No
Secondary Claims Accepted: No
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. 

9/25/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: High Desert PACE
Institutional CPID: 9031
Professional CPID: 3717
Payer-assigned Payer ID: R3467
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California
Claims Fee: $0.10

Action Required: 

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

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

9/25/2025

---

Electronic Claims Connections Available

Please be advised Optum has electronic claims connections available for the below payer:  

Payer Name: Behavioral Health Systems
Professional CPID: 6106
Institutional CPID: 1012
Payer-assigned Payer ID: 63100
Payer Enrollment Required: No
Secondary Claims Accepted: No

Action Required:

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

Action Required by customer:

For assistance with submitting claims transactions, please contact your Practice Management System Vendor or create a Optum Customer Care Hub ticket for assistance.

9/25/2025

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Real Time Eligibility 270/271 Payer ID Change

Effective immediately, please be aware of the following Real Time Eligibility 270/271 payer ID and Name change.

Previous Payer Name: UNION PACIFIC RAILROAD EMPLOYEES HEALTH SYSTEMS
Previous Real Time ID: UPREH
New Payer Name: Iron Railroad Healthcare
New Payer Real Time ID: 87042

Action Required: Please update your system with the new payer ID to avoid interruptions.

9/25/2025

---

New Avenues Electronic Claims Connection No Longer Available

Effective Oct. 1, 2025, the payer listed below will no longer be available at Optum for claims processing. 

Payer Name: New Avenues
Payer ID: 95998
Reason: Payer no longer contracted.  

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

9/25/2025

---

Electronic Routing Change for CPIDs 4799 and 5934 Atrio Health Plans

Effective September 29, 2025, Optum will be changing electronic remittance routing for the following payer:

Payer Name: Atrio Health Plans
Professional CPID: 4799
Institutional CPID: 5934
Payer-assigned Payer ID: ATRIO
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A

Enrollment Requirements:

Remittance:

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

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

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

9/25/2025

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Electronic Routing Change for CPIDs 4799 and 5934 Atrio Health Plans

Effective September 29, 2025, Optum will be changing electronic remittance routing for the following payer:

Payer Name: Atrio Health Plans
Professional CPID: 4799
Institutional CPID: 5934
Payer-assigned Payer ID: ATRIO
Line of Business Code (LOB): U6Y
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.

9/25/2025

---

999 Payer Batch Rejections for CPID 1844 Wellcare Health Plans

Professional claims transmitted to the payer listed below from Optum on Sept. 24, 2025 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 on Sept. 25, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09699922.

9/25/2025

---

UPDATE: Electronic Claims Connection Suspended Northwestern Medicine Physicians Network

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

Payer Name: Northwestern Medicine Physicians Network
Professional CPID: 3229
Current Edit Master: PE_C054
New Edit Master: PE_B800
Institutional CPID: 1918
Current Edit Master: HE9C054
New Edit Master: HE9B801
Payer-assigned Payer ID: 23550
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Original notification sent on 7/9/2025

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

Payer Name: Northwestern Medicine Physicians Network
CPIDs: 1918, 3229
Payer ID: 23550
Reason: Payer unavailable electronically

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

9/25/2025

---

UPDATE: Electronic Claims Connection Suspended Northwestern Medicine Physicians Network

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

Payer Name: Northwestern Medicine Physicians Network
Professional CPID: 3229
Institutional CPID: 1918
Payer-assigned Payer ID: 23550
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: $0.10

Original notification sent on 7/9/2025

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

Payer Name: Northwestern Medicine Physicians Network
CPIDs: 1918, 3229
Payer ID: 23550
Reason: Payer unavailable electronically

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

9/25/2025

---

Duplicate Claims Transmission for Multiple CPIDs, Multiple Payers

Due to a processing issue, Institutional and Professional claims transmitted to the payers listed below Sept. 22, 2025, were inadvertently retransmitted by the payers' intermediary Sept. 22, 2025.

• CPID 5508 Blue Cross Blue Shield of Illinois (00621)
• CPID 1405 Blue Cross Blue Shield of Illinois (00621)
• CPID 1514 Blue Cross Blue Shield of Oklahoma (00840)
• CPID 1403 Blue Cross Blue Shield of Oklahoma (00840)
• CPID 5501 Blue Cross Blue Shield of Texas (84980)
• CPID 1406 Blue Cross Blue Shield of Texas (84980)
• CPID 5565 Blue Cross Blue Shield of New Mexico (00790)
• CPID 7403 Blue Cross Blue Shield of New Mexico (00790)
• CPID 5585 Blue Cross Blue Shield of Montana (00751)
• CPID 7450 Blue Cross Blue Shield of Montana (00751)

According to the payers' intermediary, the duplicate transmission will not affect payment or processing of the claims in the original file.

This duplicate transmission affected claims released to these payers Sept. 22, 2025.

Action Required: Be aware of the processing issue above and of possible invalid duplicate rejections. Please allow the payers time to process the original claims.

If you have any questions, please contact Customer Support.

9/25/2025

---

Report Generation Delay for CPID 1871 Aetna Employee Assistance Program

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Sept. 18, 2025.

Payer impacted:

• CPID 1871 Aetna Employee Assistance 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 09699829.

9/25/2025

---

999 Payer Batch Rejections for CPID 1782 North American Medical Management (NAMM - N. CA)

Professional claims transmitted to the payer listed below from Optum on Sept. 24, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

• CPID 1782 North American Medical Management (NAMM - N. CA)

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

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09614690.

9/24/2025

---

New Avenues Electronic Claims Connection No Longer Available

Effective Oct. 1, 2025, the payer listed below will no longer be available at Optum for claims processing. 

Payer Name: New Avenues
CPIDs: 7714, 9655
Payer-assigned Payer ID: 95998
Reason: Payer no longer contracted.  

Action Required: None. 

9/24/2025

---

New Avenues Electronic Claims Connection No Longer Available

Effective Oct. 1, 2025, the payer listed below will no longer be available at Optum for claims processing. 

Payer Name: New Avenues
CPIDs: 7714, 9655
Payer-assigned Payer ID: 95998
Reason: Payer no longer contracted.  

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

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

9/24/2025

---

Electronic Routing Change for CPIDs 8250 and 3001 Old Surety Life Insurance Company

Effective September 26, 2025, Optum will be changing electronic remittance routing for the following payer:

Payer Name: Old Surety Life Insurance Company
Professional CPID: 8250
Institutional CPID: 3001
Payer-assigned Payer ID: 29237
Line of Business Code (LOB): H9E
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.

9/24/2025

---

Electronic Routing Change for CPIDs 8250 and 3001 Old Surety Life Insurance Company

Effective September 26, 2025, Optum will be changing electronic remittance routing for the following payer:

Payer Name: Old Surety Life Insurance Company
Professional CPID: 8250
Institutional CPID: 3001
Payer-assigned Payer ID: 29237
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A

Enrollment Requirements:

Remittance:

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

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

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

9/24/2025

---

Report Generation Delay for CPID 6671 HealthSun

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

Payer impacted: 

• CPID 6671 HealthSun

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09697478.

9/24/2025

---

999 Payer Batch Rejections for CPID 2997 Central California Alliance for Health

Institutional claims transmitted to the payer listed below from Optum July 17, 2025, July 28, 2025, July 30, 2025 and Aug. 12, 2025 were not processed by the payer due to a 999 Batch Rejection.

• CPID 2997 Central California Alliance for Health

A resolution has been implemented and the claims were retransmitted to the payer Aug. 13, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09686844.

9/24/2025

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835 File Delivery Delay Payer IDs 84146, 84147, 80214

The VA payer has informed Optum that they have identified a delay in producing the 835 file associated with check date 9/15/2025 for payer IDs 84146, 84147, and 80214. The VA is working to resolve the issue but do not have an ETA for resolution at this time. Please hold any research requests specific to missing 835s for this date until the issue is resolved.

9/24/2025

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Remittance Reactivation for CPIDs 2183, 6609 Meritage Medical Network

Optum recently restored and rerouted electronic remittance connectivity for the following payer:

Payer Name: Meritage Medical Network
Professional CPID: 2183
Institutional CPID: 6609
Payer-assigned Payer ID: IP097

Remittance Enrollment Requirements:

• Payer enrollment for electronic remittance is required:
  • Providers who moved their enrollment to another clearinghouse or have not received remittance will need to re-enroll to receive remittance for this payer from Optum (Change Healthcare).
  • 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.

9/23/2025

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Remittance Reactivation for CPIDs 2183, 6609 Meritage Medical Network

Optum recently restored and rerouted electronic remittance connectivity for the following payer:

Payer Name: Meritage Medical Network
Professional CPID: 2183
Institutional CPID: 6609
Payer-assigned Payer ID: IP097
Line of Business (LOB) Code: J9D

Remittance Enrollment Requirements:

• Payer enrollment for electronic remittance is required:
  • Providers who moved their enrollment to another clearinghouse or have not received remittance will need to re-enroll to receive remittance for this payer from Optum (Change Healthcare).
  • 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.

9/23/2025

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Electronic Routing Change for CPIDs 3956 and 4438 Evolutions Healthcare Systems

Effective Sept. 29, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Evolutions Healthcare Systems
Professional CPID: 4438
Institutional CPID: 3956
Payer-assigned Payer ID: 59313
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.

9/23/2025

---

Electronic Routing Change for CPIDs 3956 and 4438 Evolutions Healthcare Systems

Effective Sept. 29, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Evolutions Healthcare Systems
Professional CPID: 4438
Current Edit Master: PE_E049
New Edit Master:PE_T007
Institutional CPID: 3956
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 59313
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.

9/23/2025

---

Report Generation Delay for CPID 1708 Meritain Health

A payer is experiencing issues affecting Professional report generation for some claims submitted Sept. 2, 2025.

Payer impacted:

• CPID 1708 Meritain Health

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09677933.

9/23/2025

---

Report Generation Delay for CPID 9483 HeadsUp Healthcare

A payer is experiencing issues affecting Professional report generation for some claims submitted Sept. 9, 2025-Sept. 11, 2025.

Payer impacted:

• CPID 9483 HeadsUp 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 09689432.

9/23/2025

---

Report Generation Delay for CPID 4768 Health Payment System

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

Payer impacted:

• CPID 4768 Health Payment System

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 09689454.

9/23/2025

---

Report Generation Delay for CPID 7058 Gravie, Inc.

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

Payer impacted:

• CPID 7058 Gravie, Inc.

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09689438.

