Healthy Blue South Carolina Electronic Medical Attachment Connections No Longer Available

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

Payer Name: Healthy Blue South Carolina
Medical Attachment CPIDs: 2121, 5953
Payer-assigned Payer ID: 00403
Reason: Payer no longer offers an electronic connection. 

Action Required: None

REF 16531108 2/28/2025

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

Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check dates of January 23, 2025 through present:

• CPID 5648 Tricare West Region
• CPID 6286 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 check dates above.

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

REF 16527708  2/28/2025

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Report Generation Delay for multiple CPIDs

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 25, 2025.

Payers impacted:

• CPID 4909 Cenpatico Behavioral Health - Arizona - DOS before 10/1/18
• CPID 6136 Cenpatico Behavioral Health - Arizona - DOS before 10/1/18
• CPID 1630 Cenpatico Behavioral Health – Florida
• CPID 2190 Cenpatico Behavioral Health – Florida
• CPID 3912 Cenpatico Behavioral Health – Georgia
• CPID 4239 Cenpatico Behavioral Health – Georgia
• CPID 4663 Cenpatico Behavioral Health – Illinois
• CPID 6212 Cenpatico Behavioral Health – Illinois
• CPID 2985 Cenpatico Behavioral Health – Indiana
• CPID 3236 Cenpatico Behavioral Health – Indiana
• CPID 3663 Cenpatico Behavioral Health – Kansas
• CPID 5207 Cenpatico Behavioral Health – Kansas
• CPID 5638 Cenpatico Behavioral Health – Mississippi
• CPID 6268 Cenpatico Behavioral Health – Mississippi
• CPID 4692 Cenpatico Behavioral Health – Missouri
• CPID 6215 Cenpatico Behavioral Health – Missouri
• CPID 5629 Cenpatico Behavioral Health - New Hampshire
• CPID 6263 Cenpatico Behavioral Health - New Hampshire
• CPID 1660 Cenpatico Behavioral Health – Ohio
• CPID 2175 Cenpatico Behavioral Health – Ohio
• CPID 4676 Cenpatico Behavioral Health - South Carolina
• CPID 6205 Cenpatico Behavioral Health - South Carolina
• CPID 3962 Cenpatico Behavioral Health – Texas
• CPID 4746 Cenpatico Behavioral Health – Texas
• CPID 4927 Cenpatico Behavioral Health – Wisconsin
• CPID 3220 Cenpatico Behavioral Health – Wisconsin

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 09385701.

REF 16527708  2/28/2025

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Resolved: Delay in Electronic Remittance Advice (ERA) for Multiple Payers

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

Original Notice Sent on February 26, 2025:
Due to a processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for file dates of February 22, 2025 through present:

Payers impacted:

• CPID 1473 California Medi-cal
• CPID 1648 California Medi-cal SNF/Hospice
• CPID 2436 California Medi-cal
• CPID 3510 California Medi-cal
• CPID 5023 California Medi-cal CA009
• CPID 5024 California Medi-cal CAA7P
• CPID 5025 California Medi-cal CAEP1
• CPID 5987 California Medi-cal
• CPID 8613 California Medi-cal (Restricted)
• CPID 8871 California Medi-cal CA009
• CPID 8872 California Medi-cal CA2E5
• CPID 8873 California Medi-cal CAA7P

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 09380828.

REF 16504606  2/28/2025

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Report Generation Delay for CPIDs 3277 and 8544 WPS Midlands

A payer is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 25, 2025.

Payer impacted: 

• CPID 3277 WPS Midlands
• CPID 8544 WPS Midlands

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 09385074.

REF 16492709 2/28/2025

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Report Generation Delay for CPIDs 1474 and 3501 Indiana Medicaid

A payer is experiencing issues affecting Institutional and Professional report generation for some claims submitted Feb. 25, 2025.

Payer impacted:

• CPID 1474 Indiana Medicaid
• CPID 3501 Indiana Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09385052.

REF 16487849  2/28/2025

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

A payer is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 22, 2025.

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09385009.

REF 16487858  2/28/2025

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Electronic Claims Connection Suspended

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

Payer Name: Interface EAP
CPIDs: 8943, 4441
Payer ID: 60280

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

REF 16487158  2/28/2025

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Electronic Claims Connection Suspended

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

Payer Name: Interface EAP
CPIDs: 1444, 8943
Payer ID: 60280

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

REF 16487008  2/28/2025

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New Payer Claims Transactions Coming Soon

This message is intended for Assurance Reimbursement Management and Revenue Performance Advisor customers, as well as submitters through our Exchange and Intelligent EDI clearinghouse.

Optum is pleased to announce that Thin Blue Line also known as EOB TPA is coming soon with Optum for institutional and professional claims. We expect direct connectivity to be available with this payer March 4, 2025.

Payer Name: Thin Blue Line (EOB TPA)
Payer ID: TBL38
Transactions: 837I, 837P

Please update your system to take advantage of this new transaction and monitor our payer list for updates.

REF 16383315

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New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Redlands Yucaipa Medical Group
Institutional CPID: 7536
Payer-assigned Payer ID: 18247
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location:  California
Claims Fee: N/A

Action Required: 

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

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

REF 16389008 2/27/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name:   American Health Advantage of Pennsylvania 

Institutional CPID: 5973 

Professional CPID: 1887 

Payer-assigned Payer ID: PA901
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location:  Pennsylvania 

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.

REF 16387580 2/27/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: American Health Advantage of Pennsylvania
Institutional CPID: 5973
Professional CPID: 1887
Payer-assigned Payer ID: PA901
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Pennsylvania
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.

REF 16387579  2/27/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  IQVIA
Institutional CPID: 7548
Professional CPID: 2474
Payer-assigned Payer ID: 15060
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location:  National
Claims Fee: N/A

Action Required: 

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

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

REF 16377608 2/27/2025

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Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below on Feb. 26, 2025 were not processed by the payers.

Payers impacted: 

CPID	Payer Name
4101	AllCare Advantage
2113	Allcare Health Plan
1764	Ambetter From Absolute Total Care
1765	Ambetter From Louisiana Healthcare Connections
9278	Ambetter from Nebraska Total Care
9775	Ambetter of Alabama
9433	Ambetter of Oklahoma
9429	American Health Advantage of Idaho & Utah
9142	American Health Advantage of Mississippi
9117	American Health Advantage of Texas
4468	Americas Choice Healthplan
1741	Amerigroup
4437	Anthem Blue Cross Blue Shield New York
8749	Anthem MaineHealth
6220	Arizona Priority Care Plus
4881	Asuris Northwest Regence
7272	Axminster Medical Group
3845	Banner Health Network
8482	Benefit Plan Administrators - Roanoke, VA
1407	Blue Cross Blue Shield of Georgia
1169	Blue Cross Blue Shield of Western New York Medicaid/CHP
1243	Blue Cross Community Centennial
1167	Blue Cross Medicare Advantage PPO/HMO
4110	Bollinger Inc
6165	Bridgeview
4246	Capital Health Plan
2810	Capitol Administrators
2289	Care1st Health Plan of Arizona Medicaid DOS after 11/30/2022
9759	Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022
2830	CarePlus Health Plans
1194	CareSource of Georgia
7143	CareSource of Indiana
3826	CareSource of Ohio
7263	CareSource of West Virginia
4743	Carelon Behavioral Health
2164	Carelon Behavioral Health Maryland
6127	Carelon Behavioral Health, MBHP
3293	Carelon Health
6777	Centers Plan for Healthy Living
7275	Citrus Valley Physicians Group
8123	Clear Health Alliance
1415	Colorado Anthem Blue Cross Blue Shield
7416	Colorado Anthem Blue Cross Blue Shield HMO
7763	Columbine Health Plan
6778	Common Ground Healthcare Cooperative
8834	Commonwealth Care Alliance DOS after 3/31/2023
6865	Community Care Plan (Medicaid)
8147	Community Care Plan (Palm Beach Health District)
1420	Connecticut Anthem Blue Cross Blue Shield
3420	Connecticut Medicare Blue (Risk)
6795	Contra Costa Health Plan
7738	CountyCare Health Plan
9747	Delaware First Health
2433	Denver Health and Hospital Authority
8135	Doctors HealthCare Plans
1733	Doctors Professional Services Consultants (DPSC)
1119	Easy Choice Health Plan of California
4289	El Paso Health-CHIP
5483	Employee Benefit Management Services (EBMS)
1834	Employee Plans
9215	Everpointe
3792	Fidelis Care
2875	First Health Network (Coventry Health Care National Network)
7435	FirstCare Health Plans
1414	Florida Blue Cross Blue Shield
3417	Florida Blue Cross Blue Shield Health Options HMO
9417	Florida Complete Care
2150	Florida Health Care Plans
5440	Fox Valley Medicine
8879	Georgia Health Advantage
2720	GlobalCare
9766	Gold Kidney Health Plan
1772	HAP CareSource
1797	HAP CareSource Michigan Dual Medicare/Medicaid
2891	HAP Caresource Michigan Marketplace
1723	HealthCare Partners IPA
4448	HealthLink PPO
5243	Healthcare Management Administrators
4740	Healthways WholeHealth Networks
8750	Healthy Blue Dual Advantage Louisiana
3224	Healthy Blue Kansas
7760	Healthy Blue Louisiana
8867	Healthy Blue Missouri
9133	Healthy Blue North Carolina
6272	Hispanic Physicians IPA (Encounters Only)
7715	Hopkins Health Advantage
6259	Humana - CareSource of Kentucky
3757	IMAGINE360 ADMINISTRATORS (GPA)
5479	IU Health Plan Medicare Advantage
7426	Idaho Regence Blue Shield
1405	Illinois Blue Cross Blue Shield
5865	Indian Health Services
1412	Indiana Anthem Blue Cross Blue Shield
4116	IntegraNet Health
1107	Integrated Health Partners (IHP)
9713	Iowa Health Advantage
1404	Iowa Wellmark Blue Cross Blue Shield
6733	Iowa Wellmark Blue Cross Blue Shield Crossover
5432	Johns Hopkins Healthcare / Priority Partners
2421	Kentucky Anthem Blue Cross Blue Shield
9412	Leon Health Plans
6273	Lifepath Hospice
7446	Maine Anthem Blue Cross Blue Shield
8812	Maryland Physicians Care
3476	Masters, Mates and Pilots
8860	Medica Government Programs
7859	Medica Health Plan Solutions
6799	Medica Individual and Family (IFB)
2287	Medicare Plus Blue of MI(MAP)
3475	Memorial Hermann Health Solutions
9102	Meridian Medicare Medicaid Plan
9118	MeridianComplete Michigan
2426	Michigan Blue Care Network
1421	Michigan Blue Cross Blue Shield
1402	Minnesota Blue Cross Blue Shield
1410	Minnesota Blue Cross Blue Shield CC Systems
7892	Minnesota Blue Cross Blue Shield Health Care Programs
1408	Missouri Anthem Blue Cross Blue Shield
7450	Montana Blue Cross Blue Shield
1213	NHC Advantage
7496	Nevada Anthem Blue Cross Blue Shield
7422	New Hampshire Anthem Blue Cross Blue Shield
7403	New Mexico Blue Cross Blue Shield
8864	NextBlue of North Dakota
2411	North Dakota Blue Cross Blue Shield
2418	Ohio Anthem Blue Cross Blue Shield
1403	Oklahoma Blue Cross Blue Shield
8165	Oncology Physicians Network
2404	Oregon Regence Blue Cross Blue Shield
7829	Passport Advantage
9421	Perennial Advantage of Colorado
8128	Pool Administrators, Inc.
5838	Preferred Administrators
7168	Premier Healthcare Exchange (PHX)
4252	Presbyterian Salud
2807	Professional Benefit Administrators (Oakbrook, Illinois)
4253	Prominence Administrative Services
7281	PruittHealth Premier Medicare Advantage
5428	QualChoice of Arkansas
7264	Quartz
1776	RIS Rx
1209	Regence Group Administrators
6246	Riverside Medical Clinic
4464	SCAN Health Plan
8816	SOMOS Emblem
2254	Scott & White Health Plan
9438	Shared Health Mississippi
7225	Sharp Community Medical Group
3847	Shasta Administrative Services
8124	Simply Healthcare Plans, Inc.
1740	Sonder Health Plans
2490	South Dakota Blue Cross Blue Shield
6195	Superior Vision Services
1406	Texas Blue Cross Blue Shield
1729	Texas Childrens Health Plan (CHIP)
2483	Texas Childrens Health Plan (STAR Medicaid)
4278	The Boon Group
8473	Unicare
6849	United Group Programs
2412	Utah Regence Blue Cross Blue Shield
2788	Utah Regence Blue Cross Blue Shield Federal Employee Program
4258	VNS Health
7493	Vermont Blue Cross Blue Shield
1413	Virginia Anthem Blue Cross Blue Shield
7451	Washington Regence Blue Shield
1844	Wellcare Health Plans
3211	Wellcare Health Plans (Encounters)
9293	Wellcare by Allwell from Nebraska Total Care
9430	Wellcare by Allwell of Oklahoma
1775	Wellpoint
9441	Wellspace NEXUS LLC
1401	Wisconsin Anthem Blue Cross Blue Shield
7489	Wyoming Blue Cross Blue Shield
6731	ZELIS

A resolution has been implemented and the claims were retransmitted to the payer intermediary on Feb. 27, 2025.