9/23/2025

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Northwest Administrators Electronic Remittance Connection No Longer Available

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

Payer Name: Northwest Administrators
Remittance CPIDs: 6293, 5652
Remittance LOB: J7M
Payer-assigned Payer ID: NWADM
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

 Action Required: None. 

9/23/2025

---

Northwest Administrators Electronic Remittance Connection No Longer Available

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

Payer Name: Northwest Administrators
Remittance CPIDs: 6293, 5652
Payer-assigned Payer ID: NWADM
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None.

9/23/2025

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

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Sept. 15, 2025.

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09695662.

9/23/2025

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New Payer Edit for CPID 3826

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 September 29, 2025:

• PPRV03A019: MISSING REND PROV TAXONOMY CODE– When the associated Service Line Rendering Provider NPI is entered, the Service Line Rendering Provider Taxonomy Code is required. LOOP 2420A PRV03  

 Edit applies to: 

• CPID 3826 CARESOURCE OF OHIO

Action Required: Please be aware of updated edit requirements.  

9/23/2025

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Childrens Mercy PCN Real Time Eligibility 270/271 Connection Available

Payer Name: Childrens Mercy PCN
IMN Real Time ID: 10906
IEDI Real Time ID: 10906
Exchange Real Time ID: CMRCY
CPID(s): N/A
Payer Enrollment Required: No
Connection Type: X12

Search Options: Eligibility 

• 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.

9/23/2025

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Report Generation Delay for CPID 7264 Quartz ASO

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

Payer impacted: 

• CPID 7264 Quartz ASO

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09695472.

9/23/2025

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999 Payer Batch Rejections for CPID 1844 Wellcare Health Plan

Professional claims transmitted to the payer listed below from Optum on Sept. 22, 2025 were not processed by the payer due to a 999 Batch Rejection. 

• CPID 1844 Wellcare Health Plan

A resolution has been implemented and the claims were retransmitted to the payer on Sept. 23, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09695236.

9/23/2025

---

Electronic Routing Change for CPIDs 8120 and 1092 Group Benefit Service

Effective September 22, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Group Benefit Service  
Professional CPID: 8120
Institutional CPID: 1092
Payer-assigned Payer ID: CB951
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required. 

Report Changes:

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

Action Required: Please 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. 

9/22/2025

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Electronic Routing Change for CPIDs 8120 and 1092 Group Benefit Service

Effective September 22, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Group Benefit Service
Professional CPID: 8120
Current Edit Master: PE_T007
Institutional CPID: 1092
Current Edit Master: HE9T007
Payer-assigned Payer ID: CB951
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required. 

Report Changes:

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

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

• Edit 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. 

9/22/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Franciscan Senior Health & Wellness
Payer ID: FSHW1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Indiana 

Payer Name: Heraya Health
Payer ID: HRYA1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Oregon 

Action Required: 

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

9/22/2025

---

Behavioral Health Systems Eligibility 270/271 Connection Available

Please be advised Optum has the availability of Real-time Eligibility 270/271 for the below payer:

Payer Name: Behavioral Health Systems
Exchange Real Time ID: BHRHS
Payer Enrollment Required: No

Action Required by customer:

For assistance with submitting Real-Time transactions, please contact your Practice Management System Vendor or create a Optum Customer Care Hub ticket for assistance.

9/22/2025

---

Behavioral Health Systems Eligibility 270/271 Connection Available

Please be advised Optum has the availability of Real-time Eligibility 270/271 for the below payer:

Payer Name: Behavioral Health Systems
IMN Real Time ID: 63100
Payer Enrollment Required: No

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

9/22/2025

---

Report Generation Delay for CPID 7595 StandardHealth with Health Choice (HCS)

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Sept. 9, 2025.

Payer impacted:

• CPID 7595 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 09694142.

9/22/2025

---

Electronic Claims Connections Available

Please be advised Optum has electronic claims connections available for the below payer:  

Payer Name: Behavioral Health Systems
Professional CPID: 6106
Institutional CPID: 1012
Payer-assigned Payer ID: 63100
Payer Enrollment Required: No
Secondary Claims Accepted: No

Action Required: 

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

Action Required by customer:
For assistance with submitting claims transactions, please contact your Practice Management System Vendor or create a Optum Customer Care Hub ticket for assistance.

9/22/2025

---

Electronic Claims Connections Available

Please be advised Optum has electronic claims connections available for the below payer:  

Payer Name: Behavioral Health Systems
Professional CPID: 6106
Institutional CPID: 1012
Payer-assigned Payer ID: 63100
Payer Enrollment Required: No
Secondary Claims Accepted: No

Action Required: 

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

Action Required by customer:
For assistance with submitting claims transactions, please contact your Practice Management System Vendor or create a Optum Customer Care Hub ticket for assistance.

9/22/2025

---

Electronic Routing Change for CPID 8125 Fire Department City of New York

Effective Sept. 18, 2025, Optum changed electronic claims routing for the following payer:

Payer Name: Fire Department City of New York
Professional CPID: 8125
Edit Master: PE_T007
Current Payer-assigned Payer ID: 40043
New Payer-assigned Payer ID: FDNYP
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Plans accepted with this connection:

• FDNY World Trade Center Health Plan

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. 

9/22/2025

---

Electronic Routing Change for CPID 8125 Fire Department City of New York

Effective Sept. 22, 2025, Optum is changing electronic claims routing for the following payer:

Payer Name: Fire Department City of New York
Professional CPID: 8125
Current Payer-assigned Payer ID: 40043
New Payer-assigned Payer ID: FDNYP
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No
Claims Fee: N/A

Plans accepted with this connection:

• FDNY World Trade Center Health Plan

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. 

9/22/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Fire Department City of New York
Institutional CPID: 9033
Payer-assigned Payer ID: FDNYU
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: New York
Claims Fee: N/A

Plans accepted with this connection:

• FDNY World Trade Center Health Plan

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.

9/22/2025

---

Report Generation Delay for CPID 5976 Carelon Behavioral Health Maryland

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Sept. 8, 2025.

Payer impacted: 

• CPID 5976 Carelon Behavioral Health Maryland

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09693595.

9/22/2025

---

Electronic Routing Change for CPIDs 3416 and 8957 Optum Care Network - Inland Faculty Medical Group

Effective September 23, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Optum Care Network - Inland Faculty Medical Group
Professional CPID: 3416
Edit Master: PE_T007
Institutional CPID: 8957
Edit Master: HE9T007
Payer-assigned Payer ID: MPM70
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.

9/22/2025

---

Electronic Routing Change for CPIDs 3416 and 8957 Optum Care Network - Inland Faculty Medical Group

Effective September 23, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Optum Care Network - Inland Faculty Medical Group
Professional CPID: 3416
Institutional CPID: 8957
Payer-assigned Payer ID: MPM70
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.

9/22/2025

---

Electronic Routing Change for CPIDs 8852 EMI-KP Ambulance

Effective September 23, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: EMI-KP Ambulance
Professional CPID: 8852
Current Edit Master: PE_O007
New Edit Master: PE_T007
Payer-assigned Payer ID: 59299
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.

9/22/2025

---

Electronic Routing Change for CPIDs 8852 EMI-KP Ambulance

Effective September 23, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: EMI-KP Ambulance|
Professional CPID: 8852
Payer-assigned Payer ID: 59299
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.

9/22/2025

---

New electronic Eligibility and Claim Status connection available - OHIORISE

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 September 16, 2025:

Payer Name: OHIORISE - AETNA BETTER HEALTH OF OHIO
Exchange Real Time ID:OHRISE
CPID(s): 7052, 9435
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber

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

Claim Status Inquiry subscriber

1. 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.

9/19/2025

---

Remit delay

Update: We are actively working with the payer and our internal teams to investigate and identify the source of the processing issue.  

Original notify sent August 29, 2025:
Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for file dates of August 12, 2025-present:

• Payer id 99727 Tricare East Region

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003255.

9/19/2025

---

Payer processing issue

Update: We are actively working with the payer and our internal teams to investigate and identify the source of the processing issue.  

Original notify sent August 29, 2025:
Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for file dates of Aug. 12, 2025-present:

• Payer ID 99726 Tricare West Region

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003261.

9/19/2025

---

Report Generation Delay for CPID 9021 Inspira Health Network Life

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

Payer impacted: 

• CPID 9021 Inspira Health Network Life

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 09692491.

9/19/2025

---

Report Generation Delay for CPID 5607 Century PHO

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

Payer impacted: 

• CPID 5607 Century PHO

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 09692506.

9/19/2025

---

Update: Delay in Electronic Remittance Advice (ERA) for CPIDs 6286,5648, TRICARE WEST REGION

Update: We are actively working with the payer and our internal teams to investigate and identify the source of the processing issue.  

Original notify sent August 29, 2025:
Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for file dates of Aug. 12, 2025-present:

• CPID 6286 Tricare West Region
• CPID 5648 Tricare West Region

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003261.

9/19/2025

---

Update: Delay in Electronic Remittance Advice (ERA) for CPIDs 2872, 5979, TRICARE EAST REGION

Update: We are actively working with the payer and our internal teams to investigate and identify the source of the processing issue.  

Original notify sent August 29, 2025:
Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for file dates of August 12, 2025-present:

• CPID 2872 Tricare East Region
• CPID 5979 Tricare East Region

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003255.

9/19/2025

---

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:

66012 – Blue Cross Community Health Plans
84109 – Pinnacol Assurance
CCIH0 – CorrectCare Integrated Health
MPM10 – Bella Vista Medical Group IPA
R3498 – Sunrise PACE

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.

9/19/2025

---

Report Generation Delay for CPID 1485 Kansas Medicaid

A payer is experiencing issues affecting Professional report generation for some claims submitted Sept. 15, 2025.

Payer impacted:

• CPID 1485 Kansas Medicaid

The payer has been unable to generate and deliver the reports for some claims submitted Sept. 15, 2025.

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

If you have any questions, please contact Customer Support and refer to Case Number 09689897.

9/19/2025

---

Report Generation Delay for CPID 9166 Yale University Health Plan

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

Payer impacted:

• CPID 9166 Yale University 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 09692203.

9/19/2025

---

Electronic Routing Change for CPIDs 7642 and 6861 Pan-American Life Insurance Company

Effective September 22, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Pan-American Life Insurance Company
Professional CPID: 6861
Edit Master: PE_T007
Institutional CPID: 7642
Edit Master: HE9T007
Payer-assigned Payer ID: 04218
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

9/18/2025

---

Electronic Routing Change for CPIDs 7642 and 6861 Pan-American Life Insurance Company

Effective September 22, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Pan-American Life Insurance Company
Professional CPID: 6861
Institutional CPID: 7642
Payer-assigned Payer ID: 04218
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.