This delay affected claims released to Optum between 2 p.m. and 6 p.m. CT on Feb. 26, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09383129.

REF 16376458 2/27/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: KISx Card, LLC
Institutional CPID: 6039
Professional CPID: 9193
Payer-assigned Payer ID: 83313
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Pennsylvania
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.

REF 16378708  2/27/2025

---

New Electronic Claims Connections Available

Effective Feb. 28, 2025, Optum has new electronic claims connections available:

Payer Name: IQVIA
Institutional CPID: 7548
Professional CPID: 2474
Payer-assigned Payer ID: 15060
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National
Claims Fee: N/A

Action Required:

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

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

REF 16377609  2/27/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Imperial Insurance Companies Exchange Texas
Institutional CPID: 1657
Professional CPID: 1810
Payer-assigned Payer ID: IEXTX
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Texas

Action Required:

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

REF 16375810  2/27/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Imperial Insurance Companies Exchange Texas
Institutional CPID: 1657
Professional CPID: 1810
Payer-assigned Payer ID: IEXTX
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Texas
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.

REF 16375809  2/27/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Beaver Medical Group
Institutional CPID: 1967
Payer-assigned Payer ID: 45967
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
Claims Fee: N/A

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

When a payer requires enrollment, forms must be submitted and approved to begin submitting transactions.

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

REF 16375508  2/27/2025

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Report Generation Delay for CPID 6134 Innovante Benefit Administrators

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

Payer impacted:

• CPID 6134 Innovante Benefit Administrators

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09383096.

REF 16374758  2/27/2025

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Report Generation Delay for CPIDs 8257 and 3009 Veterans Affairs Community Care Network Region 1, 2, 3 - VACCN

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

Payer impacted:

• CPID 8257 Veterans Affairs Community Care Network Region 1, 2, 3 – VACCN
• CPID 3009 Veterans Affairs Community Care Network Region 1, 2, 3 – VACCN

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 09361509.

REF 16374109  2/27/2025

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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 Feb. 13, 2025.

Payers impacted:

• CPID 8664 Oak West Physician Association
• CPID 7245 Oak West Physician Association
• CPID 8275 Essential Health Partners
• CPID 3017 Gonzaba Medical Group
• CPID 8266 Gonzaba Medical Group
• CPID 3088 Lake County Physicians Association
• CPID 1851 Lake County Physicians Association
• CPID 3770 Physician Health Associates/Midland Mgmt
• CPID 1029 Physician Health Associates/Midland Mgmt

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 09383046.

REF 16374108  2/27/2025

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

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

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

Original notify sent Feb. 11, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Jan. 28, 2025.

Payer impacted:

• CPID 6127 Carelon Behavioral Health, MBHP

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09361312.

REF 16372908  2/27/2025

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Report Generation Delay for CPID 5547 Arizona Blue Cross Blue Shield

A payer is experiencing issues affecting Institutional report generation for some claims submitted on Feb. 24, 2025.

Payer impacted:

• CPID 5547 Arizona Blue Cross Blue Shield

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 09382885.

REF 16371811 2/27/2025

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Update: Report Generation Delay for CPID 5428 QualChoice of Arkansas

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 4, 2025-Feb. 19, 2025.

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

Original notify sent Feb. 13, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Jan. 31, 2025.

Payer impacted:

• CPID 5428 QualChoice of Arkansas

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09364994.

REF 16372008  2/27/2025

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Electronic Routing Change and new Payer Name for CPIDs 9731 and 8013 Dignity Health Plan DOS after Dec. 31, 2022

Effective Feb. 26, 2025, Optum is changing electronic claims routing for the following payer:

Current Payer Name: Dignity Health Plan DOS after Dec. 31, 2022
New Payer Name: American Health Advantage of Louisiana
Professional CPID: 9731
Current Edit Master: PE_T007
New Edit Master: PE_B800
Institutional CPID: 8013
Current Edit Master: HE9T007
New Edit Master: HE9B801
Payer-assigned Payer ID: 83247

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

REF 16364506  2/26/2025

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Electronic Routing Change and new Payer Name for CPIDs 9731 and 8013 Dignity Health Plan DOS after Dec. 31, 2022

Effective Feb. 26, 2025, Optum is changing electronic claims routing for the following payer:

Current Payer Name: Dignity Health Plan DOS after Dec. 31, 2022
New Payer Name: American Health Advantage of Louisiana
Professional CPID: 9731
Institutional CPID: 8013
Payer-assigned Payer ID: 83247
Current Claims Fee: $0.10
New 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 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.

REF 16364458  2/26/2025

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Report Generation Delay for CPID 3509 Ohio Medicaid

A payer is experiencing issues affecting Institutional report generation for some claims submitted Feb. 24, 2025.

Payer impacted:

• CPID 3509 Ohio Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09381529.

REF 16362958  2/26/2025

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Reminder: Payer Change for CPIDs 1579, 6467 Government Employees Health Association

Reminder: Providers must begin using CPIDs 5402 and 4590 United Medical Resources by March 4, 2025 to avoid claim rejections and interruptions with remittance delivery for Government Employees Health Association transactions.

Update sent Feb. 20, 2025: Effective March 4, 2025, CPIDs 1579 and 6467 Government Employees Health Association will be terminated for claims and remittance transactions. Claims sent to CPIDs 1579 and 6467 will be rejected. Providers must begin using CPIDs 5402 and 4590 United Medical Resources before the termination date to avoid claim rejections.

Original notify sent Feb. 6, 2025:
Effective immediately, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: Government Employees Health Association
Professional CPID: 6467
Institutional CPID: 1579
Remittance Available: Yes
Payer-assigned Payer ID: 44054

Providers must begin using the following for claims and remittance:

Payer Name: United Medical Resources
Professional CPID: 5402
Institutional CPID: 4590
Remittance Available: Yes
Payer-assigned Payer ID: 39026
Claim Fee: No

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
• Providers currently receiving electronic remittance through Optum for CPIDs 5402, 4590 United Medical Resources do not need to complete a new enrollment form.
• Providers not receiving electronic remittance through Optum for CPIDs 5402, 4590 United Medical 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.

REF 16359483  2/26/2025

---

Reminder: Payer Change for CPIDs 1579, 6467 Government Employees Health Association

Reminder: Providers must begin using CPIDs 5402 and 4590 United Medical Resources by March 4, 2025 to avoid claim rejections and interruptions with remittance delivery for Government Employees Health Association transactions.

Update sent Feb. 20, 2025: Effective March 4, 2025, CPIDs 1579 and 6467 Government Employees Health Association will be terminated for claims and remittance transactions. Claims sent to CPIDs 1579 and 6467 will be rejected. Providers must begin using CPIDs 5402 and 4590 United Medical Resources before the termination date to avoid claim rejections.

Original notify sent Feb. 6, 2025:
Effective immediately, claims and remittance currently exchanged with the following payer must use different CPIDs.:

Payer Name: Government Employees Health Association
Professional CPID: 6467
Professional Edit Master: PE_E049
Institutional CPID: 1579
Institutional Edit Master: HE9E049
Payer-assigned Payer ID: 44054
Line of Business Code (LOB): H45

Providers must begin using the following for claims and remittance:

Payer Name: United Medical Resources
Professional CPID: 5402
Professional Edit Master: PE_E049
Institutional CPID: 4590
Institutional Edit Master: HE9E049
Payer-assigned Payer ID: 39026
Line of Business Code (LOB): H25

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 5402, 4590 United Medical Resources do not need to complete a new enrollment form.
• Providers not receiving electronic remittance through Optum for CPIDs 5402, 4590 United Medical 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.

REF 16359481  2/26/2025

---

Delay in Electronic Remittance Advice (ERA) for Multiple Payers

Due to a processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for file dates of February 22, 2025 through present:

Payers impacted:

• CPID 1473 California Medi-cal
• CPID 1648 California Medi-cal SNF/Hospice
• CPID 2436 California Medi-cal
• CPID 3510 California Medi-cal
• CPID 5023 California Medi-cal CA009
• CPID 5024 California Medi-cal CAA7P
• CPID 5025 California Medi-cal CAEP1
• CPID 5987 California Medi-cal
• CPID 8613 California Medi-cal (Restricted)
• CPID 8871 California Medi-cal CA009
• CPID 8872 California Medi-cal CA2E5
• CPID 8873 California Medi-cal CAA7P

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 09380828.

REF 16355761  2/26/2025

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Report Generation Delay for CPID 7011 Wellcare by Allwell from Nebraska Total Care

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

Payer impacted:

• CPID 7011 Wellcare by Allwell from Nebraska Total Care

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 09381306.

REF 16358908  2/26/2025

---

Report Generation Delay for CPID 1214 AgeRight Advantage Health Plan

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 14, 2025.

Payer impacted:

• CPID 1214 AgeRight Advantage Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09381259.

REF 16356761  2/26/2025

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Report Generation Delay for CPID 9409 Align Senior Care of California

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 14, 2025 and Feb. 15, 2025.

Payer impacted:

• 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 09381105.

REF 16355809  2/26/2025

---

Report Generation Delay for CPIDs 3061 and 8454 Align Senior Care of Michigan

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Feb. 14, 2025 and Feb. 15, 2025.

Payer impacted:

• CPID 3061 Align Senior Care of Michigan
• CPID 8454 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 09381058.

REF 16355808  2/26/2025

---

Payer Transmit Delay for multiple CPIDs

Due to a payer system issue, a delay is occurring in the transmissions to the following payers since Feb. 22, 2025.

Payers impacted:

• CPID 1473 California Medi-cal
• CPID 1648 California Medi-cal SNF/Hospice
• CPID 2436 California Medi-cal
• CPID 3510 California Medi-cal
• CPID 5023 California Medi-cal CA009
• CPID 5024 California Medi-cal CAA7P
• CPID 5025 California Medi-cal CAEP1
• CPID 5987 California Medi-cal
• CPID 8613 California Medi-cal (Restricted)
• CPID 8871 California Medi-cal CA009
• CPID 8872 California Medi-cal CA2E5
• CPID 8873 California Medi-cal CAA7P

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

Action Required: Be aware of the transmit delay above.

If you have any questions, please contact Customer Support and refer to Case Number 09380839.

REF 16353159  2/26/2025

---

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Florida Blue Medicare
Institutional CPID: 5081
Professional CPID: 9128
Payer-assigned Payer ID: FBM01
Line of Business (LOB) Code: K5A
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Florida

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.

REF 16352058  2/26/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Florida Blue Medicare
Institutional CPID: 5081
Professional CPID: 9128
Payer-assigned Payer ID: FBM01
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Florida

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.

REF 16352059  2/26/2025

Update: Payer Change for CPIDs 1285, 7499, 7567 Sentara Health Plans and 7828, 1003 Virginia Premier Health Plans - Electronic Claims Connection Suspended

Effective immediately, due to intermediary issues, the payer listed below has been permanently suspended at Optum for claims processing and removed from the payer list.

Payer Name: Virginia Premier Health Plans
CPIDs: 1003, 7828
Payer ID: VAPRM

Action Required: Please refrain from submitting claims to CPIDs 1003 and 7828. Claims must be submitted to CPIDs 7499 and 7567. Enrollment is required.

2nd notify sent Feb. 21, 2025:
Reminder: Effective Feb. 28, 2025, CPID 1285 Sentara Mental Health and CPIDs 7828, 1003 Virginia Premier Health Plans will be terminated for claims and remittance transactions. Claims sent to CPIDs 1285, 7828, and 1003 will be rejected. Providers must begin using CPIDs 7499 and 7567 Sentara Health Plans before the termination date to avoid claim rejections.  Claims and remittance enrollment is required.

Original notify sent Feb 14, 2025:
Effective Feb. 28, 2025, claims and remittance currently exchanged with the following payers must use different CPIDs:

Payer Name: Sentara Mental Health
Professional CPID: 1285
Professional Edit Master: PE_T007
Payer-assigned Payer ID: 5415M

Payer Name: Virginia Premier Health Plans
Professional CPID: 7828
Professional Edit Master: PE_T007
Institutional CPID: 1003
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: VAPRM

Providers must begin using the below for claims and remittance transactions. Optum will also be changing electronic claims routing for this payer. Claims enrollment is now required:

Old Payer Name: Sentara Health/Optima Health
New Payer Name: Sentara Health Plans

Professional CPID: 7499
Old Professional Edit Master: PE_T007
New Professional Edit Master: PE_B800
Payer-assigned Payer ID: 54154

Institutional CPID: 7567
Old Institutional Edit Master: HE9T007
New Institutional Edit Master: HE9B801
Old Payer-assigned Payer ID: 00453
New Payer-assigned Payer ID: 54154

Payer Claim Enrollment Required: Yes
Secondary Claims Accepted: No
Payer Remittance Enrollment Required: Yes
Line of Business Code (LOB): U97

Both Fee For Service and Mental Health claims should be sent to Payer ID 54154, CPIDs 7499, 7567.

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is required with the new route.
• Providers must complete a new enrollment form by Feb. 28, 2025, to avoid claim rejections.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 7499 and 7567, Sentara Health Plans, do not need to complete a new enrollment form.
  • Providers currently not receiving electronic remittance through Optum for CPIDs 7499 and 7567, Sentara Health Plans, must complete a new enrollment form.
  • New providers must complete a new enrollment form.

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

Action Required: Please make the following 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.

Complete claim enrollment forms by Feb. 28, 2025, to avoid rejections.

REF 16340313  2/25/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Univera Healthcare
Institutional CPID: 1655
Payer-assigned Payer ID: 12X18
Professional CPID: 1790
Payer-assigned Payer ID: SX087
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location:  New York 

Action Required: 

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

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

REF 16341309 2/25/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Univera Healthcare
Institutional CPID: 1655
Payer-assigned Payer ID: 12X18
Professional CPID: 1790
Payer-assigned Payer ID: SX087
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location:  New York
Claims Fee: $0.10

Action Required: 

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

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

REF 16341308 2/25/2025

---

Optum Alert: Update: Payer Change for CPIDs 1285, 7499, 7567 Sentara Health Plans and 7828, 1003 Virginia Premier Health Plans - Electronic Claims Connection Suspended

Update:
Effective immediately, due to intermediary issues, the payer listed below has been permanently suspended at Optum for claims processing and removed from the payer list.

Payer Name: Virginia Premier Health Plans
CPIDs: 1003, 7828
Payer ID: VAPRM

Action Required: Please refrain from submitting claims to CPIDs 1003 and 7828. Claims must be submitted to CPIDs 7499 and 7567. Enrollment is required.

2nd notify sent Feb. 21, 2025:
Reminder: Effective Feb. 28, 2025, CPID 1285 Sentara Mental Health and CPIDs 7828, 1003 Virginia Premier Health Plans will be terminated for claims and remittance transactions. Claims sent to CPIDs 1285, 7828, and 1003 will be rejected. Providers must begin using CPIDs 7499 and 7567 Sentara Health Plans before the termination date to avoid claim rejections. Claims and remittance enrollment is required. 

Original notify sent Feb 14, 2025:
Effective Feb. 28, 2025, claims and remittance currently exchanged with the following payers must use different CPIDs:

Payer Name: Sentara Mental Health
Professional CPID: 1285
Payer-assigned Payer ID: 5415M

Payer Name: Virginia Premier Health Plans
Professional CPID: 7828
Institutional CPID: 1003
Payer-assigned Payer ID: VAPRM

Providers must begin using the below for claims and remittance transactions. Optum will also be changing electronic claims routing for this payer. Claims enrollment is now required.

Old Payer Name: Sentara Health/Optima Health
New Payer Name: Sentara Health Plans

Professional CPID: 7499
Payer-assigned Payer ID: 54154
Claim Fee: N/A

Institutional CPID: 7567
Old Payer-assigned Payer ID: 00453
New Payer-assigned Payer ID: 54154
Claim Fee: N/A

Payer Claim Enrollment Required: Yes
Secondary Claims Accepted: No
Payer Remittance Enrollment Required: Yes

Both Fee for Service and Mental Health claims should be sent to Payer ID 54154, CPIDs 7499, 7567.

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is required with the new route.
• Providers must complete a new enrollment form by Feb. 25, 2025, to avoid claim rejections.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 7499 and 7567, Sentara Health Plans, do not need to complete a new enrollment form.
  • Providers currently not receiving electronic remittance through Optum for CPIDs 7499 and 7567, Sentara Health Plans, must complete a new enrollment form.
  • New providers must complete a new enrollment form.

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

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

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

Complete claim enrollment forms by Feb. 28, 2025, to avoid rejections.

REF 16340310  2/25/2025

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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 Feb. 19, 2025.

Payer impacted: 

• CPID 1928 Medical Associates 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 09379335.

REF 16339308 2/25/2025

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New Electronic Claim Status Connection Available

Effective February 6, 2025 Optum is pleased to announce the availability of Real-time Claim Status Inquiry 276/277 for the below payer:

Payer Name: Promise Health Plan
Industry Payer ID: RP128
IMN Real Time ID: RP128
Exchange Real Time ID: PROMS
CPID(s): 2751, 7928
Optum IEDi Real Time ID: RP128
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Subscriber

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

Dependent

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

Action Required by customer:

Please update your system to take advantage of this payer transaction. For assistance with submitting Real-Time transactions, please contact your Practice Management System Vendor or Optum Customer Care Hub ticket https://customercare.changehealthcare.com/public/home.html.

REF 16338308 2/25/2025

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Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below on Feb. 24, 2025 were not processed by the payers.

Payers impacted: 

CPID	Payer Name
1214	AgeRight Advantage Health Plan
2842	Alexian PACE
4101	AllCare Advantage
8714	Allstate - Except New Jersey
9278	Ambetter from Nebraska Total Care
9431	Ambetter from WellCare of Kentucky
9432	Ambetter from WellCare of New Jersey
9433	Ambetter of Oklahoma
9142	American Health Advantage of Mississippi
7854	American Health Advantage of Oklahoma
1741	Amerigroup
4437	Anthem Blue Cross Blue Shield New York
6220	Arizona Priority Care Plus
4881	Asuris Northwest Regence
7272	Axminster Medical Group
3845	Banner Health Network
1407	Blue Cross Blue Shield of Georgia
1243	Blue Cross Community Centennial
1167	Blue Cross Medicare Advantage PPO/HMO
9162	Blue Medicare Advantage
6779	Bridgespan Regence
6165	Bridgeview
4246	Capital Health Plan
2810	Capitol Administrators
8146	Care N Care Insurance Co.
2289	Care1st Health Plan of Arizona Medicaid DOS after 11/30/2022
9759	Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022
2830	CarePlus Health Plans
1194	CareSource of Georgia
7143	CareSource of Indiana
3826	CareSource of Ohio
7263	CareSource of West Virginia
4743	Carelon Behavioral Health
2164	Carelon Behavioral Health Maryland
6127	Carelon Behavioral Health, MBHP
3293	Carelon Health
2885	Carelon Health of Pennsylvania
6777	Centers Plan for Healthy Living
9765	Central Valley Medical Providers
7275	Citrus Valley Physicians Group
8123	Clear Health Alliance
1415	Colorado Anthem Blue Cross Blue Shield
7416	Colorado Anthem Blue Cross Blue Shield HMO
6778	Common Ground Healthcare Cooperative
8834	Commonwealth Care Alliance DOS after 3/31/2023
2160	Community Care Plan (Commercial)
6865	Community Care Plan (Medicaid)
8147	Community Care Plan (Palm Beach Health District)
1420	Connecticut Anthem Blue Cross Blue Shield
2427	Connecticut BlueCare Family Plan
3420	Connecticut Medicare Blue (Risk)
6795	Contra Costa Health Plan
4460	Cook Group Health Plan
7738	CountyCare Health Plan
9747	Delaware First Health
1232	Denver Health Medical Plan, Inc. - Medicare Choice
2433	Denver Health and Hospital Authority
8135	Doctors HealthCare Plans
1119	Easy Choice Health Plan of California
4289	El Paso Health-CHIP
5483	Employee Benefit Management Services (EBMS)
1834	Employee Plans
5238	Evolent Specialty Cardiology
3792	Fidelis Care
2875	First Health Network (Coventry Health Care National Network)
7435	FirstCare Health Plans
1414	Florida Blue Cross Blue Shield
3417	Florida Blue Cross Blue Shield Health Options HMO
9128	Florida Blue Medicare
9417	Florida Complete Care
2150	Florida Health Care Plans
5440	Fox Valley Medicine
6851	Friday Health Plans
8189	Gemcare IPA
8879	Georgia Health Advantage
2720	GlobalCare
1772	HAP CareSource
1723	HealthCare Partners IPA
4448	HealthLink PPO
5243	Healthcare Management Administrators
8750	Healthy Blue Dual Advantage Louisiana
3224	Healthy Blue Kansas
7760	Healthy Blue Louisiana
8867	Healthy Blue Missouri
9133	Healthy Blue North Carolina
6272	Hispanic Physicians IPA (Encounters Only)
7715	Hopkins Health Advantage
6259	Humana - CareSource of Kentucky
3757	IMAGINE360 ADMINISTRATORS (GPA)
5479	IU Health Plan Medicare Advantage
7426	Idaho Regence Blue Shield
1405	Illinois Blue Cross Blue Shield
2234	Illinois Health Partners
5865	Indian Health Services
1412	Indiana Anthem Blue Cross Blue Shield
4116	IntegraNet Health
1107	Integrated Health Partners (IHP)
1404	Iowa Wellmark Blue Cross Blue Shield
6733	Iowa Wellmark Blue Cross Blue Shield Crossover
5432	Johns Hopkins Healthcare / Priority Partners
7782	Kansas Health Advantage
2421	Kentucky Anthem Blue Cross Blue Shield
9412	Leon Health Plans
6273	Lifepath Hospice
7446	Maine Anthem Blue Cross Blue Shield
8812	Maryland Physicians Care
3476	Masters, Mates and Pilots
8860	Medica Government Programs
7859	Medica Health Plan Solutions
6799	Medica Individual and Family (IFB)
2287	Medicare Plus Blue of MI(MAP)
9102	Meridian Medicare Medicaid Plan
9118	MeridianComplete Michigan
2426	Michigan Blue Care Network
1421	Michigan Blue Cross Blue Shield
1402	Minnesota Blue Cross Blue Shield
1410	Minnesota Blue Cross Blue Shield CC Systems
1429	Minnesota Blue Cross Blue Shield HMO
7892	Minnesota Blue Cross Blue Shield Health Care Programs
1408	Missouri Anthem Blue Cross Blue Shield
7450	Montana Blue Cross Blue Shield
7496	Nevada Anthem Blue Cross Blue Shield
7422	New Hampshire Anthem Blue Cross Blue Shield
7403	New Mexico Blue Cross Blue Shield
8864	NextBlue of North Dakota
2411	North Dakota Blue Cross Blue Shield
2881	Northwell Direct
2418	Ohio Anthem Blue Cross Blue Shield
1403	Oklahoma Blue Cross Blue Shield
2404	Oregon Regence Blue Cross Blue Shield
7829	Passport Advantage
8128	Pool Administrators, Inc.
5838	Preferred Administrators
3198	Preferred Benefit Administrators (Longwood, Florida)
7168	Premier Healthcare Exchange (PHX)
4252	Presbyterian Salud
2807	Professional Benefit Administrators (Oakbrook, Illinois)
4253	Prominence Administrative Services
7281	PruittHealth Premier Medicare Advantage
8182	PruittHealth Premier NC/SC
5428	QualChoice of Arkansas
7264	Quartz
1776	RIS Rx
1209	Regence Group Administrators
3257	ResourceOne Administrators
6246	Riverside Medical Clinic
4464	SCAN Health Plan
8816	SOMOS Emblem
2254	Scott & White Health Plan
9438	Shared Health Mississippi
7225	Sharp Community Medical Group
3847	Shasta Administrative Services
8124	Simply Healthcare Plans, Inc.
1740	Sonder Health Plans
2490	South Dakota Blue Cross Blue Shield
8134	Summit Community Care
6195	Superior Vision Services
1406	Texas Blue Cross Blue Shield
1729	Texas Childrens Health Plan (CHIP)
2483	Texas Childrens Health Plan (STAR Medicaid)
4278	The Boon Group
8473	Unicare
6849	United Group Programs
2412	Utah Regence Blue Cross Blue Shield
2788	Utah Regence Blue Cross Blue Shield Federal Employee Program
4258	VNS Health
7493	Vermont Blue Cross Blue Shield
1413	Virginia Anthem Blue Cross Blue Shield
7451	Washington Regence Blue Shield
1844	Wellcare Health Plans
3211	Wellcare Health Plans (Encounters)
9293	Wellcare by Allwell from Nebraska Total Care
9430	Wellcare by Allwell of Oklahoma
1775	Wellpoint
9441	Wellspace NEXUS LLC
1401	Wisconsin Anthem Blue Cross Blue Shield
7489	Wyoming Blue Cross Blue Shield
6731	ZELIS

A resolution has been implemented and the claims were retransmitted to the payer intermediary on Feb. 25, 2025.