9/18/2025

---

Claims Rejection Error - Zing Health 83248

Due to an external processing issue, claims are rejecting in error for the below payer ID with the following message: Billing Provider NPI isn't registered. Please call Gateway EDI Provider Enrollment at 800.969.3666 x2045.

Payer: Zing Health              
Payer ID: 83248

Additional updates will be forwarded as more information becomes available.

Action Required: None at this time.

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003356.

9/18/2025

---

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Sept. 8, 2025.

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

Original notify sent Sept. 11, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Sept. 8, 2025.

Payer impacted:

• CPID 2481 Ohio Medicaid
• CPID 3509 Ohio Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09682688.

9/18/2025

---

Report Generation Delay for CPID 2201 Maryland Medicare

A payer is experiencing issues affecting Professional report generation for some claims submitted since Sept. 9, 2025.

Payer impacted:

• CPID 2201 Maryland Medicare

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 09691157.

9/18/2025

---

PAR status change for Real Time payers

Effective immediately, the PAR status is changing from Gateway (G) to Transitional (T) for the following real time payer(s):

Payer Name: Create
Industry Payer ID: CREA8
Transaction: Eligibility, Claim Status
IEDI Payer ID: CREA8

Payer Name: Essence Healthcare
Industry Payer ID: 20818
Transaction: Eligibility, Claim Status
IEDI Payer ID: ESSNC

Payer Name: American Administrative Services
Industry Payer ID: 59141
Transaction: Eligibility
IEDI Payer ID: 59141

Payer Name: Magnacare
Industry Payer ID: 11303
Transaction: Eligibility
IEDI Payer ID: 10867

Payer Name: Magnacare
Industry Payer ID: 11303
Transaction: Claim Status
IEDI Payer ID: 11303

Payer Name: Mary Washington Health Plan
Industry Payer ID: 83269
Transaction: Eligibility, Claim Status
IEDI Payer ID: 83269

Payer Name: Prominence Health Plan of Nevada
Industry Payer ID: 93082
Transaction: Eligibility, Claim Status
IEDI Payer ID: 93082

Payer Name: Prominence Health Plan of Texas
Industry Payer ID: 80095
Transaction: Eligibility, Claim Status
IEDI Payer ID: 80095

 Payer Name: Prominence Health Plan PPO/HMO
Industry Payer ID: 88029
Transaction: Eligibility, Claim Status
IEDI Payer ID: 88029

Payer Name: Prominence HealthFirst of Florida Inc
Industry Payer ID: 83352
Transaction: Eligibility, Claim Status
IEDI Payer ID: 83352

Payer Name: Stanford Health Care Advantage/ University Health Care Advantage
Industry Payer ID: 46407
Transaction: Eligibility, Claim Status
IEDI Payer ID: 46407

Payer Name: Physicians Health Plan of Michigan Medicare
Industry Payer ID: 83276
Transaction: Eligibility
IEDI Payer ID: 83276

Payer Name: Physicians Health Plan of Michigan
Industry Payer ID: 83276
Transaction: Claim Status
IEDI Payer ID: 11015

Action Required: Please be aware of the upcoming changes.

9/18/2025

---

Consumers Life New Electronic Eligibility Inquiry 270/271 Connection Available

Effective Sept. 15, 2025, Optum is pleased to announce the availability of Real-time Eligibility 270/271 for the below payer:

Payer Name: Consumers Life
Industry Payer ID: 10911
IMN Real Time ID: 10911
Exchange Real Time ID: CSUML
IEDI Real Time ID: 10911
Payer Enrollment Required: No
Connection Type: X12

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

9/18/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: Heraya Health
Professional CPID: 3716
Payer-assigned Payer ID: HRYA1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Oregon
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. 

9/18/2025

---

Electronic Routing Change for CPIDs 6778 and 6674 Common Ground Healthcare Cooperative

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

Payer Name: Common Ground Healthcare Cooperative
Professional CPID: 6778
Institutional CPID: 6674
Payer-assigned Payer ID: 77170
Line of Business Code (LOB): J5A
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. 

9/18/2025

---

Electronic Routing Change for CPIDs 6778 and 6674 Common Ground Healthcare Cooperative

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

Payer Name: Common Ground Healthcare Cooperative
Professional CPID: 6778
Institutional CPID: 6674
Payer-assigned Payer ID: 77170
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A 

Enrollment Requirements
Remittance:

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

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

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

9/18/2025

---

Report Generation Delay for CPID 6273 Lifepath Hospice

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

Payer impacted: 

• CPID 6273 Lifepath Hospice

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 09690602.

9/18/2025

---

Processing Issue - Multiple Payers

This issue has caused a delay in the Professional and Institutional Electronic Remittance Advice (ERA) for the following payers, affecting check dates Sept. 11, 2025-Sept. 15, 2025:

Payer Wellpoint
Payer ID WLPNT

Payer Simply Healthcare
Payer ID SMPLY

Payer Amerigroup
Payer ID 26375

Payer All Anthem States
Payer ID ANTHM

Payer Clear Health Alliance
Payer ID CLEAR

Payer Healthy Blue
Payer ID Multiple

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-000003349.

9/17/2025

---

Report Generation Delay for CPID 5607 Century PHO

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Sept. 3, 2025.

Payer impacted: 

• CPID 5607 Century PHO

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 09689727.

9/17/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Franciscan Senior Health & Wellness
Institutional CPID: 9029
Professional CPID: 3710
Payer-assigned Payer ID: FSHW1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Indiana
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.

9/17/2025

---

Electronic Routing Change for CPIDs 7135 and 8687 Primary Care Associates of California

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

Payer Name: Primary Care Associates of California
Professional CPID: 7135
Institutional CPID: 8687
Payer-assigned Payer ID: PCACZ
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 
Claims Fee: N/A 

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required. 

Report Changes:

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

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

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

9/16/2025

---

Electronic Routing Change for CPIDs 6272 Hispanic Physicians IPA

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

Payer Name: Hispanic Physicians IPA
Professional CPID: 6272
Current Edit Master: PE_B800
New Edit Master: PE_T007
Payer-assigned Payer ID: HPIPA
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required. 

Report Changes:

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

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

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

9/16/2025

---

Update: Report Generation Delay for CPID 1605 Pennsylvania Medicaid Long Term Care

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Sept. 8, 2025.

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

Original notify sent Sept. 12, 2025:

The payer intermediary listed below is experiencing issues affecting Institutional report generation for some claims submitted on Sept. 8, 2025.

Payer impacted:

• CPID 1605 Pennsylvania Medicaid Long Term Care

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 09681918.

9/16/2025

---

Electronic Routing Change for CPIDs 7135 and 8687 Primary Care Associates of California

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

Payer Name: Primary Care Associates of California
Professional CPID: 7135
Current Edit Master: PE_T007
Institutional CPID: 8687
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: PCACZ
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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

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

• Edit 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.

9/16/2025

---

Report Generation Delay for CPID 3937 AgeRight Advantage Health Plan

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

Payer impacted: 

• CPID 3937 AgeRight Advantage Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09687164.

9/16/2025

---

New Electronic Remittance Connections Available - Pinnacol Assurance (84109)
Optum has new electronic remittance connections available:  

Payer Name: Pinnacol Assurance
Payer ID: 84109
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.

9/16/2025

---

Electronic Routing Change for CPID 6272 Hispanic Physicians IPA

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

Payer Name: Hispanic Physicians IPA
Professional CPID: 6272
Payer-assigned Payer ID: HPIPA
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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

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

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

9/16/2025

---

Report Generation Delay for CPID 9563 PruittHealth Premier Medicare Advantage

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Sept. 2, 2025.

Payer impacted: 

• CPID 9563 PruittHealth Premier Medicare Advantage

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 09686948.

9/16/2025

---

Report Generation Delay for CPID 3066 Procare Advantage of Texas

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Sept. 2, 2025.

Payer impacted: 

• CPID 3066 Procare Advantage of Texas

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 09686892.

9/16/2025

---

New Electronic Medical Attachment Connections Available

Optum has new electronic medical attachment connections available:

Payer Name: BLUE CROSS COMMUNITY HEALTH PLANS
Professional CPID: 3498
Institutional CPID: 9020
Payer-assigned Payer ID: 66012
Accepted Attachment Type: Unsolicited
Payer Enrollment Required: No
Payer Location: Illinois

Action Required:

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

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

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

9/16/2025

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New Assurance Attach Assist Medical Attachment Connections Available

Optum has new electronic medical attachment connections available:

Payer Name: Blue Cross Community Health Plans
Professional CPID: 3498
Institutional CPID: 9020
Payer-assigned Payer ID: 66012
Accepted Attachment Type: Unsolicited
Payer Enrollment Required: No
Payer Location: Illinois

Action Required:

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

9/16/2025

---

Report Generation Delay for CPID 5077 Perennial Advantage

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Sept. 2, 2025.

Payer impacted: 

• CPID 5077 Perennial Advantage

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 09686879.

9/16/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Pinnacol Assurance
Professional CPID: 3711
Payer-assigned Payer ID: 84109
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. 

9/16/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Pinnacol Assurance
Professional CPID: 3711
Payer-assigned Payer ID: 84109
Line of Business (LOB) Code: H8W
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. 

9/16/2025

---

Electronic Routing Change for CPIDs 2254 and 7907 Scott & White Health Plan

Effective Sept. 16, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Scott & White Health Plan
Professional CPID: 2254
Current Edit Master: PE_B800
New Edit Master: PE_T007
Institutional CPID: 7907
Current Edit Master: HE9B801
New Edit Master: HE9T007
Payer-assigned Payer ID: 88030
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.

9/15/2025

---

Electronic Routing Change for CPIDs 2254 and 7907 Scott & White Health Plan

Effective Sept. 16, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Scott & White Health Plan
Professional CPID: 2254
Institutional CPID: 7907
Payer-assigned Payer ID: 88030
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.

9/15/2025

---

999 Payer Batch Rejections for CPID 1782 North American Medical Management

Professional claims transmitted to the payer listed below from Optum Sept. 15, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

• CPID 1782 North American Medical Management (NAMM - N. CA)

A resolution has been implemented, and the claims were retransmitted to the payer Sept. 15, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09614690.

9/15/2025

---

Electronic Routing Change for CPIDs 3485 and 9000 Greater Newport IPA

Effective Sept. 15, 2025, Optum is changing electronic claims routing for the following payer: 

Payer Name: Greater Newport IPA
Professional CPID: 3485
Current Edit Master: PE_T007
Institutional CPID: 9000
Current Edit Master: HE9T007
Payer-assigned Payer ID: GNPMG
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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

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

• Edit 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. 