This delay affected claims released to Optum between 10 a.m. and 2 p.m. CT on Feb. 24, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09378951.

REF 16337758 2/25/2025

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Report Generation Delay for CPID 6284 Trillium Health Resources

A payer is experiencing issues affecting Professional report generation for some claims submitted Feb. 14, 2025 through Feb. 21, 2025.

Payer impacted:

• CPID 6284 Trillium Health Resources

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 09379088.

REF 16335258  2/25/2025

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Report Generation Delay for CPIDs 6704 and 9576 Conifer Health Solutions

A payer is experiencing issues affecting Professional and Institutional report generation for claims submitted from Feb. 13, 2025 through Feb. 19, 2025.

Payer impacted:

• CPID 6704 Conifer Health Solutions
• CPID 9576 Conifer Health Solutions

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 09378921.

REF 16333709  2/25/2025

---

Report Generation Delay for CPID 5971 State Farm Insurance

A payer intermediary is experiencing issues affecting Professional report generation for claims submitted Jan. 28, 2025.

Payer impacted:

• CPID 5971 State Farm Insurance

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 09378875.

REF 16333708  2/25/2025

---

Report Generation Delay for CPID 9684 MotivHealth Insurance Company

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

Payer impacted: 

• CPID 9684 MotivHealth Insurance Company

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 09378887.

REF 16333658 2/25/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Patient Physician Cooperatives
Institutional CPID:  5020
Professional CPID:  8868
Payer-assigned Payer ID:  20510
Payer Enrollment Required:  No
Secondary Claims Accepted:  Yes
Payer Location:  National
Claims Fee:  N/A

Action Required: 

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

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

REF 16332408 2/25/2025

---

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below Feb. 21, 2025 were not processed by the payers.

Payers impacted:

CPID	Payer Name
9409	Align Senior Care of California
9267	Align Senior Care of Florida
4101	AllCare Advantage
2113	Allcare Health Plan
1765	Ambetter From Louisiana Healthcare Connections
9278	Ambetter from Nebraska Total Care
9431	Ambetter from WellCare of Kentucky
9775	Ambetter of Alabama
9433	Ambetter of Oklahoma
9270	American Benefit Corporation
9429	American Health Advantage of Idaho & Utah
9142	American Health Advantage of Mississippi
9117	American Health Advantage of Texas
4468	Americas Choice Healthplan
1741	Amerigroup
4437	Anthem Blue Cross Blue Shield New York
8749	Anthem MaineHealth
6220	Arizona Priority Care Plus
4477	Asuris Northwest Medadvantage Regence
7272	Axminster Medical Group
3845	Banner Health Network
8482	Benefit Plan Administrators - Roanoke, VA
1407	Blue Cross Blue Shield of Georgia
1169	Blue Cross Blue Shield of Western New York Medicaid/CHP
1243	Blue Cross Community Centennial
1167	Blue Cross Medicare Advantage PPO/HMO
6779	Bridgespan Regence
6145	CSI Network Services
4246	Capital Health Plan
2810	Capitol Administrators
2289	Care1st Health Plan of Arizona Medicaid DOS after 11/30/2022
9759	Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022
2830	CarePlus Health Plans
1194	CareSource of Georgia
7143	CareSource of Indiana
3826	CareSource of Ohio
4743	Carelon Behavioral Health
2164	Carelon Behavioral Health Maryland
6127	Carelon Behavioral Health, MBHP
3293	Carelon Health
6777	Centers Plan for Healthy Living
6700	Centurion Managed Care
7275	Citrus Valley Physicians Group
8123	Clear Health Alliance
1415	Colorado Anthem Blue Cross Blue Shield
7763	Columbine Health Plan
6778	Common Ground Healthcare Cooperative
8834	Commonwealth Care Alliance DOS after 3/31/2023
2160	Community Care Plan (Commercial)
6865	Community Care Plan (Medicaid)
8147	Community Care Plan (Palm Beach Health District)
1420	Connecticut Anthem Blue Cross Blue Shield
3419	Connecticut Federal Employee Health Benefits
6795	Contra Costa Health Plan
6241	Correctional Health Partners
7738	CountyCare Health Plan
9747	Delaware First Health
1232	Denver Health Medical Plan, Inc. - Medicare Choice
2433	Denver Health and Hospital Authority
8135	Doctors HealthCare Plans
3477	Early Intervention Central Billing
1119	Easy Choice Health Plan of California
7787	El Paso First Health Plans - Health Care Options (HCO)
4289	El Paso Health-CHIP
4279	El Paso Health-STAR
5483	Employee Benefit Management Services (EBMS)
1834	Employee Plans
2805	Employer Driven Insurance Services, Inc.
8137	Empower Healthcare Solutions
5238	Evolent Specialty Cardiology
3792	Fidelis Care
2875	First Health Network (Coventry Health Care National Network)
7435	FirstCare Health Plans
1414	Florida Blue Cross Blue Shield
3417	Florida Blue Cross Blue Shield Health Options HMO
9128	Florida Blue Medicare
9417	Florida Complete Care
2150	Florida Health Care Plans
5440	Fox Valley Medicine
8189	Gemcare IPA
8879	Georgia Health Advantage
2720	GlobalCare
9766	Gold Kidney Health Plan
1772	HAP CareSource
2891	HAP Caresource Michigan Marketplace
1723	HealthCare Partners IPA
4448	HealthLink PPO
5243	Healthcare Management Administrators
4740	Healthways WholeHealth Networks
3224	Healthy Blue Kansas
7760	Healthy Blue Louisiana
8867	Healthy Blue Missouri
9133	Healthy Blue North Carolina
6272	Hispanic Physicians IPA (Encounters Only)
6259	Humana - CareSource of Kentucky
3757	IMAGINE360 ADMINISTRATORS (GPA)
5479	IU Health Plan Medicare Advantage
7426	Idaho Regence Blue Shield
1405	Illinois Blue Cross Blue Shield
5865	Indian Health Services
1412	Indiana Anthem Blue Cross Blue Shield
4116	IntegraNet Health
1107	Integrated Health Partners (IHP)
8814	Integrated Homecare Services
1404	Iowa Wellmark Blue Cross Blue Shield
6733	Iowa Wellmark Blue Cross Blue Shield Crossover
5432	Johns Hopkins Healthcare / Priority Partners
5882	Kane County IPA
7782	Kansas Health Advantage
2421	Kentucky Anthem Blue Cross Blue Shield
9412	Leon Health Plans
6273	Lifepath Hospice
7446	Maine Anthem Blue Cross Blue Shield
8812	Maryland Physicians Care
3476	Masters, Mates and Pilots
8860	Medica Government Programs
7859	Medica Health Plan Solutions
6799	Medica Individual and Family (IFB)
2287	Medicare Plus Blue of MI(MAP)
9102	Meridian Medicare Medicaid Plan
9118	MeridianComplete Michigan
2426	Michigan Blue Care Network
1421	Michigan Blue Cross Blue Shield
1402	Minnesota Blue Cross Blue Shield
1410	Minnesota Blue Cross Blue Shield CC Systems
1429	Minnesota Blue Cross Blue Shield HMO
7892	Minnesota Blue Cross Blue Shield Health Care Programs
1408	Missouri Anthem Blue Cross Blue Shield
7450	Montana Blue Cross Blue Shield
1213	NHC Advantage
7496	Nevada Anthem Blue Cross Blue Shield
7422	New Hampshire Anthem Blue Cross Blue Shield
7403	New Mexico Blue Cross Blue Shield
8864	NextBlue of North Dakota
2411	North Dakota Blue Cross Blue Shield
2418	Ohio Anthem Blue Cross Blue Shield
1403	Oklahoma Blue Cross Blue Shield
2404	Oregon Regence Blue Cross Blue Shield
7829	Passport Advantage
9421	Perennial Advantage of Colorado
3280	Pool Administrators Oregon Secondary
8128	Pool Administrators, Inc.
4252	Presbyterian Salud
2807	Professional Benefit Administrators (Oakbrook, Illinois)
4253	Prominence Administrative Services
5428	QualChoice of Arkansas
7264	Quartz
1776	RIS Rx
1209	Regence Group Administrators
6246	Riverside Medical Clinic
4464	SCAN Health Plan
8708	SOMOS Anthem
8816	SOMOS Emblem
2254	Scott & White Health Plan
9438	Shared Health Mississippi
7225	Sharp Community Medical Group
3847	Shasta Administrative Services
8124	Simply Healthcare Plans, Inc.
1740	Sonder Health Plans
2490	South Dakota Blue Cross Blue Shield
8134	Summit Community Care
6195	Superior Vision Services
1406	Texas Blue Cross Blue Shield
1729	Texas Childrens Health Plan (CHIP)
2483	Texas Childrens Health Plan (STAR Medicaid)
4278	The Boon Group
8473	Unicare
6849	United Group Programs
2412	Utah Regence Blue Cross Blue Shield
2788	Utah Regence Blue Cross Blue Shield Federal Employee Program
4258	VNS Health
7493	Vermont Blue Cross Blue Shield
1413	Virginia Anthem Blue Cross Blue Shield
7451	Washington Regence Blue Shield
1844	Wellcare Health Plans
3211	Wellcare Health Plans (Encounters)
1775	Wellpoint
2448	Wellpoint Encounters
9441	Wellspace NEXUS LLC
1401	Wisconsin Anthem Blue Cross Blue Shield
7489	Wyoming Blue Cross Blue Shield
6731	ZELIS

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

This delay affected claims released to Optum Feb. 21, 2025, 2:00 p.m.-6:00 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 09377938.

REF 16327708  2/24/2025

---

Report Generation Delay for CPID 5473 Geisinger Health Plan

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

Payer impacted:

• CPID 5473 Geisinger 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 09378307.

REF 16326642  2/24/2025

---

Report Generation Delay for CPID 2795 Cigna HealthSpring Tennessee/Alabama

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

Payer impacted:

• CPID 2795 Cigna HealthSpring Tennessee/Alabama

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09378309.

REF 16326641  2/24/2025

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Report Generation Delay for CPIDs 3271 and 4508 Physicians Mutual Insurance Company

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted between Jan. 15, 2025 and Feb. 11, 2025.

Payer impacted:

• CPID 4508 Physicians Mutual Insurance Company
• CPID 3271 Physicians Mutual Insurance Company

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 09378151.

REF 16326410  2/24/2025

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Report Generation Delay for CPID 5835 Trilogy Health Network (TRLHN/EB)

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 14, 2025.

Payer impacted:

• CPID 5835 Trilogy Health Network (TRLHN/EB)

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 09371856.

REF 16326408  2/24/2025

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Report Generation Delay for CPID 2233 Consolidated Associates Railroad

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 5, 2025 and Feb. 14, 2025.

Payer impacted:

• CPID 2233 Consolidated Associates Railroad

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 09378147.

REF 16325564  2/24/2025

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Report Generation Delay for CPID 9685 Direct Care Administrators

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

Payer impacted:

• CPID 9685 Direct Care Administrators

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09378143.

REF 16325563  2/24/2025

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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 Feb. 6, 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 09373735.

REF 16325562  2/24/2025

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Invalid Error Message for Multiple Payers

Due to a payer processing issue, Professional claims for the payers listed below may have received the following invalid error message 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):

• A8:249 ACKNOWLEDGEMENT, REJECTED FOR RELATIONAL FIELD IN ERROR.:PLACE OF SERVICE.
• A8:454 ACKNOWLEDGEMENT, REJECTED FOR RELATIONAL FIELD IN ERROR.:PROCEDURE CODE FOR SERVICES RENDERED.
• A8:475 ACKNOWLEDGEMENT, REJECTED FOR RELATIONAL FIELD IN ERROR.:PROCEDURE CODE NOT VALID FOR PATIENT AGE
• R RELATIONAL EDIT -POS, PROCEDURE CODE AND AGE

This issue began January 25, 2025 and was resolved by the payer February 8, 2025.