9/15/2025

---

Electronic Routing Change for CPIDs 3485 and 9000 Greater Newport IPA

Effective Sept. 15, 2025, Optum is changing electronic claims routing for the following payer: 

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

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required. 

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

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

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

9/15/2025

---

Payer Processing Issue for CPID 4480 SelectHealth

Due to a payer processing issue, some Professional claims transmitted to the payer listed below on Aug. 25, 2025 and Sept. 3, 2025 were not processed by the payer.

Payer impacted:

• CPID 4480 SelectHealth                                                                              

A resolution has been implemented and the claims were retransmitted to the payer on Sept. 12, 2025.

This delay affected claims released to Optum between 7 p.m. CT on Aug. 22, 2025 - 7 p.m. CT on Aug. 25, 2025 and 7 p.m. CT on Sept. 2, 2025 - 7 p.m. CT on Sept. 3, 2025.

Action Required: Be aware of the processing issue above and of possible invalid duplicate rejections.

If you have any questions, please contact Customer Support and refer to Case Number 09684295.

9/12/2025

---

New Electronic Claims Connections Available on RPA

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

35600 – IN Dept of Health (Children)
49984 – Business Administrators & Consultants
66012 – Blue Cross Community Health Plans
IP083 – Key Medical Group
MOMTM – Momentum TPA
MPM05 –Global Care Medical Group IPA
QCP01 – QualCare IPA
R3482 – Inspira Health Network Life
SBMCO – Staff Benefits Management & Administrators (SBMA)
SCP01 –Southern California Physicians Managed Care Services

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

49984 – Business Administrators & Consultants
35600 – IN Dept of Health (Children)
66012 – Blue Cross Community Health Plans
MOMTM – Momentum TPA
QCP01 – QualCare IPA
R3482 – Inspira Health Network Life
SBMCO– Staff Benefits Management & Administrators (SBMA)

9/12/2025

---

New Electronic Remittance Connection Available on Revenue Performance Advisor

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

• 36481 – Providence Health Plan Powered by Collective 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.

9/12/2025

---

New Payer Name - Greater Newport Physicians MemorialCare

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

Previous Payer Name: Greater Newport Physicians MemorialCare
New Payer Name: MemorialCare Independent Physicians
Payer ID: 33010

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

9/12/2025

---

New Electronic Claims and Remittance Connections Available - Sunrise PACE (R3498)

Optum has new electronic claims and remittance connections available:  

Payer Name: Sunrise PACE
Payer ID: R3498
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Michigan 

Action Required:

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

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

9/12/2025

---

Electronic Routing Change for CPIDs 9180 and 7517 Guarantee Trust Life

Effective Sept. 12, 2025, Optum is changing electronic remittance routing for the following payer: 

Payer Name: Guarantee Trust Life
Professional CPID: 9180
Institutional CPID: 7517
Payer-assigned Payer ID: 36117
Line of Business Code (LOB): K57
Payer Remittance Enrollment Required: Yes/No 

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. 

9/12/2025

---

Electronic Routing Change for CPIDs 9180 and 7517 Guarantee Trust Life

Effective Sept. 12, 2025, Optum is changing electronic remittance routing for the following payer: 

Payer Name: Guarantee Trust Life
Professional CPID: 9180
Institutional CPID: 7517
Payer-assigned Payer ID: 36117
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A 

Enrollment Requirements
Remittance:

• Payer enrollment for electronic remittance is required. 
• Providers currently receiving electronic remittance through Optum 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. 

9/12/2025

---

Report Generation Delay for CPID 1605 Pennsylvania Medicaid Long Term Care

The payer intermediary listed below is experiencing issues affecting Institutional report generation for some claims submitted Sept. 8, 2025.

Payer impacted:

• CPID 1605 Pennsylvania Medicaid Long Term Care

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 09681918.

9/12/2025

---

New Payer Name - Greater Newport Physicians MemorialCare

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

Previous Payer Name: Greater Newport Physicians MemorialCare
New Payer Name: MemorialCare Independent Physicians (formerly known as Greater Newport Physicians)
Professional CPID: 5845
Institutional CPID: 7594

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

9/12/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Blue Cross Community Health Plans
Payer ID: 66012
Payer Enrollment Required: Yes
Payer Location: Illinois 

Payer Name: Nassau Life Insurance Company of Kansas
Payer ID: 68284
Payer Enrollment Required: Yes
Payer Location: Kansas

Payer Name: The Macaluso Group
Payer ID: 82694
Payer Enrollment Required: Yes 

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.

9/11/2025

---

Report Generation Delay for CPIDs 2481 and 3509 Ohio Medicaid

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Sept. 8, 2025.

Payer impacted:

• CPID 2481 Ohio Medicaid
• CPID 3509 Ohio Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09682688.

9/11/2025

---

999 Payer Batch Rejections for CPID 1782 North American Medical Management

Professional claims transmitted to the payer listed below from Optum Sept. 11, 2025 were not processed by the payer due to a 999 Batch Rejection.

Payer impacted:

• CPID 1782 North American Medical Management (NAMM - N. CA)

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

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09614690.

9/11/2025

---

Masters, Mates and Pilots Electronic Claims No Longer Available

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

Payer Name: Masters, Mates and Pilots
Claims CPIDs: 3476, 4936
Payer-assigned Payer ID: MMPHB
Reason: Payer no longer offers an electronic connection.

Payer will no longer accept paper claims.

Action Required: Payer no longer accepts paper nor electronic. 

9/11/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Blue Cross Community Health Plans
Institutional CPID: 9020
Professional CPID: 3498
Payer-assigned Payer ID: 66012
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Illinois 

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. 

9/11/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Blue Cross Community Health Plans
Institutional CPID: 9020
Professional CPID: 3498
Payer-assigned Payer ID: 66012
Line of Business (LOB) Code: H7S
Payer Enrollment Required: Yes
Payer Location: Illinois 

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.

9/11/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Nassau Life Insurance Company of Kansas
Professional CPID: 3709
Payer-assigned Payer ID: 68284
Line of Business (LOB) Code: H78
Payer Enrollment Required: Yes
Payer Location: Kansas 

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. 

9/11/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: Nassau Life Insurance Company of Kansas
Professional CPID: 3709
Payer-assigned Payer ID: 68284
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Kansas

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. 

9/11/2025

---

Remittance Reactivation for CPIDs 1273, 6517 The Macaluso Group

Optum recently restored and rerouted electronic remittance connectivity for the following payer:

Payer Name: The Macaluso Group
Professional CPID: 1273
Institutional CPID: 6517
Payer-assigned Payer ID: 82694
Line of Business (LOB) Code: J9U

Remittance Enrollment Requirements:

• Payer enrollment for electronic remittance is required:
  • All 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.

9/11/2025

---

Remittance Reactivation for CPIDs 1273, 6517 The Macaluso Group

Optum recently restored and rerouted electronic remittance connectivity for the following payer:

Payer Name: The Macaluso Group
Professional CPID: 1273
Institutional CPID: 6517
Payer-assigned Payer ID: 82694

Remittance Enrollment Requirements:

• Payer enrollment for electronic remittance is required:
  • All 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.

9/11/2025

---

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted on Aug. 14, 2025 and Aug. 22, 2025.

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

Original notify sent Sept. 2, 2025:

Due to a payer processing issue, some Professional and Institutional claims transmitted to the payer listed below since July 31, 2025 were not processed by the payer.

Payer(s) impacted:

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

Optum is working with the payer to resolve this processing issue. We will notify you once this issue has been resolved.

This delay affected claims released to Optum since 5 a.m. CT on July 30, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09668606.

9/10/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Evernorth Care Solutions
Payer ID: 62350
Payer Enrollment Required: Yes
Payer Location: National

Payer Name: CorrectCare Integrated Health
Payer ID: CCIH0
Payer Enrollment Required: Yes

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.

9/10/2025

---

Electronic Routing Change for Multiple Payers

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

Payer Name: Global Care Medical Group IPA
Professional CPID: 5870
Institutional CPID: 8692
Payer-assigned Payer ID: MPM05
Line of Business Code (LOB): H8B
Payer Remittance Enrollment Required: Yes

Payer Name: Bella Vista Medical Group
Professional CPID: 5874
Institutional CPID: 8688
Payer-assigned Payer ID: MPM10
Line of Business Code (LOB): H6E
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.

9/10/2025

---

Electronic Routing Change for Multiple Payers

Effective immediately, Optum is changing electronic remittance routing for the following payers:

Payer Name: Global Care Medical Group IPA
Professional CPID: 5870
Institutional CPID: 8692
Payer-assigned Payer ID: MPM05
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A

Payer Name: Bella Vista Medical Group
Professional CPID: 5874
Institutional CPID: 8688
Payer-assigned Payer ID: MPM10
Payer Remittance Enrollment Required: Yes
Remittance Fee: N/A

Enrollment Requirements
Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum 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.

9/10/2025

---

WellMed New Electronic Claim Status Inquiry 276/277 Connection Available

Optum is pleased to announce the availability of Real-time Claim Status Inquiry 276/277 for the below payer, effective Sept. 5 2025.

Payer Name: WellMed
Industry Payer ID: WELM2
IMN Real Time ID: WELM2
Exchange Real Time ID: WLMED
Payer Enrollment Required: No
Connection Type: X12

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

9/10/2025

---

Report Generation Delay for CPID 2930 Health Choice Arizona

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Sept. 1, 2025.

Payer impacted:

• CPID 2930 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 09680309.

9/10/2025

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Electronic Routing Change for CPID 6707 OLOLRMC Uninsured Patient Services Program

Effective September 10, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: OLOLRMC Uninsured Patient Services Program
Professional CPID: 6707
Edit Master: PE_T007
Payer-assigned Payer ID: OLRMC
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.

9/10/2025

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Electronic Routing Change for CPID 6707 OLOLRMC Uninsured Patient Services Program

Effective Sept. 10, 2025, Optum is changing electronic claims routing for the following payer:

Payer Name: OLOLRMC Uninsured Patient Services Program
Professional CPID: 6707
Payer-assigned Payer ID: OLRMC
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.

9/10/2025

---

Remittance Reactivation for CPIDs 5862, 3658 CorrectCare Integrated Health

Optum recently restored electronic remittance connectivity for the following payer: 

Payer Name: CorrectCare Integrated Health
Professional CPID: 5862
Institutional CPID: 3658
Payer-assigned Payer ID: CCIH0 

Remittance Enrollment Requirements:

• Payer enrollment for electronic remittance is required: 
• Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum. 