Payers Affected:

• CPID 2414 New Jersey Horizon Blue Cross Blue Shield
• CPID 8844 Braven Health

Action Required: Please resubmit any impacted claims.

REF 16325559  2/24/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Bankers Life and Casualty
Institutional CPID: 5543
Professional CPID: 1240
Payer-assigned Payer ID: 61263
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National
Claims Fee: N/A

Action Required:

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

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

REF 16322759  2/24/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Bankers Life and Casualty
Institutional CPID: 5543
Professional CPID: 1240
Payer-assigned Payer ID: 61263
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National
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.

REF 16322758  2/24/2025

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Report Generation Delay for CPIDs 3935 and 1213 NHC Advantage

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Feb. 14, 2025.

Payer impacted:

• CPID 3935 NHC Advantage
• CPID 1213 NHC 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 09377749.

REF 16321858  2/24/2025

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Report Generation Delay for CPID 9769 Brain and Spine Network

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 13, 2025.

Payer impacted:

• CPID 9769 Brain and Spine Network

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 09377676.

REF 16321210  2/24/2025

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Southwestern Health Resources Clinically Integrated Network DOS after Dec. 31, 2022 Electronic Claims and Remittance Connection No Longer Available

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

Payer Name: Southwestern Health Resources Clinically Integrated Network DOS after Dec. 31, 2022
Claim and Remittance CPIDs: 8012, 9726
Payer-assigned Payer ID: RP085
Reason: Payer no longer contracted. Payer will no longer accept paper claims.

Action Required: None.

REF 16319558  2/24/2025

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Southwestern Health Resources Clinically Integrated Network DOS after Dec. 31, 2022 Electronic Claims and Remittance Connection No Longer Available

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

Payer Name: Southwestern Health Resources Clinically Integrated Network DOS after Dec. 31, 2022

Claim CPIDs: 8012, 9726
Remittance LOB: H4L
Payer-assigned Payer ID: RP085
Reason: Payer no longer contracted. Payer will no longer accept paper claims.

Action Required: None.

REF 16319564  2/24/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Harmony
Institutional CPID: 8505
Professional CPID: 3218
Payer-assigned Payer ID: HARM1
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: California
Claims Fee: N/A

Action Required:

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

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

REF 16319458

---

Report Generation Delay for CPID 2712 The Alliance

A payer is experiencing issues affecting Professional report generation for some claims submitted Feb. 14, 2025 and Feb. 15, 2025.

Payer impacted:

• CPID 2712 The Alliance

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 09377241.

REF 16316614  2/24/2025

---

Report Generation Delay for CPID 1281 Passport Health Plan DOS prior to Jan. 1, 2021

A payer is experiencing issues affecting Professional report generation for some claims submitted Feb. 14, 2025.

Payer impacted:

• CPID 1281 Passport Health Plan DOS prior to Jan. 1, 2021

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 09377240.

REF 16316613

---

Report Generation Delay for CPID 1748 MVP Health Care

A payer is experiencing issues affecting Professional report generation for some claims submitted Feb. 15, 2025 and Feb. 16, 2025.

Payer impacted:

• CPID 1748 MVP Health Care

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 09377239.

RE 16316612  2/24/2025

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Additional ERA Agreement Form Now Required for CPID 6130 – Payer ID - 65054 Payer Name- Premier Eye Care

The following payer now requires providers to submit a additional ERA enrollment form for 

• 5529 -Payer ID – 65062 -  Care Access PSN

In addition providers will need to follow enrollment instructions listed on the additional enrollment form and add this payer to their Smart Data Provider Account.

Both Payer ID 65054 and Payer ID 65062 will need to be added to Smart Data Provider Account in order to receive ERAs for 65054.

Providers already submitting transactions through Optum must complete an enrollment form.

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

Action Required:  All providers should submit an enrollment form to obtain authorization for this payer.

REF 16311008 2/21/2025

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Remittance Reactivation for CPIDs 6820, 7613 CenterLight Healthcare

Optum has restored electronic remittance connectivity for the following payer:

Payer Name: CenterLight Healthcare
Institutional CPID: 7613
Professional CPID: 6820
Industry Payer ID: 13360

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.
  • New providers must complete a new enrollment form.

Action Required: 

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

REF 16308359 2/21/2025

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Remittance Reactivation for CPIDs 6820, 7613 CenterLight Healthcare

Optum has restored electronic remittance connectivity for the following payer:

Payer Name: CenterLight Healthcare
Institutional CPID: 7613
Professional CPID: 6820
Industry Payer ID: 13360
Line of Business (LOB) Code: H3Z

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
  • New providers must complete a new enrollment form.

Action Required:

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

REF 16308358  2/21/2025

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Electronic Eligibility and Claim Status No Longer Available

Effective immediately, electronic Eligibility and Claim Status for the payer listed below will no longer be available at Optum.

Payer Name: Benefit Management Inc. of Kansas (aka Benefit Management of Kansas)
Industry Payer ID: 48611
IMN Real Time ID: BMNKS
Exchange Real Time ID: BNMGT, BNMGT1
CPID(s): 1632, 6118
Optum iEDI Real Time ID: N/A
Connection Type: X12 and Portal

Reason: Payer went out of business.

Action Required: None.

REF 16306958  2/21/2025

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Payer Change for CPIDs 2923, 8455 Peoples Health Network

Update: Effective February 28, 2025, CPIDs 8455 and 2923 Peoples Health Network will be terminated for remittance transactions. Providers must enroll under CPIDs 3429 and 3550 UnitedHealthcare before the termination date to avoid interruptions with remittance delivery.

Original notify sent Dec. 17, 2024:

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

Claims and Remittance containing Dates of Service on or prior to December 31, 2023, must continue to use the following. After January 1, 2025, this payer will be terminated:

Payer Name: Peoples Health Network
Professional CPID: 8455
Professional Edit Master:  PE_E049
Institutional CPID: 2923
Institutional Edit Master: HE9E049
Payer-assigned Payer ID: 72126
Line of Business Code (LOB): U1V

All Claims and Remittance must begin using the following on January 1, 2025:

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

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 3429, 3550 UnitedHealthcare do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 3429, 3550 UnitedHealthcare 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.

REF 16305908 2/21/2025

---

Payer Change for CPIDs 2923, 8455 Peoples Health Network

Update: Effective February 28, 2025, CPIDs 8455 and 2923 Peoples Health Network will be terminated for remittance transactions. Providers must enroll under CPIDs 3429 and 3550 UnitedHealthcare before the termination date to avoid interruptions with remittance delivery.

Original notify sent Dec. 17, 2024:

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

Claims and Remittance containing Dates of Service on or prior to December 31, 2023, must continue to use the following. After January 1, 2025, this payer will be terminated:

Payer Name: Peoples Health Network
Professional CPID:  8455
Institutional CPID:  2923
Remittance Available: Yes
Payer-assigned Payer ID: 72126

All Claims and Remittance must begin using the following on January 1, 2025:

Payer Name: UnitedHealthcare
Professional CPID: 3429
Institutional CPID: 3550
Remittance Available: Yes
Payer-assigned Payer ID: 87726
Claim Fee: N/A

Enrollment Requirements:

Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
• Providers currently receiving electronic remittance through Optum for CPIDs 3429, 3550 UnitedHealthcare do not need to complete a new enrollment form.
• Providers not receiving electronic remittance through Optum for CPIDs 3429, 3550 UnitedHealthcare 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.

REF 16305910 2/21/2025

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Medicare HETS - Upcoming HETS2025-1 System Release - April 2025

CMS announces upcoming HETS2025-1 system release which will impact HETS 270/271 Submitters.   

The HETS2025-1 release will introduce changes to the HETS 270 request and the HETS 271 response. CMS has published the HETS2025-1 Release Summary in anticipation of this release.  CMS urges all HETS submitters to use this HETS2025-1 Release Summary and the upcoming HETS2025-1 Companion Guide to prepare for this future release. The vast majority of HETS submitters will need to make 270 request changes for this release.

HETS2025-1 Release Summary: https://www.cms.gov/files/document/hets2025-1-hets-270/271-release-summary.pdf (version 1.0)

The HETS2025-1 release is currently scheduled for April, 2025. Submitters will be notified when additional information is available regarding this release.

Action Required:  Review updated details on the potential changes that are linked above and distribute as appropriate within your facility.

REF 16268608 2/21/2025

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Report Generation Delay for CPID 7493 Vermont Blue Cross Blue Shield

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

Payer impacted: 

• CPID 7493 Vermont Blue Cross Blue Shield

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 09375406 .

REF 16301468 2/21/2025

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New Electronic Real Time Connections Available on RPA

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

77170 – Common Ground Healthcare Cooperative
MICS1 – HAP Caresource Michigan Marketplace
MPCHA – Atrio Health Plans
PRVMS – Provident American Life Medicare Supplement

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

68039 – Western Health Advantage
77170 – Common Ground Healthcare Cooperative
MICS1 – HAP Caresource Michigan Marketplace
PRVMS – Provident American Life Medicare Supplement
RP129 – Wellstar Health Plan
SKCT0 – Connecticut Medicaid
SKNM0 – New Mexico Medicaid
SKOH0 – Ohio Medicaid

REF 16301508 2/21/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available: 

Payer Name: Clearwater
Institutional CPID: 7960
Professional CPID: 2834
Payer-assigned Payer ID: DCRSS
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.

REF 16300708 2/21/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available: 

Payer Name: Clearwater
Institutional CPID: 7960
Professional CPID: 2834
Payer-assigned Payer ID: DCRSS
Line of Business (LOB) Code: K1E
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.

REF 16300709 2/21/2025

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Invalid Error Message for CPID 2098 Physicians Medical Group of San Jose

Due to a processing issue, Institutional claims for the payer listed below may have received the following invalid error messages 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: A3^125^PR
Message: PAYER NAME MATCHING REQUIRED. X12 INFO- 2010BB-NM1.PAYER NAME MATCHING REQUIRED

Payer impacted:

• CPID 2098 Physicians Medical Group of San Jose

This issue began Feb. 11, 2025 and was resolved Feb. 18, 2025.

Claims were retransmitted to the payer Feb. 21, 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 09374788.

REF 16302559  2/21/2025

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Real Time Transactions Unavailable

Optum has confirmed the following Medicaid payers are not responding with usable data for eligibility checks. We are working with the payers to restore service as quickly as possible.

List of Medicaid payers affected: 

• Delaware 
• Indiana
• Kansas 
• Kentucky 
• Montana 
• New Jersey 
• South Carolina 
• Tennessee 
• Texas 
• Virginia 
• Washington 
• West Virginia 
• New York 
• North Carolina 
• District of Columbia 

We will provide updates as more information becomes available.

REF 16303858  2/21/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: East West Administrators
Institutional CPID: 3659
Professional CPID: 1839
Payer-assigned Payer ID: EWACA
Line of Business (LOB) Code: U37
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.

REF 16302210  2/21/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: East West Administrators
Institutional CPID: 3659
Professional CPID: 1839
Payer-assigned Payer ID: EWACA
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.

REF 16302209  2/21/2025

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New Electronic Remittance Connections Available on Revenue Performance Advisor

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

3833S – McLaren Medicare Supplement
54398 – Allina Health and Aetna Insurance Company
IHS21 – Covet Health
SHPS1 – Scripps Coastal Medical Group

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

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

REF 16301509  2/21/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Live Well IPA
Institutional CPID: 2679
Professional CPID: 1831
Payer-assigned Payer ID: LWIPA
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: California
Claims Fee: N/A

Action Required: 

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

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

REF 16299758  2/21/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Live Well IPA
Institutional CPID: 2679
Professional CPID: 1831
Payer-assigned Payer ID: LWIPA
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.

REF 16299708  2/21/2025

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Electronic Routing Change for CPIDs 5953, 2121 Healthy Blue South Carolina

Effective February 20, 2025, Optum will be changing electronic claims and remittance routing for the following payer: 

Payer Name: Healthy Blue South Carolina
Professional CPID: 2121
Institutional CPID: 5953
Payer-assigned Payer ID: 00403
Line of Business Code (LOB): U2O 

Enrollment Requirements:  

Claims: 

Payer enrollment for electronic claims is not required. 

Remittance: 

Payer enrollment for electronic remittance is required. 

Providers currently receiving electronic remittance through Optum must complete a new enrollment form. 

New providers must complete a new enrollment form. 

Report Changes: 

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

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

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.

REF 16293810 2/20/2025

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Electronic Routing Change for CPIDs 5953, 2121 Healthy Blue South Carolina

Effective February 20, 2025, Optum will be changing electronic claims and remittance routing for the following payer: 

Payer Name: Healthy Blue South Carolina
Professional CPID: 2121
Institutional CPID: 5953
Payer-assigned Payer ID: 00403 

Enrollment Requirements:  

Claims: 

Payer enrollment for electronic claims is not required. 