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. 

9/10/2025

---

Remittance Reactivation for CPIDs 5862, 3658 CorrectCare Integrated Health

Optum recently restored electronic remittance connectivity for the following payer: 

Payer Name: CorrectCare Integrated Health
Professional CPID: 5862
Institutional CPID: 3658
Payer-assigned Payer ID: CCIH0
Line of Business (LOB) Code: U9A 

Remittance Enrollment Requirements:

• Payer enrollment for electronic remittance is required: 
• Enrollment forms must be submitted and approved to begin receiving electronic remittance through Optum. 

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.

9/10/2025

---

Invalid Error Message for CPID 4752 Cook Childrens STAR Plan

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

Reject Code:    A6^145^85

Message:           ^ENTITY'S SPECIALTY CODE, ENTITY'S SPECIALTY, TAXONOMY CODE.^BILLING PROVIDER    BILLING PROVIDER TAXONOMY CODE MISSING. REQUIRED BY PAYER.

Payer impacted:

• CPID 4752 Cook Childrens STAR Plan

This issue affected claims sent to the payer since Sept. 2, 2025.

Affected claims were retransmitted to the payer on Sept. 9, 2025.

Action Required: Please be aware of the invalid error message and possible valid duplicate rejections.

If you have any questions, please contact Customer Support and refer to Case Number 09677972.

9/10/2025

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Electronic Routing Change for CPIDs 2482 and 9687 Cox Health Plan

Effective September 09, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Cox Health Plan
Professional CPID: 2482
Current Edit Master: PE_T007
Institutional CPID: 9687
Current Edit Master: HE9T007
Payer-assigned Payer ID: 00019
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes 

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required. 

Report Changes:

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

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

• Edit 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. 

9/9/2025

---

Electronic Routing Change for CPIDs 2482 and 9687 Cox Health Plan

Effective September 09, 2025, Optum will be changing electronic claims routing for the following payer: 

Payer Name: Cox Health Plan
Professional CPID: 2482
Institutional CPID: 9687
Payer-assigned Payer ID: 00019
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A 

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required. 

Report Changes:

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

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

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

9/9/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Evernorth Care Solutions
Professional CPID: 2789
Payer-assigned Payer ID: 62350
Line of Business (LOB) Code: E15
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.

9/9/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Evernorth Care Solutions
Professional CPID: 2789
Payer-assigned Payer ID: 62350
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.

9/9/2025

---

Payer Change for Physicians Medical Group of San Jose (EXC01, PMGSJ)

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

Payer Name: Physicians Medical Group of San Jose
Payer-assigned Payer ID: EXC01, PMGSJ

Claims must begin using the following:

Payer Name: Optum Care Network
Payer-assigned Payer ID: OCN01

Payer IDs EXC01 and PMGSJ Physicians Medical Group of San Jose will be terminated Oct. 2, 2025.

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for Payer ID OCN01 Optum Care Network do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for Payer ID OCN01 Optum Care Network 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.

9/9/2025

---

Update: Report Generation Delay for CPIDs 7567 and 7499 Sentara Health Plans

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Aug. 21, 2025-Aug. 26, 2025.

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

Original notify sent Aug. 25, 2025:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Aug. 12, 2025.

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09658095.

9/9/2025

---

Payer Change for CPIDs 3430, 2098 Physicians Medical Group of San Jose

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

Payer Name: Physicians Medical Group of San Jose
Professional CPID: 3430
Institutional CPID: 2098
Payer-assigned Payer ID: EXC01

Claims must begin using the following:

Payer Name: Optum Care Network
Professional CPID: 4730
Institutional CPID: 2940
Payer-assigned Payer ID: OCN01
Claim Fee: N/A

CPIDs 3430 and 2098 Physicians Medical Group of San Jose will be terminated effective October 7, 2025.

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 4730, 2940 Optum Care Network do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 4730, 2940 Optum Care Network 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

9/9/2025

---

Payer Change for CPIDs 3430, 2098 Physicians Medical Group of San Jose

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

Payer Name: Physicians Medical Group of San Jose
Professional CPID: 3430
Professional Edit Master: PE_O007
Institutional CPID: 2098
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: EXC01
Line of Business Code (LOB): HC9

 Claims must begin using the following:

Payer Name: Optum Care Network
Professional CPID: 4730
Professional Edit Master: PE_O007
Institutional CPID: 2940
Institutional Edit Master: HE9O007
Payer-assigned Payer ID: OCN01
Line of Business Code (LOB): U3H

CPIDs 3430 and 2098 Physicians Medical Group of San Jose will be terminated effective October 7, 2025.

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 4730, 2940 Optum Care Network do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 4730, 2940 Optum Care Network 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 masters.
• 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.

9/9/2025

---

Report Generation Delay for CPID 1928 Medical Associates Health Plan

The payer listed below is experiencing issues affecting Institutional report generation for some claims submitted on Sept. 2, 2025.

Payer impacted: 

• CPID 1928 Medical Associates 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 09678140.

9/9/2025

---

Report Generation Delay for CPID 1681 International Medical Group

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Sept. 1, 2025.

Payer impacted: 

• CPID 1681 International Medical Group

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 09678102.

9/9/2025

---

Report Generation Delay for CPID 5428 QualChoice of Arkansas

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Sept. 1, 2025.

Payer impacted: 

• CPID 5428 QualChoice of Arkansas

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09678069.

9/9/2025

---

Payer Processing Issue for CPID 7110 Community Health Group

Due to a payer processing issue, some Professional claims transmitted to the payer listed below Aug. 28, 2025 were not processed by the payer.

Payer impacted:

• CPID 7110 Community Health Group

Optum is working with the payer to resolve this processing issue. We will notify you once this issue has been resolved.

This delay affected claims released to Optum Aug. 27, 2025, 5:00 p.m.-Aug. 28, 2025, 5:00 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 09677872.

9/9/2025

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New Payer edit for CPID 6031 Three Rivers Preferred

The payer below has informed Optum of a new edit requirement effective immediately. In order to meet the new requirement, we will add the following edit Sept. 15, 2025: 

• ISBR03A003: MISSING SUBSCRIBER GROUP NUMBER- The Active Subscriber Policy or Group Number is required.

Exception: When the CPID is 8561 and the Active Subscriber Group Name is present, this requirement does not apply.

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

LOOP 2000B SBR03

Edit applies to: 

• CPID 6031 THREE RIVERS PREFERRED

Action Required: Please be aware of updated edit requirements.  

9/92025

---

Report Generation Delay for CPID 3061 Align Senior Care of Michigan

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted since Aug. 29, 2025.

Payer impacted: 

• CPID 3061 Align Senior Care of Michigan

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 09677921.

9/9/2025

---

Report Generation Delay for CPIDs 7024 and 9409 Align Senior Care of California

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

Payer impacted: 

• CPID 7024 Align Senior Care of California
• CPID 9409 Align Senior Care of California

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 09677876.

9/9/2025

---

Report Generation Delay for CPID 6671 HealthSun

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

Payer impacted:

• CPID 6671 HealthSun

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09677864.

9/9/2025

---

Report Generation Delay for CPIDs 8764 and 4036 Emanate Health IPA

A payer is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Sept. 1, 2025.

Payer impacted:

• CPID 8764 Emanate Health IPA
• CPID 4036 Emanate Health IPA

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 09676236.

9/8/2025

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Electronic Routing Change for CPIDs 8831 and 4089 Valley Presbyterian Hospital Community Family Care

Effective September 09, 2025. Optum will be changing electronic claims routing for the following payer: 

Payer Name: Valley Presbyterian Hospital Community Family Care
Professional CPID: 8831
Institutional CPID: 4089
Payer-assigned Payer ID: MPM61
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 are receiving. 

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

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

9/8/2025

---

Luther Care Electronic Claims Connection No Longer Available

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

Payer Name: Luther Care
Claims CPIDs: 1278, 6524
Payer-assigned Payer ID: CB212
Reason: Payer no longer offers an electronic connection to which Optum can connect. 

Action Required: None. 

9/8/2025

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:  

Payer Name: Sunrise PACE
Institutional CPID: 9028
Professional CPID: 3708
Payer-assigned Payer ID: R3498
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Michigan
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. 

9/8/2025

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:  

Payer Name: Sunrise PACE
Institutional CPID: 9028
Professional CPID: 3708
Payer-assigned Payer ID: R3498
Line of Business(LOB) Code: H16
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Michigan 

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. 

9/8/2025

---

Electronic Routing Change for CPIDs 8831 and 4089 Valley Presbyterian Hospital Community Family Care

Effective Sept. 9, 2025. Optum will be changing electronic claims routing for the following payer: 

Payer Name: Valley Presbyterian Hospital Community Family Care
Professional CPID: 8831
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 4089
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: MPM61
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 are receiving.

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

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

9/8/2025

---

Update: Report Generation Delay for CPID 2824 The Health Plan of West Virginia, Inc

Update: The payer has been unable to generate and deliver the reports for some claims submitted Aug. 14, 2025-Aug. 15, 2025.

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

Original notify sent Aug. 25, 2025:
A payer is experiencing issues affecting Professional report generation for some claims submitted since Aug. 14, 2025.

Payer impacted:

• CPID 2824 The Health Plan of West Virginia, Inc

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09657994.

9/5/2025

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Electronic Routing Change for CPIDs 3295 and 8651 Cedars Sinai Medical Network
Effective Sept. 9, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Cedars Sinai Medical Network
Professional CPID: 3295
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 8651
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: 95166
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.

9/5/2025

---

Electronic Routing Change for CPIDs 3295 and 8651 Cedars Sinai Medical Network

Effective Sept. 9, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Cedars Sinai Medical Network
Professional CPID: 3295
Institutional CPID: 8651
Payer-assigned Payer ID: 95166
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.

9/5/2025

---

Payer Change for Eastpointe Human Services (08044)

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

Payer Name: Eastpointe Human Services
Payer ID: 08044 

Payer Name: Eastpointe Human Services DOS after June 30, 2023
Payer ID: 08044 

Claims sent on or after Sept. 4, 2025, must begin using the following:

Payer Name: Trillium Health Resources
Payer-assigned Payer ID: 56089

Payer ID 08044 Eastpointe Human Services will be terminated immediately.  

Enrollment Requirements

Claims:

• Payer enrollment for electronic claims is not required. 

Remittance:

• Payer enrollment for electronic remittance is required. 
• Providers currently receiving electronic remittance through Optum for Payer ID 56089 Trillium Health Resources do not need to complete a new enrollment form.  
• Providers not receiving electronic remittance through Optum for Payer ID 56089 Trillium Health Resources 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 payer IDs. 
• To access the new enrollment forms, please visit IEDI Portal. 