Remittance: 

Payer enrollment for electronic remittance is required. 

Providers currently receiving electronic remittance through Optum must complete a new enrollment form. 

New providers must complete a new enrollment form. 

Report Changes: 

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

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

Make any necessary system changes. 

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

REF 16293809 2/20/2025

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Update: Payer Change for CPIDs 1579, 6467 Government Employees Health Association

Update: Effective March 4, 2025, CPIDs 1579 and 6467 Government Employees Health Association will be terminated for claims and remittance transactions. Claims sent to CPIDs 1579 and 6467 will be rejected. Providers must begin using CPIDs 5402 and 4590 United Medical Resources before the termination date to avoid claim rejections.

Original notify 16112708 sent Feb. 6, 2025:
Effective immediately, claims currently exchanged with the following payer must use different CPIDs.

Payer Name: Government Employees Health Association
Professional CPID: 6467
Institutional CPID: 1579
Remittance Available: Yes
Payer-assigned Payer ID: 44054

Providers must begin using the following for claims and remittance:
Payer Name: United Medical Resources
Professional CPID: 5402
Institutional CPID: 4590
Remittance Available: Yes
Payer-assigned Payer ID: 39026
Claim Fee: No

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 5402, 4590 United Medical Resources do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 5402, 4590 United Medical 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.

REF 16112708  2/6/2025
REF 16286710  2/20/2025

---

New Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Provider Partners Health Plan of Indiana
Institutional CPID: 8533
Professional CPID: 3223
Payer-assigned Payer ID: 31407
Line of Business (LOB) Code: H5R
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Indiana

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.

REF 16284811  2/20/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Provider Partners Health Plan of Indiana
Institutional CPID: 8533
Professional CPID: 3223
Payer-assigned Payer ID: 31407
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Indiana

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.

REF 16284810  2/20/2025

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Update: Report Generation Delay for CPIDs 5909 and 4743 Carelon Behavioral Health

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Jan. 27, 2025 through Feb. 6, 2025.

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

Original notify sent Feb. 5, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 24, 2025.

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09353922.

REF 16087608 / 16283458 2/20/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: WPS Midlands
Institutional CPID: 8544
Professional CPID: 3277
Payer-assigned Payer ID: 95930
Payer Enrollment Required: Yes
Secondary Claims Accepted: No
Payer Location: Wisconsin
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.

REF 16275010  2/19/2025

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Electronic Routing Change for CPID 7845 WPS Optum Health

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

Payer Name: WPS Optum Health
Professional CPID: 7845
Payer-assigned Payer ID: 95937

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is required.
• Providers currently sending electronic claims through Change Healthcare must complete a new enrollment form.
• New providers must complete a new enrollment form.

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

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

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

REF 16275009  2/19/2025

---

Electronic Routing Change for CPID 7845 WPS Optum Health

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

Payer Name: WPS Optum Health
Professional CPID: 7845
Current Edit Master: PE_T007
Payer-assigned Payer ID: 95937

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is required.
• Providers currently sending electronic claims through Change Healthcare must complete a new enrollment form.
• New providers must complete a new enrollment form.

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

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

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

REF 16275008  2/19/2025

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CMS Medicare HETS - Upcoming HETS2025-1 System Release - April 2025

CMS announces upcoming HETS2025-1 system release which will impact HETS 270/271 Submitters.   

The HETS2025-1 release will introduce changes to the HETS 270 request and the HETS 271 response. CMS has published the HETS2025-1 Release Summary in anticipation of this release.  CMS urges all HETS submitters to use this HETS2025-1 Release Summary and the upcoming HETS2025-1 Companion Guide to prepare for this future release. The vast majority of HETS submitters will need to make 270 request changes for this release.

HETS2025-1 Release Summary: https://www.cms.gov/files/document/hets2025-1-hets-270/271-release-summary.pdf (version 1.0)

The HETS2025-1 release is currently scheduled for April, 2025. Submitters will be notified when additional information is available regarding this release.

Action Required:  Review updated details on the potential changes that are linked above and distribute as appropriate within your facility.

REF 16268608 2/19/2025

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New electronic Eligibility and Claim Status connection available -CONNECTICUT MEDICAID 

Effective February 04, 2025, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271, and Claim Status 276/277 transactions for the below payer:

Payer Name: CONNECTICUT MEDICAID
IMN Real Time ID: SKCT0
Exchange Real Time ID: CTCAID
CPID(s): 3535 / 4476
Optum IEDi Real Time ID: CTMCD
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber:

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

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

REF 16272608 2/19/2025

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New electronic Eligibility and Claim Status connection available - OHIO MEDICAID

Effective February 04, 2025, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271, and Claim Status 276/277 transactions for the below payer:

Payer Name: OHIO MEDICAID
IMN Real Time ID: SKOH0
Exchange Real Time ID: OHCAID
CPID(s): 2481 / 3509
Optum IEDi Real Time ID: OHMCD
Payer Enrollment Required: No
Connection Type: X12

Search Options:

Eligibility Subscriber:

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

REF 16270509 2/19/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Assist Health Group
Institutional CPID: 2965
Professional CPID: 1762
Payer-assigned Payer ID: 86147
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.

REF 16274109 2/19/2025

---

Electronic Claims Connection Suspended

Effective immediately, the payer listed below has/have been temporarily suspended at Optum for claims processing and removed from the payer list.

Payer Name: Northwest Community Health Partners
CPIDs: 8480, 3070
Payer ID: NWCHP

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

REF 16272762  2/19/2025

---

Resolved: Electronic Remittance Advice (ERA) Delay for California Medi-Cal

This message is intended for Revenue Performance Advisor (RPA) customers.

Update 2/19/2025: This issue has been resolved.

Update 1/28/2025: Thank you for your patience as we work to resolve this issue. The payer is working to process the impacted ERA.

Original Notice Sent on Jan. 14, 2025:

Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payer for check date of Jan. 6, 2025:

• SKCA3 California Medi-Cal 
• SKCA0 California Medi-Cal

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 dates above.

REF 16269609  2/19/2025

---

Payer Enrollment Processing Time Change for TRICARE West & East Regions

This message is intended for Revenue Performance Advisor (RPA) customers.

Due to the recent payer change, the processing time on enrollments has increased from 30 days to 60 days due to an influx of enrollments received.

• 12C01 Tricare West Region (Institutional)
• SCWI0 Tricare West Region (Professional)
• 99727 Tricare East Region (Institutional)
• 99727 Tricare East Region (Professional)

Optum's Enrollment Team will continue to monitor the backlog of enrollments and update our processing time once we see Tricare enrollments processing has returned to optimal levels.

REF 16269608  2/19/2025

---

New Payer Name

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

Previous Payer Name: Midwest Health Partners
New Payer Name: Auxiant fka Midwest Health Partners
Professional CPID: 1108
Institutional CPID: 9520
Edit Masters: HE9E049, PE_E049

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

Action Required:  You may choose to update the Payer Alias in your system to accommodate the new payer name after the Feb. 20, 2025 edit release.

REF 16268458  2/19/2025

---

New Payer Name

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

Previous Payer Name: Midwest Health Partners
New Payer Name: Auxiant fka Midwest Health Partners
Professional CPID: 1108
Institutional CPID: 9520

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

REF 16268358  2/19/2025

---

New Electronic Claims Connections Available

This message is intended for Assurance Reimbursement Management and Assurance EDI customers.

Optum has a new electronic claims connection available:

Payer Name: Affiliated Physicians IPA
Professional CPID: 3262
Payer-assigned Payer ID: POP06
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National
Claims Fee: N/A

Action Required:

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

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

REF 16260158  2/18/2025

---

Delay in Electronic Remittance Advice (ERA) for Multiple Payers

Due to a payer intermediary processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for file date of January 24, 2025:

• CPID 2161 AR MEDICARE OKC ONLY
• CPID 2455 AR MEDICARE
• CPID 1526 ARKANSAS MEDICARE
• CPID 2162 CO MEDICARE OKC ONLY
• CPID 1449 COLORADO MEDICARE
• CPID 1547 COLORADO MEDICARE
• CPID 2165 DC MEDICARE OKC ONLY
• CPID 1522 DC MEDICARE
• CPID 2163 DELAWARE MEDICARE OKC ONLY
• CPID 2456 DELAWARE MEDICARE
• CPID 5912 DELAWARE MEDICARE
• CPID 3650 JH MUTUAL OF OMAHA CO NM OK TX
• CPID 3677 JL MUTUAL OMAHA DC DE MD NJ PA
• CPID 2171 LOUISIANA MEDICARE OKC ONLY
• CPID 1460 LOUISIANA MEDICARE
• CPID 3579 LOUISIANA MEDICARE
• CPID 2464 MARYLAND MEDICARE
• CPID 7402 MARYLAND MEDICARE
• CPID 2201 MD MEDICARE OKC ONLY
• CPID 5554 MD MEDICARE
• CPID 2451 MISSISSIPPI MEDICARE
• CPID 5556 MS MEDICARE
• CPID 1465 NEW JERSEY MEDICARE
• CPID 1457 NEW MEXICO MEDICARE
• CPID 2205 NJ MEDICARE OKC ONLY
• CPID 4938 NJ MEDICARE OKC ONLY
• CPID 5503 NJ MEDICARE UB92
• CPID 2204 NM MEDICARE OKC ONLY
• CPID 2206 OK MEDICARE OKC ONLY
• CPID 4942 OK MEDICARE OKC ONLY
• CPID 1458 OKLAHOMA MEDICARE
• CPID 1558 OKLAHOMA MEDICARE
• CPID 2207 PA MEDICARE OKC ONLY
• CPID 4944 PA MEDICARE OKC ONLY
• CPID 5598 PA MEDICARE
• CPID 2457 PENNSYLVANIA MEDICARE
• CPID 5502 TEXAS MEDICARE UB92
• CPID 1440 TEXAS MEDICARE
• CPID 2208 TX MEDICARE OKC ONLY
• CPID 4946 TX MEDICARE OKC ONLY
• CPID 2459 WASHINGTON DC MEDICARE

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-000002276.

REF 16258059  2/18/2025

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Report Generation Delay for CPID 1503 CHAMPVA

A payer is experiencing issues affecting Institutional report generation for some claims submitted since Feb. 6, 2025

Payer impacted:

• CPID 1503 CHAMPVA

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 09370465.

REF 16255908  2/18/2025

---

New Payer Name

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

Previous Payer Name: Tervist
New Payer Name: StarMed Administrators
Professional CPID: 9109
Institutional CPID: 5064
Edit Master: PE_T007, HE9T007

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

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

REF 16250909  2/18/2025

---

New Payer Name

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

Previous Payer Name: Tervist
New Payer Name: StarMed Administrators
Professional CPID: 9109
Institutional CPID: 5064

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

REF 16250908  2/18/2025

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Optum Notice: Electronic Routing Change and Payer Name Change for Multiple Payers

Effective February 18, 2025, Optum will be changing electronic claims routing and Payer Name Change for the following payers:

Current Payer Name: HealthComp
New Payer Name:  HealthComp North
Professional CPID: 4287
Institutional CPID: 2984
Payer-assigned Payer ID: 36149
Secondary Claims Accepted: No

Current Payer Name:  HealthComp
New Payer Name:  HealthComp West
Professional CPID: 3206
Institutional CPID:  2934
Payer-assigned Payer ID:  85729
Secondary Claims Accepted: Yes 

Current Payer Name: HealthComp
New Payer Name: HealthComp South
Professional CPID: 2802
Institutional CPID:  2557
Payer-assigned Payer ID:  07205
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.

REF 16242059 2/17/2025

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Electronic Routing Change and Payer Name Change for Multiple Payers

Effective Feb. 18, 2025, Optum is changing electronic claims routing and Payer Name Change for the following payers:

Current Payer Name: HealthComp
New Payer Name: HealthComp North
Professional CPID: 4287
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 2984
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 36149
Secondary Claims Accepted: No

Current Payer Name: HealthComp
New Payer Name: HealthComp West
Professional CPID: 3206
Current Edit Master: PE_N000
New Edit Master: PE_T007
Institutional CPID: 2934
Current Edit Master: HE9N000
New Edit Master: HE9T007
Payer-assigned Payer ID: 85729
Secondary Claims Accepted: Yes

Current Payer Name: HealthComp
New Payer Name: HealthComp South
Professional CPID: 2802
Current Edit Master: PE_E049
New Edit Master: PE_T007
Institutional CPID: 2557
Current Edit Master: HE9E049
New Edit Master: HE9T007
Payer-assigned Payer ID: 07205
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 names and CPIDs are not changing.
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

REF 16242058  2/17/2025

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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 Feb. 1, 2025.