9/5/2025

---

Electronic Routing Change for CPIDs 4253 and 2979 Prominence Administrative Services

Effective Sept. 8, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Prominence Administrative Services
Professional CPID: 4253
Current Edit Master: PE_B800
New Edit Master: PE_T007
Institutional CPID: 2979
Current Edit Master: HE9B801
New Edit Master: HE9T007
Payer-assigned Payer ID: 88022
Payer Claim Enrollment Required: No
Secondary Claims Accepted: No

Enrollment Requirements

Claims:

• Payer enrollment for electronic claims is not required.

Report Changes

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

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

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

9/5/2025

---

Electronic Routing Change for CPIDs 4253 and 2979 Prominence Administrative Services

Effective Sept. 8, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Prominence Administrative Services
Professional CPID: 4253
Institutional CPID: 2979
Payer-assigned Payer ID: 88022
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.

9/5/2025

---

New Electronic Claims Connections Available - Network Administrators (IHS26)

Optum has new electronic claims connections available:  

Payer Name: Network Administrators
Payer ID: IHS26
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National  

Action Required:   

• Add the payer 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. 

9/5/2025

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Payer ID Change - Total Senior Care

Effective immediately, please be aware of the following payer ID change for claims:

Payer name: Total Senior Care
Previous Payer ID: 12268
New Payer ID: R3474

Action Required: Please update your system with the new payer ID to avoid interruptions.

9/5/2025

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Report Generation Delay for Multiple CPIDs

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

Payers impacted:

• CPID 1865 Multiplan New Orleans Division
• CPID 8556 Multiplan New Orleans Division
• CPID 6482 Associates for Healthcare, Inc
• CPID 4592 Associates for Healthcare, Inc
• CPID 3899 Health Care Network of WI (HCN)
• CPID 4571 Health Care Network of WI (HCN)
• CPID 3823 WI Preferred Provider Network (WPPN)
• CPID 2971 WI Preferred Provider Network (WPPN)

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 09673957.

9/5/2025

---

Report Generation Delay for Multiple CPIDs

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted Aug. 21, 2025.

Payer impacted:

• CPID 3963 Southwest Service Life 
• CPID 3244 Southwest Service Life

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 09673837.

9/5/2025

---

Report Generation Delay for Multiple CPIDs

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

Payers impacted:

• CPID 8639 County Medical Services Program
• CPID 2409 Emergency Medical Services Fund
• CPID 8856 Alta Med Clinics (HPMC - AMC)
• CPID 2552 Preferred IPA (HPMC - PMG)
• CPID 8701 San Judas IPA (HPMC - SJM)
• CPID 7223 County Medical Services Program
• CPID 7640 Orange County Health Care Agency
• CPID 7237 Seoul Medical Group

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 09673672.

9/5/2025

---

Report Generation Delay for CPID 6195 Superior Vision Services

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

Payer impacted: 

• CPID 6195 Superior Vision 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 09673599.

9/5/2025

---

Payer Change for CPIDs 6427, 5662, 1771, 1990 Eastpointe Human Services

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

Payer Name: Eastpointe Human Services
Professional CPID: 6427
Professional Edit Master: PE_T007
Institutional CPID: 5662
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: 08044 

Payer Name: Eastpointe Human Services DOS after 06/30/2023
Professional CPID: 1771
Professional Edit Master: PE_C051
Institutional CPID: 1990
Institutional Edit Master: HE9C051
Payer-assigned Payer ID: 08044 

Claims sent on or after September 4, 2025, must begin using the following:

Payer Name: Trillium Health Resources
Professional CPID: 6284
Professional Edit Master: PE_E049
Institutional CPID: 5658
Institutional Edit Master: HE9E049
Payer-assigned Payer ID: 56089
Line of Business Code (LOB): U7W 

CPIDs 6427, 5662, 1771, and 1990 Eastpointe Human Services will be terminated immediately.  

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 6284, 5658 Trillium Health Resources do not need to complete a new enrollment form.  
• Providers not receiving electronic remittance through Optum for CPIDs 6284, 5658 Trillium Health Resources 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. 

9/4/2025

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Payer Change for CPIDs 6427, 5662, 1771, 1990 Eastpointe Human Services

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

Payer Name: Eastpointe Human Services
Professional CPID: 6427
Institutional CPID: 5662
Remittance Available: No
Payer-assigned Payer ID: 08044 

Payer Name: Eastpointe Human Services DOS after 06/30/2023
Professional CPID: 1771
Institutional CPID: 1990
Remittance Available: No
Payer-assigned Payer ID: 08044 

Claims sent on or after September 4, 2025 must begin using the following:

Payer Name: Trillium Health Resources
Professional CPID: 6284
Institutional CPID: 5658
Remittance Available: Yes
Payer-assigned Payer ID: 56089
Claim Fee: N/A 

CPIDs 6427, 5662, 1771, and 1990 Eastpointe Human Services will be terminated immediately.  

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 6284, 5658 Trillium Health Resources do not need to complete a new enrollment form.  
• Providers not receiving electronic remittance through Optum for CPIDs 6284, 5658 Trillium Health Resources 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.

9/4/2025

---

Electronic Routing Change for CPIDs 7028 and 9412 Leon Health Plans

Effective Sept. 8, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Leon Health Plans
Professional CPID: 9412
Current Edit Master: PE_B800
New Edit Master:PE_T007
Institutional CPID: 7028
Current Edit Master: HE9B801
New Edit Master: HE9T007
Payer-assigned Payer ID: A3565
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.

9/4/2025

---

Electronic Routing Change for CPIDs 7028 and 9412 Leon Health Plans

Effective Sept. 8, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Leon Health Plans
Professional CPID: 9412
Institutional CPID: 7028
Payer-assigned Payer ID: A3565
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.

9/4/2025

---

Electronic Routing Change for CPID 8052 Medcore HP

Effective Sept. 4, 2025, Optum is changing electronic claims routing for the following payer:

Payer Name: Medcore HP
Institutional CPID: 8052
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: 31057
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

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

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

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

9/4/2025

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Electronic Routing Change for CPID 8052 Medcore HP

Effective Sept. 4, 2025, Optum is changing electronic claims routing for the following payer:

Payer Name: Medcore HP
Institutional CPID: 8052
Payer-assigned Payer ID: 31057
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements
Claims:

• Payer enrollment for electronic claims is not required.

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

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

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

9/4/2025

---

Report Generation Delay for CPID 7543 UPMC Health Plan

The payer listed below is experiencing issues affecting Institutional report generation for some claims submitted Aug. 27, 2025.

Payers 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 09670311.

9/3/2025

---

Report Generation Delay for CPID 8861 Aetna Better Health of Illinois - Medicaid

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted between Aug. 22, 2025 and Aug. 25, 2025.

Payer impacted:

• CPID 8861 Aetna Better Health of Illinois - 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 09670043.

9/3/2025

---

Electronic Routing Change for CPIDs 3256 and 2995 Sentinel Management Services

Effective Sept. 4, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Sentinel Management Services
Professional CPID: 3256
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 2995
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 23249
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. 

9/3/2025

---

Electronic Routing Change for CPIDs 3256 and 2995 Sentinel Management Services

Effective Sept. 4, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Sentinel Management Services
Professional CPID: 3256
Institutional CPID: 2995
Payer-assigned Payer ID: 23249
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. 

9/3/2025

---

Electronic Routing Change for CPID 6246 Riverside Medical Clinic

Effective Sept. 3, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Riverside Medical Clinic
Professional CPID: 6246
Payer-assigned Payer ID: RMC01
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. 

9/3/2025

---

Electronic Routing Change for CPID 6246 Riverside Medical Clinic

Effective Sept. 3, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: Riverside Medical Clinic
Professional CPID: 6246
Current Edit Master: PE_B800
New Edit Master: PE_T007
Payer-assigned Payer ID: RMC01
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. 

9/3/2025

---

Electronic Routing Change for CPIDs 1122 and 1550 South Atlantic Medical Group

Effective Sept. 3, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: South Atlantic Medical Group
Professional CPID: 1122
Current Edit Master: PE_O007
New Edit Master: PE_T007
Institutional CPID: 1550
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: SAMG1
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. 

9/3/2025

---

Electronic Routing Change for CPIDs 1122 and 1550 South Atlantic Medical Group

Effective Sept. 3, 2025, Optum is changing electronic claims routing for the following payer:

Payer Name: South Atlantic Medical Group
Professional CPID: 1122
Institutional CPID: 1550
Payer-assigned Payer ID: SAMG1
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.  

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. 

9/3/2025

---

Report Generation Delay for CPID 3532 Blue Care Network of Michigan

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Aug. 27, 2025.

Payer impacted: 

• CPID 3532 Blue Care Network of Michigan

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 09669780.

9/3/2025

---

Report Generation Delay for CPID 9133 Healthy Blue North Carolina

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

Payer impacted: 

• CPID 9133 Healthy Blue North Carolina

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 09669523.

9/3/2025

---

Electronic Routing Change for CPIDs 5854 and 1656 FirstCare STAR Medicaid 

MCO/FirstCare & FirstCare Advantage HMO

Effective September 3, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: FirstCare STAR Medicaid MCO/FirstCare & FirstCare Advantage HMO
Professional CPID: 5854
Edit Master: PE_T007
Institutional CPID: 1656
Edit Master: HE9T007
Payer-assigned Payer ID: 94998
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Report Changes:

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

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

• Edit 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.

9/3/2025

---

Electronic Routing Change for CPIDs 5854 and 1656 FirstCare STAR Medicaid 

MCO/FirstCare & FirstCare Advantage HMO

Effective September 3, 2025, Optum will be changing electronic claims routing for the following payer:

Payer Name: FirstCare STAR Medicaid MCO/FirstCare & FirstCare Advantage HMO
Professional CPID: 5854
Institutional CPID: 1656
Payer-assigned Payer ID: 94998
Payer Claim Enrollment Required: No
Secondary Claims Accepted: Yes
Claims Fee: N/A

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Report Changes:

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

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

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

9/3/2025

---

Eligibility payer termination

Effective September 12, Real Time Eligibility 270/271 and Claim Status 276/277 for the payer listed below will no longer be available at Optum.