Payer impacted:

• CPID 2287 Medicare Plus Blue of MI(MAP)

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 09367823.

REF 16236311 2/17/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name:  Allina Health and Aetna Insurance Company
Institutional CPID: 7599
Professional CPID: 7780
Payer-assigned Payer ID: 54398
Line of Business (LOB) Code: K4W
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.

REF 16235813 2/17/2025

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: Pool Administrators Oregon Secondary
Professional CPID: 3280
Payer-assigned Payer ID: PAIOR02
Line of Business(LOB) Code: K4Y
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Oregon
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.

REF 16235309  2/17/2025

---

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: Pool Administrators Oregon Secondary
Professional CPID: 3280
Payer-assigned Payer ID: PAIOR02
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Oregon
Claims Fee: $0.10
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.

REF 16235308  2/17/2025

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Payer Enrollment Processing Time Change for CPIDs 5648, 6286 TRICARE West Region

Due to the recent payer change, the processing time on enrollments has increased from 30 days to 60 days due to an influx of enrollments received.

CPIDs:

• 5648 Tricare West Region
• 6286 Tricare West Region

Optum's Enrollment Team will continue to monitor the backlog of enrollments and update our processing time once we see Tricare enrollments processing has returned to optimal levels.

REF 16226758 2/14/2025

---

Resolved: Delay in Electronic Remittance Advice (ERA) for California Medi-Cal

This message is intended for Assurance EDI and Assurance Reimbursement Management customers.

Update: This issue has been resolved.

Action Required: 

Medi-cal had a system issue that affected payments for certain providers. The issue caused incorrect payments for some providers (both under payments and overpayments with a payment date of 12/30/24). Medi-Cal rectified the problem and corrected the payments via Account Receivable (AR) transaction(s) in subsequent weeks.

It was later identified that this same system issue also resulted in incomplete or in some cases missing X12N 835 files. To remedy this, Medi-Cal had to recreate the incomplete or missing X12N 835 files. This task has been completed and the files are available for Receiver download in the Medi-Cal Provider Portal.

 Medi-cal informed that you would have to go into the Medi-Cal Provider Portal and download the new X12N 835 file(s) that have been loaded

• If the X12N 835 file was missing originally, then the Receiver(s) simply download the file 
• If the X12N 835 file was missing records (but a file was present originally), then the Receiver(s) will see a second file is now loaded (which contains the missing records). They need to download and use both files.

If you have any questions, feel free to contact your Customer Support Team and refer to Case INC-000002175.

Original Notice Sent on Jan. 13, 2025:

Due to a payer processing issue, there has been a delay in Professional and Institutional Electronic Remittance Advice (ERA) for the following payers for check date of January 6, 2025:

• CPID 1473 California Medi-Cal
• CPID 1648 California Medi-Cal
• CPID 3510 California Medi-Cal
• CPID 5023 California Medi-Cal
• CPID 5024 California Medi-Cal
• CPID 5025 California Medi-Cal
• CPID 5026 California Medi-Cal
• CPID 5987 California Medi-Cal
• CPID 8613 California Medi-Cal

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 dates above.

If you have any questions, feel free to contact your Customer Support Team and refer to case 09312305.

REF 15806982 15878458 16224147 2/14/2025

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Payer Change for CPIDs 1285, 7499, 7567 Sentara Health Plans and 7828, 1003 Virginia Premier Health Plans

Effective Feb. 28, 2025, claims and remittance currently exchanged with the following payers must use different CPIDs:

Payer Name: Sentara Mental Health
Professional CPID: 1285
Payer-assigned Payer ID: 5415M
Payer Name: Virginia Premier Health Plans
Professional CPID: 7828
Institutional CPID: 1003
Payer-assigned Payer ID: VAPRM

Providers must begin using the below for claims and remittance transactions. Optum will also be changing electronic claims routing for this payer. Claims enrollment is now required.

Old Payer Name: Sentara Health/Optima Health
New Payer Name: Sentara Health Plans
Professional CPID: 7499
Payer-assigned Payer ID: 54154
Claim Fee: N/A
Institutional CPID: 7567
Old Payer-assigned Payer ID: 00453
New Payer-assigned Payer ID: 54154
Claim Fee: N/A
Payer Claim Enrollment Required: Yes
Secondary Claims Accepted: No
Payer Remittance Enrollment Required: Yes

Both Fee For Service and Mental Health claims should be sent to Payer ID 54154, CPIDs 7499, 7567.

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is required with the new route.
• Providers must complete a new enrollment form by Feb. 28, 2025 to avoid claim rejections.

Remittance:

• Payer enrollment for electronic remittance is required.
• Providers currently receiving electronic remittance through Optum for CPIDs 7499 and 7567, Sentara Health Plans, do not need to complete a new enrollment form.
• Providers currently not receiving electronic remittance through Optum for CPIDs 7499 and 7567, Sentara Health Plans, must complete a new enrollment form.
• New providers must complete a new enrollment form.

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

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

• Make any necessary system changes.
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.
• Complete claim enrollment forms by Feb. 28, 2025 to avoid rejections.

REF 16221986

---

Payer Change for CPIDs 1285, 7499, 7567 Sentara Health Plans and 7828, 1003 Virginia Premier Health Plans

Effective Feb. 28, 2025, claims and remittance currently exchanged with the following payers must use different CPIDs:

Payer Name: Sentara Mental Health
Professional CPID: 1285
Professional Edit Master: PE_T007
Payer-assigned Payer ID: 5415M

Payer Name: Virginia Premier Health Plans
Professional CPID: 7828
Professional Edit Master: PE_T007
Institutional CPID: 1003
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: VAPRM

Providers must begin using the below for claims and remittance transactions. Optum will also be changing electronic claims routing for this payer. Claims enrollment is now required:

Old Payer Name: Sentara Health/Optima Health
New Payer Name: Sentara Health Plans
Professional CPID: 7499
Old Professional Edit Master: PE_T007
New Professional Edit Master: PE_B800
Payer-assigned Payer ID: 54154
Institutional CPID:  7567
Old Institutional Edit Master: HE9T007
New Institutional Edit Master: HE9B801
Old Payer-assigned Payer ID: 00453
New Payer-assigned Payer ID: 54154
Payer Claim Enrollment Required: Yes
Secondary Claims Accepted: No
Payer Remittance Enrollment Required: Yes
Line of Business Code (LOB): U97

Both Fee For Service and Mental Health claims should be sent to Payer ID 54154, CPIDs 7499, 7567.

Enrollment Requirements:
Claims:

Payer enrollment for electronic claims is required with the new route.

• Providers must complete a new enrollment form by 02/28/2025 to avoid claim rejections.

Remittance:

• Payer enrollment for electronic remittance is required.
• Providers currently receiving electronic remittance through Optum for CPIDs 7499 and 7567, Sentara Health Plans, do not need to complete a new enrollment form.
• Providers currently not receiving electronic remittance through Optum for CPIDs 7499 and 7567, Sentara Health Plans, must complete a new enrollment form.
• New providers must complete a new enrollment form.

Report Changes:

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

Action Required: Please make the following 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.

Complete claim enrollment forms by Feb 28, 2025 to avoid rejections.

REF 16221984  2/14/2025

---

Rendering Taxonomy Code Required

Please be advised that Partnership Health Plan of California (payer ID SX140) is in the process of implementing a new system to process claim files.

Please ensure to include the billing and rendering taxonomy codes when submitting claims; this is for informational purposes only, and no further action is required.

REF 16208558 2/14/2025

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Remittance Reactivation for CPIDs 8749, 4020 Anthem MaineHealth

Optum recently restored electronic remittance connectivity for the following payer:

Payer Name: Anthem MaineHealth
Professional CPID: 8749
Institutional CPID: 4020
Industry Payer ID: 00958
Line of Business (LOB) Code: U5U

Remittance Enrollment Requirements:

• Payer enrollment for electronic remittance is required:
  • Providers currently receiving electronic remittance for this payer do not need to complete a new enrollment form.
  • 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.

REF 16216661 2/14/2025

---

Remittance Reactivation for CPIDs 8749, 4020 Anthem MaineHealth

Optum recently restored electronic remittance connectivity for the following payer:

Payer Name: Anthem MaineHealth
Professional CPID: 8749
Institutional CPID: 4020
Industry Payer ID: 00958

Remittance Enrollment Requirements:

• Payer enrollment for electronic remittance is required:
• Providers currently receiving electronic remittance for this payer do not need to complete a new enrollment form.
• 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.
• 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.

REF 16216658  2/14/2025

---

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

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

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

Original notify REF 15942309 sent Jan. 24, 2025:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 14, 2025.

Payer impacted:

• CPID 1913 Medicare Plus Blue of MI (MAP)
• 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 09339386.

REF 16215758  2/14/2025

---

UPDATE: Electronic Routing Change for CPIDs 7670 and 7113 Continuum Health Solutions

The below notify was sent with an incorrect Payer ID.  The correct payer ID for Continuum Health Solutions / Aspirion MVA is Payer ID 46478.

Effective February 12, 2025, Optum will be reactivating and changing electronic remittance routing for the following payer. There will also be a payer name change.

Current Payer Name: Continuum Health Solutions
New Payer Name: Aspirion MVA
Professional CPID: 7113
Institutional CPID: 7670
Payer-assigned Payer ID: 83247
Line of Business Code (LOB): J7G

Enrollment Requirements: 

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Change Healthcare 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: 

• Modify related Payer Alias names
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

REF 16209165 2/13/2025

---

Electronic Routing Change for CPID 6910 Care Access PSN

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

Payer Name: Care Access PSN
Institutional CPID: 6910
Current Edit Master: HE9T007
New Edit Master: HE9B801
Payer-assigned Payer ID: 12K89

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.

REF 16207560  2/13/2025

---

Electronic Routing Change for CPID 6910 Care Access PSN

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

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

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.

REF 16207558  2/13/2025

---

Report Generation Delay for CPIDs 3066 and 8468 Procare Advantage of TX

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

Payer impacted: 

• CPID 3066 Procare Advantage of TX
• CPID 8468 Procare Advantage of TX

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 09365245.

REF 16205458 2/13/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Highmark Health Options Dual
Institutional CPID: 8553
Professional CPID: 3298
Payer-assigned Payer ID: 47183
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location: Delaware
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.

REF 16205117  2/13/2025

---

Report Generation Delay for CPIDs 9563 and 7281 PruittHealth Premier Medicare Advantage

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

Payer impacted: 

• CPID 9563 PruittHealth Premier Medicare Advantage
• CPID 7281 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 09365159.

REF 16203909

---

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 on Feb. 3, 2025.

Payer impacted: 

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

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 09365056.

REF 16202612 2/13/2025

---

Report Generation Delay for CPIDs 3061 and 8454 Align Senior Care of Michigan

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

Payer impacted:

• CPID 3061 Align Senior Care of Michigan
• CPID 8454 Align Senior Care 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 09365109.

REF 16203908  2/13/2025

---

Electronic Routing Change for CPIDs 7670 and 7113 Continuum Health Solutions

Effective February 12, 2025, Optum will be reactivating and changing electronic remittance routing for the following payer. There will also be a payer name change.

Current Payer Name: Continuum Health Solutions
New Payer Name: Aspirion MVA
Professional CPID: 7113
Institutional CPID: 7670
Payer-assigned Payer ID: 46478

Enrollment Requirements: 

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Change Healthcare 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.
• Custom

REF 16188826 2/12/2025

---

Electronic Routing Change for CPIDs 7670 and 7113 Continuum Health Solutions

Effective February 12, 2025, Optum will be reactivating and changing electronic remittance routing for the following payer. There will also be a payer name change.

Current Payer Name: Continuum Health Solutions
New Payer Name: Aspirion MVA
Professional CPID: 7113
Institutional CPID: 7670
Payer-assigned Payer ID: 83247
Line of Business Code (LOB): J7G

Enrollment Requirements: 

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Change Healthcare 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: 

• Modify related Payer Alias names
• When a payer requires enrollment, forms must be submitted and approved from Enrollment Central.

REF 16190458 2/12/2025

---

Report Generation Delay for CPIDs 3554 and 1205 Lifeworks Advantage (ISNP Plan)

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

Payer impacted:

• CPID 3554 Lifeworks Advantage (ISNP Plan)
• CPID 1205 Lifeworks Advantage (ISNP 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 09363082.

REF 16183395  2/12/2025

---

Report Generation Delay for CPIDs 5077 and 9123 Perennial Advantage

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

Payer impacted:

• CPID 5077 Perennial Advantage
• CPID 9123 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 09363025.