Payer Name:  Banner University Family Care
Industry Payer ID: 66901
IMN Real Time ID: 66901
Exchange Real Time ID: BUFCR
CPID(s): 6548 / 1290
Optum IEDI Real Time ID: 66901
Connection Type: X12

Reason: Payer no longer offers an electronic connection

Action Required by customer:

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

9/2/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name: Network Administrators
Institutional CPID: 9017
Professional CPID: 3493
Payer-assigned Payer ID: IHS26
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National
Claims Fee: N/A 

Action Required: 

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

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

9/2/2025

---

Payer ID Change CPID 8288 Total Senior Care

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

Payer name: Total Senior Care
Professional CPID: 8288
Professional Edit Master: PE_T007
Institutional CPID: 3037
Institutional Edit Master: HE9T007
Previous Payer ID: 12268
New Payer ID: R3474

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

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

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

9/2/2025

---

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

Due to a payer processing issue, some Professional and Institutional claims transmitted to the payer listed below since July 31, 2025 were not processed by the payer.

Payer(s) impacted:

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

Optum is working with the payer to resolve this processing issue. We will notify you once this issue has been resolved.

This delay affected claims released to Optum since 5 a.m. CT on July 30, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09668606.

9/2/2025

---

Report Generation Delay for CPID 1564 Hill Physicians Medical Group

A payer is experiencing issues affecting Institutional report generation for some claims submitted on Aug. 14, 2025.

Payer impacted:

• CPID 1564 Hill Physicians Medical Group

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 09668499.

9/2/2025

Delay in Electronic Remittance Advice (ERA) for Payer ID 99727 Tricare East

Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for file dates of August 12, 2025-present:

• Payer ID 99727 Tricare East Region

Additional updates will be forwarded as more information becomes available.

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000003255.

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

9/2/2025

---

Update: Report Generation Delay for Multiple CPIDs

Update: The intermediary payer has been unable to generate and deliver the reports for some claims submitted from July 31, 2025 to Aug. 12, 2025.

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

Original notify sent Aug. 21, 2025:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted between July 31, 2025 and Aug. 12, 2025.

Payers impacted:

• CPID 7765 Access Community Health Network
• CPID 1893 American Health Resources
• CPID 6135 Avesis TPA
• CPID 3400 Community Care Health (CCH)
• CPID 4471 Connecticare Medicare
• CPID 6440 Connecticare, Inc.
• CPID 2482 Cox HealthPlan
• CPID 1819 Diversified Benefit Administrators
• CPID 1896 EmblemHealth Insurance Company
• CPID 2744 EmblemHealth Plan, Inc. (MCR)
• CPID 6776 Eyequest
• CPID 9196 Global Medical Management (GMMI)
• CPID 6798 HCC Life Insurance Company
• CPID 2105 Health Sun
• CPID 1709 Horizon NJ Health
• CPID 7790 Iowa Screening Programs
• CPID 9222 Massachusetts Behavioral Health Partnership
• CPID 2475 Monarch IPA
• CPID 9197 New York Medical Indemnity Fund
• CPID 2828 OSU Centene Oklahoma Complete Health
• CPID 6763 OSU SoonerCare
• CPID 1763 Parkland Community Healthplan
• CPID 9198 Primary Care Coalition
• CPID 1715 VitalCore Millette
• CPID 8440 Vytra Healthcare
• CPID 6804 Western Oregon Advanced Health CCO

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 09628596.

9/2/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connection available effective Sept. 1, 2025, :  

Payer Name: Evernorth Care Solutions
Payer ID: 62350
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.

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

9/2/2025

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available effective Sept. 1, 2025:  

Payer Name: Providence Health Plan Powered by Collective Health
Payer ID: 36481
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: National 

Action Required:

• Add the payer 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. 

9/2/2025

---

Electronic Claims Connection Suspended

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

Payer Name: Total Senior Care
Payer ID: 12268
Reason: Payer unavailable electronically 

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

9/2/2025

---

Report Generation Delay for CPID 1681 International Medical Group

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Aug. 25, 2025.

Payer impacted: 

• CPID 1681 International Medical Group

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 09668290.

9/2/2025

---

New Electronic Claims Connections Available

Optum has new professional and institutional electronic claims connections available:

Payer Name: United Care Medical Group
Payer ID: ADCUC
Payer Enrollment Required: No
Secondary Claims Accepted: Yes

Payer Name: Summit Administration Services Inc.
Payer ID: 86083
Payer Enrollment Required: No
Secondary Claims Accepted: Yes

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.

9/2/2025

---

New Electronic Claims Connections Available

Optum has new professional and institutional electronic claims connections available:  

Payer Name: EYLEA4U Commercial Copay Card Program
Payer ID: 61461
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Regional 

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. 

9/2/2025

---

Par Status Changes – Claim Payers

Please note the PAR status changes for the following payer(s):

Payer Name: People 1st Health Strategies 

Industry Payer ID: IHS03

Exch Inst CPID: 5057

Exch Prof CPID: 9100

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: PeopleOne Health

Industry Payer ID: IHS01

Exch Inst CPID: 5054

Exch Prof CPID: 8898

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Populytics

Industry Payer ID: 23253

Exch Inst CPID: 3904

Exch Prof CPID: 3436

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Preferred Health Care of Pennsylvania

Industry Payer ID: 33898

Exch Inst CPID: 2674

Exch Prof CPID: 5253

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Preferred Health Plan of the Carolinas

Industry Payer ID: CB404

Exch Inst CPID: 5018

Exch Prof CPID: 8866

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Prezzo

Industry Payer ID: CB531

Exch Inst CPID: 3025

Exch Prof CPID: 8274

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Prime Community Care of Central Valley (PCCCV)

Industry Payer ID: MVCV1

Exch Inst CPID: 9679

Exch Prof CPID: 6705

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Prominence Health Plan of Nevada

Industry Payer ID: 93082

Exch Inst CPID: 8635

Exch Prof CPID: 7218

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Prominence Health Plan of Texas

Industry Payer ID: 80095

Exch Inst CPID: 8636

Exch Prof CPID: 7219

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Prominence Health Plan PPO/HMO

Industry Payer ID: 88029

Exch Inst CPID: 2956

Exch Prof CPID: 4256

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Prominence HealthFirst of Florida Inc

Industry Payer ID: 83352

Exch Inst CPID: 5030

Exch Prof CPID: 8878

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Quality Care Partners

Industry Payer ID: 89461

Exch Inst CPID: 4641

Exch Prof CPID: 6160

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Quest Behavioral Health

Industry Payer ID: 44219

Exch Inst CPID: 4681

Exch Prof CPID: 6207

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Rubicon Health Group

Industry Payer ID: IHS18

Exch Inst CPID: 1593

Exch Prof CPID: 1400

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Saint Mary's Health Plan (Encounters)

Industry Payer ID: 88082

Exch Inst CPID: 7568

Exch Prof CPID: 2700

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Sana Benefits

Industry Payer ID: 50114

Exch Inst CPID: 2025

Exch Prof CPID: 8161

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: South Central Preferred

Industry Payer ID: 23266

Exch Inst CPID: 2926

Exch Prof CPID: 3888

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Specialty Care Program

Industry Payer ID: IHS17

Exch Inst CPID: 1589

Exch Prof CPID: 1430

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: StarMed Administrators

Industry Payer ID: IHS08

Exch Inst CPID: 5064

Exch Prof CPID: 9109

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: The Care Network/The Savannah Business Group

Industry Payer ID: 68423

Exch Inst CPID: 4642

Exch Prof CPID: 6161

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: The Preferred Healthcare System - PPO Altoona, PA

Industry Payer ID: 04320

Exch Inst CPID: 2524

Exch Prof CPID: 2814

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: The Preferred Healthcare Systems (TPHS)

Industry Payer ID: 23212

Exch Inst CPID: 4065

Exch Prof CPID: 8809

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Total Plan Concepts

Industry Payer ID: 80900

Exch Inst CPID: 2027

Exch Prof CPID: 8200

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Tru Blue TPA

Industry Payer ID: 83413

Exch Inst CPID: 2046

Exch Prof CPID: 8186

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: UltraBenefits

Industry Payer ID: 41206

Exch Inst CPID: 5632

Exch Prof CPID: 6266

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Unified Health Plan TPA

Industry Payer ID: IHS12

Exch Inst CPID: 8063

Exch Prof CPID: 9780

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Unite Here Health Las Vegas

Industry Payer ID: 59144

Exch Inst CPID: 4073

Exch Prof CPID: 8817

Current Par Status: Gateway

New Par Status: Par

Effective Date: 9/1/2025

Payer Name: United Claim Solutions

Industry Payer ID: 20090

Exch Inst CPID: 6546

Exch Prof CPID: 1288

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: University Health Care Advantage

Industry Payer ID: 46407

Exch Inst CPID: 8634

Exch Prof CPID: 7217

Current Par Status: Gateway

New Par Status: Par

Effective Date: 9/1/2025

Payer Name: University of Michigan Health Medicare

Industry Payer ID: 83276

Exch Inst CPID: 3044

Exch Prof CPID: 8293

Current Par Status: Gateway

New Par Status: Par

Effective Date: 9/1/2025

Payer Name: Verdegard Administrators

Industry Payer ID: 86066

Exch Inst CPID: 1981

Exch Prof CPID: 4753

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Verdegard Administrators LLC

Industry Payer ID: 86070

Exch Inst CPID: 7931

Exch Prof CPID: 2755

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: VIECARE LIFE BUTLER

Industry Payer ID: 25923

Exch Inst CPID: 6012

Exch Prof CPID: 9161

Current Par Status: Transitional

New Par Status: Non Par

Effective Date: 10/1/2025

Payer Name: Vitori Health

Industry Payer ID: IHS25

Exch Inst CPID: 8091

Exch Prof CPID: 1702

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Vitori Health FH205

Industry Payer ID: FH205

Exch Inst CPID: 3024

Exch Prof CPID: 8273

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Vytra Healthcare

Industry Payer ID: 22264

Exch Inst CPID: 6562

Exch Prof CPID: 8440

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: WellNet Health Plans

Industry Payer ID: 25711

Exch Inst CPID: 4057

Exch Prof CPID: 8801

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Yuzu Health

Industry Payer ID: IHS15

Exch Inst CPID: 1524

Exch Prof CPID: 1426

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

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

9/2/2025

---

Par Status Changes – Claim Payers

Please note the PAR status changes for the following payer(s):

Payer Name: 6Degrees Health, Inc.

Industry Payer ID: 20446

Exch Inst CPID: 4014

Exch Prof CPID: 8721

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Advisory Health Administrators

Industry Payer ID: CB159

Exch Inst CPID:3055

Exch Prof CPID: 8426

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Aegis Administrative Services

Industry Payer ID: CB637

Exch Inst CPID: 4256

Exch Prof CPID: 1226

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Allegeant, LLC

Industry Payer ID: 52193

Exch Inst CPID: 3691

Exch Prof CPID: 512`

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Alternative Insurance Resources

Industry Payer ID: IHS06

Exch Inst CPID: 5061

Exch Prof CPID: 9106

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: American Plan Administrators

Industry Payer ID: 95606

Exch Inst CPID: 3027

Exch Prof CPID: 8276

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Anchor - Claimsbridge

Industry Payer ID: IHS10

Exch Inst CPID: 5066

Exch Prof CPID: 9111

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Antidote Health Plan

Industry Payer ID: IHS05

Exch Inst CPID: 5060

Exch Prof CPID: 9105

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Assured Benefits Administrators - ClaimsBridge

Industry Payer ID: IHS13

Exch Inst CPID: 8064

Exch Prof CPID: 9778

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Benefit Plan Administrators - Eau Claire, WI

Industry Payer ID: IHS19

Exch Inst CPID: 8065

Exch Prof CPID: 1416

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Berkshire Intergroup

Industry Payer ID: 10956

Exch Inst CPID: 3002

Exch Prof CPID: 8251

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Black Hawk

Industry Payer ID: CB987

Exch Inst CPID: 6605

Exch Prof CPID: 6896

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Centurion, LLC

Industry Payer ID: IHS11

Exch Inst CPID: 8062

Exch Prof CPID: 9779

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: ClaimsBridge

Industry Payer ID: 23243

Exch Inst CPID: 4066

Exch Prof CPID: 8810

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Claimsbridge West

Industry Payer ID: 11752

Exch Inst CPID: 5640

Exch Prof CPID: 6270

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Colorado HealthOP

Industry Payer ID: 49718

Exch Inst CPID: 7600

Exch Prof CPID: 6816

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: ConnectiCare

Industry Payer ID: 06105

Exch Inst CPID: 6500

Exch Prof CPID: 6440

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: ConnectiCare VIP Medicare Advantage

Industry Payer ID: 78375

Exch Inst CPID: 4969

Exch Prof CPID: 4471

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Cornerstone Hospice and Palliative Care, Inc

Industry Payer ID: RP111

Exch Inst CPID: 3623

Exch Prof CPID: 1829

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Cornerstone Preferred Resources

Industry Payer ID: CB268

Exch Inst CPID: 7643

Exch Prof CPID: 6863

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Covet Health

Industry Payer ID: IHS21

Exch Inst CPID: 3909

Exch Prof CPID: 1861

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: CPR Share Plans

Industry Payer ID: CB695

Exch Inst CPID: 3079

Exch Prof CPID: 8707

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Decent Health

Industry Payer ID: DCENT

Exch Inst CPID: 7098

Exch Prof CPID: 9711

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: DirectCARE

Industry Payer ID: 55731

Exch Inst CPID: 1654

Exch Prof CPID: 1719

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Driscoll Children's Health Plan

Industry Payer ID: 74284

Exch Inst CPID: 3925

Exch Prof CPID: 3234

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: EmblemHealth Insurance Company

Industry Payer ID: 55247

Exch Inst CPID: 8599

Exch Prof CPID: 1896

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: EmblemHealth Plan, Inc. (MCR)

Industry Payer ID: 13551

Exch Inst CPID: 6509

Exch Prof CPID: 2744

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: EmblemHealth Plan, Inc. (HMO)

Industry Payer ID: 25531

Exch Inst CPID: 1578

Exch Prof CPID: 1784

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Employer Health Network

Industry Payer ID: IHS07

Exch Inst CPID: 5063

Exch Prof CPID: 9108

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: ES Beveridge and Associates

Industry Payer ID: 34108

Exch Inst CPID: 4953

Exch Prof CPID: 7101

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Essence

Industry Payer ID: 20818

Exch Inst CPID: 8993

Exch Prof CPID: 2274

Current Par Status: Gateway

New Par Status: Par

Effective Date: 9/1/2025

Payer Name: Firefly Health

Industry Payer ID: FRFLY

Exch Inst CPID: 7097

Exch Prof CPID: 9710

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Frontier Direct

Industry Payer ID: IHS14

Exch Inst CPID: 1515

Exch Prof CPID: 1424

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Gloria Gates

Industry Payer ID: IHS20

Exch Inst CPID: 8066

Exch Prof CPID: 1418

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: GMR HEALTH

Industry Payer ID: 85664

Exch Inst CPID: 1041

Exch Prof CPID: 7869

Current Par Status: Transitional

New Par Status: Non Par

Effective Date: 10/1/2025

Payer Name: Group Benefit Services

Industry Payer ID: CB951

Exch Inst CPID: 1092

Exch Prof CPID: 8120

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Gulf Stream General Dynamics

Industry Payer ID: CB624

Exch Inst CPID: 7610

Exch Prof CPID: 6819

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Health In Tech

Industry Payer ID: IHS09

Exch Inst CPID: 5065

Exch Prof CPID: 9110

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: HEALTHCOMP NORTH

Industry Payer ID: 36149

Exch Inst CPID: 2984

Exch Prof CPID: 4287

Current Par Status: Non Par

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: HEALTHCOMP SOUTH

Industry Payer ID: 07205

Exch Inst CPID: 2557

Exch Prof CPID: 2802

Current Par Status: Non Par

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: HEALTHCOMP WEST

Industry Payer ID: 85729

Exch Inst CPID: 2934

Exch Prof CPID: 3206

Current Par Status: Non Par

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: HealthPlan Services

Industry Payer ID: 59140

Exch Inst CPID: 2953

Exch Prof CPID: 8431

Current Par Status: Gateway

New Par Status: Par

Effective Date: 9/1/2025

Payer Name: Healthy York Network

Industry Payer ID: 22251

Exch Inst CPID: 7661

Exch Prof CPID: 6883

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Hillsborough County

Industry Payer ID: 59141

Exch Inst CPID: 9565

Exch Prof CPID: 4295

Current Par Status: Gateway

New Par Status: Par

Effective Date: 9/1/2025

Payer Name: HPI Vanderbilt

Industry Payer ID: IHS22

Exch Inst CPID: 8068

Exch Prof CPID: 1454

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Independence American Insurance Company

Industry Payer ID: CB231

Exch Inst CPID: 2563

Exch Prof CPID: 1189

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Inetico

Industry Payer ID: 43471

Exch Inst CPID: 5673

Exch Prof CPID: 6460

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Insight Benefit Administrators

Industry Payer ID: 38254

Exch Inst CPID: 2531

Exch Prof CPID: 5404

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Insurance Design Administrators

Industry Payer ID: IHS16

Exch Inst CPID: 1536

Exch Prof CPID: 1427

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: INSURANCE MANAGEMENT ADMINISTRATORS

Industry Payer ID: 72091

Exch Inst CPID: 1040

Exch Prof CPID: 7189

Current Par Status: Transitional

New Par Status: Non Par

Effective Date: 10/1/2025

Payer Name: Integra Administrative Group

Industry Payer ID: 51020

Exch Inst CPID: 6551

Exch Prof CPID: 6754

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: International Benefit Administrators, LLC

Industry Payer ID: 11329

Exch Inst CPID: 2512

Exch Prof CPID: 1165

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Jericho Share

Industry Payer ID: IHS02

Exch Inst CPID: 5055

Exch Prof CPID: 8899

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: KEY SOLUTIONS

Industry Payer ID: 37323

Exch Inst CPID: 8673

Exch Prof CPID: 7256

Current Par Status: Transitional

New Par Status: Non Par

Effective Date: 10/1/2025

Payer Name: Lancaster General Health Group - Preferred Health Care (IHS Payer)

Industry Payer ID: 16109

Exch Inst CPID: 8939

Exch Prof CPID: 5262

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Lockard and Williams

Industry Payer ID: CB752

Exch Inst CPID: 4661

Exch Prof CPID: 6189

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Mary Washington Health Plan

Industry Payer ID: 83269

Exch Inst CPID: 3045

Exch Prof CPID: 8294

Current Par Status: Gateway

New Par Status: Par

Effective Date: 9/1/2025

Payer Name: MBACLM

Industry Payer ID: IHS24

Exch Inst CPID: 8070

Exch Prof CPID: 1701

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Med-Pay

Industry Payer ID: 88058

Exch Inst CPID: 7075

Exch Prof CPID: 7480

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Mid America Benefits

Industry Payer ID: 22823

Exch Inst CPID: 5668

Exch Prof CPID: 6424

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: MPMBA

Industry Payer ID: IHS23

Exch Inst CPID: 8069

Exch Prof CPID: 1700

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

Payer Name: Ohio PPO Connect (OPPOC)

Industry Payer ID: 74431

Exch Inst CPID: 4640

Exch Prof CPID: 6159

Current Par Status: Gateway

New Par Status: Transitional

Effective Date: 9/1/2025

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

9/2/2025

---

Par Status and Claim Fee Changes

Please note, the PAR status and claim fees are changing for the following payer(s):

 

Payer Name: IBEW Local 26

Industry ID: 30506

Exchange CPID(s): 9173

Current PAR Status: Transitional

Current Fee: $0.00

New PAR Status: Non Par

New Fee: $0.10

Effective Date: 10/1/2025

 

Payer Name: Key Benefit Administrators, Inc.

Industry ID: 37217

Exchange CPID(s): 7505, 2821

Current PAR Status: Transitional

Current Fee: $0.00

New PAR Status: Non Par

New Fee: $0.10

Effective Date: 10/1/2025

 

Payer Name: Medcost Benefit Services (MBS)

Industry ID: 56205

Exchange CPID(s): 8974, 1880

Current PAR Status: Non Par

Current Fee: $0.10

New PAR Status: Transitional

New Fee: $0.00

Effective Date: 9/1/2025

 

Payer Name: Mercy Provider Network

Industry ID: 43185

Exchange CPID(s): 6506, 1270

Current PAR Status: Non Par

Current Fee: $0.10

New PAR Status: Transitional

New Fee: $0.00

Effective Date: 9/1/2025

 

Payer Name: Planned Administrators (Non Preferred Blue)

Industry ID: 37287

Exchange CPID(s): 3927, 3883

Current PAR Status: Transitional

Current Fee: $0.00

New PAR Status: Non Par

New Fee: $0.10

Effective Date: 10/1/2025

 

Payer Name: Silver Star Pace

Industry ID: 97691

Exchange CPID(s): 1571, 1146

Current PAR Status: Transitional

Current Fee: $0.00

New PAR Status: Non Par

New Fee: $0.10

Effective Date: 10/1/2025

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

9/2/2025