REF 16183109  2/12/2025

---

Report Generation Delay for CPIDs 3935 and 1213 NHC Advantage

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

Payer impacted: 

• CPID 3935 NHC Advantage
• CPID 1213 NHC 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 09362954.

REF 16180366 2/12/2025

---

Electronic Routing Change for CPIDs 2007 and 8139 Surest

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

Payer Name: Surest
Professional CPID: 8139
Institutional CPID: 2007
Payer-assigned Payer ID: 25463
Line of Business (LOB) Code: H6V

Enrollment Requirements:
Remittance:

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

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

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

REF 16180010  2/12/2025

---

Electronic Claims Connection Suspended

Effective immediately, the payer listed below has/have been temporarily suspended at Optum for claims processing and removed from the payer list.

Payer Name: HealthComp
CPIDs: 2557, 2802
Payer ID: 07205

Payer Name: HealthComp
CPIDs: 2934, 3206
Payer ID: 85729

Payer Name: HealthComp
CPIDs: 2984, 4287
Payer ID: 36149

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

REF 16180206 2/12/2025

---

Report Generation Delay for CPID 8257 Veterans Affairs Community Care Network Region 1, 2, 3 - VACCN

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

Payer impacted:

• CPID 8257 Veterans Affairs Community Care Network Region 1, 2, 3 - VACCN

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 09361509.

REF 16165408  2/12/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name:  Heritage Consultants
Institutional CPID: 8512
Payer-assigned Payer ID: 59230
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: National
Claims Fee: N/A

Action Required:

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

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

REF 16171444  2/12/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name:  Amada Health
Institutional CPID: 8552
Professional CPID: 3297
Payer-assigned Payer ID: AMADA
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location:  California
Claims Fee: N/A

Action Required:

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

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

REF 16171443  2/12/2025

---

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name:  Lifeshield National Insurance
Institutional CPID: 8550
Professional CPID: 3289
Payer-assigned Payer ID: 47865
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location:  Oklahoma
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.

REF 16169859  2/11/2025

---

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below on Feb. 10, 2025 were not processed by the payers.

Payers impacted: 

CPID	Payer Name
2842	Alexian PACE
9409	Align Senior Care of California
4101	AllCare Advantage
2113	Allcare Health Plan
8714	Allstate - Except New Jersey
1764	Ambetter From Absolute Total Care
1765	Ambetter From Louisiana Healthcare Connections
9278	Ambetter from Nebraska Total Care
9431	Ambetter from WellCare of Kentucky
9775	Ambetter of Alabama
3235	Ambetter of Delaware
9433	Ambetter of Oklahoma
9429	American Health Advantage of Idaho & Utah
9142	American Health Advantage of Mississippi
7854	American Health Advantage of Oklahoma
4468	Americas Choice Healthplan
1741	Amerigroup
4437	Anthem Blue Cross Blue Shield New York
6220	Arizona Priority Care Plus
7794	Associated Hispanic Physicians IPA
4477	Asuris Northwest Medadvantage Regence
4881	Asuris Northwest Regence
7272	Axminster Medical Group
3845	Banner Health Network
1407	Blue Cross Blue Shield of Georgia
1243	Blue Cross Community Centennial
1167	Blue Cross Medicare Advantage PPO/HMO
9162	Blue Medicare Advantage
4110	Bollinger Inc
6779	Bridgespan Regence
6165	Bridgeview
4246	Capital Health Plan
2810	Capitol Administrators
2289	Care1st Health Plan of Arizona Medicaid DOS after 11/30/2022
9759	Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022
2830	CarePlus Health Plans
9226	CareSource PASSE of Arkansas
1194	CareSource of Georgia
7143	CareSource of Indiana
3826	CareSource of Ohio
7263	CareSource of West Virginia
4743	Carelon Behavioral Health
2164	Carelon Behavioral Health Maryland
6127	Carelon Behavioral Health, MBHP
3293	Carelon Health
2885	Carelon Health of Pennsylvania
6777	Centers Plan for Healthy Living
9765	Central Valley Medical Providers
7275	Citrus Valley Physicians Group
8123	Clear Health Alliance
1415	Colorado Anthem Blue Cross Blue Shield
6778	Common Ground Healthcare Cooperative
8834	Commonwealth Care Alliance DOS after 3/31/2023
2160	Community Care Plan (Commercial)
8147	Community Care Plan (Palm Beach Health District)
1420	Connecticut Anthem Blue Cross Blue Shield
3419	Connecticut Federal Employee Health Benefits
6795	Contra Costa Health Plan
7738	CountyCare Health Plan
9747	Delaware First Health
1232	Denver Health Medical Plan, Inc. - Medicare Choice
2433	Denver Health and Hospital Authority
8135	Doctors HealthCare Plans
1733	Doctors Professional Services Consultants (DPSC)
1119	Easy Choice Health Plan of California
4289	El Paso Health-CHIP
5483	Employee Benefit Management Services (EBMS)
8137	Empower Healthcare Solutions
5238	Evolent Specialty Cardiology
3792	Fidelis Care
2875	First Health Network (Coventry Health Care National Network)
7435	FirstCare Health Plans
1414	Florida Blue Cross Blue Shield
3417	Florida Blue Cross Blue Shield Health Options HMO
9128	Florida Blue Medicare
9417	Florida Complete Care
2150	Florida Health Care Plans
8189	Gemcare IPA
8879	Georgia Health Advantage
2720	GlobalCare
9766	Gold Kidney Health Plan
1772	HAP CareSource
1797	HAP CareSource Michigan Dual Medicare/Medicaid
1723	HealthCare Partners IPA
4448	HealthLink PPO
5243	Healthcare Management Administrators
8750	Healthy Blue Dual Advantage Louisiana
3224	Healthy Blue Kansas
7760	Healthy Blue Louisiana
8867	Healthy Blue Missouri
9133	Healthy Blue North Carolina
6272	Hispanic Physicians IPA (Encounters Only)
7715	Hopkins Health Advantage
6259	Humana - CareSource of Kentucky
3757	IMAGINE360 ADMINISTRATORS (GPA)
5479	IU Health Plan Medicare Advantage
7426	Idaho Regence Blue Shield
1405	Illinois Blue Cross Blue Shield
2234	Illinois Health Partners
5865	Indian Health Services
1412	Indiana Anthem Blue Cross Blue Shield
4445	Insurance Management Services TX
4116	IntegraNet Health
1107	Integrated Health Partners (IHP)
8814	Integrated Homecare Services
1404	Iowa Wellmark Blue Cross Blue Shield
6733	Iowa Wellmark Blue Cross Blue Shield Crossover
5432	Johns Hopkins Healthcare / Priority Partners
7782	Kansas Health Advantage
2421	Kentucky Anthem Blue Cross Blue Shield
9412	Leon Health Plans
6273	Lifepath Hospice
7446	Maine Anthem Blue Cross Blue Shield
8812	Maryland Physicians Care
8860	Medica Government Programs
7859	Medica Health Plan Solutions
6799	Medica Individual and Family (IFB)
2287	Medicare Plus Blue of MI(MAP)
3475	Memorial Hermann Health Solutions
9102	Meridian Medicare Medicaid Plan
9118	MeridianComplete Michigan
2426	Michigan Blue Care Network
1421	Michigan Blue Cross Blue Shield
1402	Minnesota Blue Cross Blue Shield
1410	Minnesota Blue Cross Blue Shield CC Systems
1429	Minnesota Blue Cross Blue Shield HMO
7892	Minnesota Blue Cross Blue Shield Health Care Programs
1408	Missouri Anthem Blue Cross Blue Shield
7450	Montana Blue Cross Blue Shield
7496	Nevada Anthem Blue Cross Blue Shield
7422	New Hampshire Anthem Blue Cross Blue Shield
7403	New Mexico Blue Cross Blue Shield
8864	NextBlue of North Dakota
2411	North Dakota Blue Cross Blue Shield
2881	Northwell Direct
2418	Ohio Anthem Blue Cross Blue Shield
1403	Oklahoma Blue Cross Blue Shield
2404	Oregon Regence Blue Cross Blue Shield
7829	Passport Advantage
9421	Perennial Advantage of Colorado
8128	Pool Administrators, Inc.
5838	Preferred Administrators
4252	Presbyterian Salud
8468	Procare Advantage of TX
2807	Professional Benefit Administrators (Oakbrook, Illinois)
4253	Prominence Administrative Services
7281	PruittHealth Premier Medicare Advantage
5428	QualChoice of Arkansas
7264	Quartz
1776	RIS Rx
1209	Regence Group Administrators
6246	Riverside Medical Clinic
4464	SCAN Health Plan
8708	SOMOS Anthem
8816	SOMOS Emblem
2254	Scott & White Health Plan
9438	Shared Health Mississippi
7225	Sharp Community Medical Group
3847	Shasta Administrative Services
8124	Simply Healthcare Plans, Inc.
1740	Sonder Health Plans
2490	South Dakota Blue Cross Blue Shield
1116	Special Agents Mutual Benefit Association (SAMBA) Teledoc only
8134	Summit Community Care
6195	Superior Vision Services
1406	Texas Blue Cross Blue Shield
1729	Texas Childrens Health Plan (CHIP)
2483	Texas Childrens Health Plan (STAR Medicaid)
4278	The Boon Group
2812	Troy Medicare
8473	Unicare
2412	Utah Regence Blue Cross Blue Shield
2788	Utah Regence Blue Cross Blue Shield Federal Employee Program
4258	VNS Health
7493	Vermont Blue Cross Blue Shield
1413	Virginia Anthem Blue Cross Blue Shield
7451	Washington Regence Blue Shield
1844	Wellcare Health Plans
3211	Wellcare Health Plans (Encounters)
1775	Wellpoint
9441	Wellspace NEXUS LLC
1401	Wisconsin Anthem Blue Cross Blue Shield
7489	Wyoming Blue Cross Blue Shield
6731	ZELIS

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

This delay affected claims released to Optum between 10 a.m. and 2 p.m. CT on Feb. 10, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09361508.

REF 16170061 2/11/2025

---

UPDATE: New Electronic Claims and Remittance Connections Available

Update: The previous communication included an Institutional claims connection in error, please see corrected communication. 

Optum has new electronic claims and remittance connections available:  

Payer Name: Pool Administrators Oregon Primary
Professional CPID: 3264
Payer-assigned Payer ID: PAIOR01 

Line of Business(LOB) Code: K4X
Payer Claim Enrollment Required: Yes
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Oregon
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.

REF 16164609 2/11/2025

---

Report Generation Delay for CPID 8257 Veterans Affairs Community Care Network Region 1, 2, 3 - VACCN

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

Payer impacted:

• CPID 8257 Veterans Affairs Community Care Network Region 1, 2, 3 - VACCN

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 09361509.

REF 16165408  2/11/2025

---

UPDATE: New Electronic Claims and Remittance Connections Available

Update: The previous communication included an Institutional claims connection in error, please see corrected communication.

Optum has new electronic claims and remittance connections available: 

Payer Name: Pool Administrators Oregon Primary
Professional CPID: 3264
Payer-assigned Payer ID: PAIOR01
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: Oregon
Claims Fee: $0.10
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.

REF 16164208  2/11/2025

---

Report Generation Delay for CPID 3937 AgeRight Advantage Health Plan

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Feb. 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 09361423.

REF 16162664  2/11/2025

---

Report Generation Delay for CPID 8467 Keycare

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

Payer impacted: 

• CPID 8467 Keycare

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 09361398.

REF 16162663 2/11/2025

---

Report Generation Delay for CPID 6127 Carelon Behavioral Health, MBHP

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

Payer impacted: 

• CPID 6127 Carelon Behavioral Health, MBHP

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09361312.

REF 16161862 2/11/2025

---

Update: Report Generation Delay for CPIDs 6284 and 5658 Trillium Health Resources

Update: The payer has been unable to generate and deliver the reports for some claims submitted from Dec. 2, 2024 through Feb. 7, 2025.

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

Original notify sent Jan. 30, 2025

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Dec. 2, 2024.

Payer impacted:

• CPID 6284 Trillium Health Resources
• CPID 5658 Trillium Health Resources

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 09347156.

REF 16015446 / 16162166 2/11/2025

---

Electronic Routing Change for CPID 2098 Physicians Medical Group of San Jose

Effective Feb. 11, 2025, Optum is reactivating and changing electronic claims routing for the following payer:

Payer Name: Physicians Medical Group of San Jose
Institutional CPID: 2098
Current Edit Master: HE9O007
New Edit Master: HE9T007
Payer-assigned Payer ID: EXC01

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 change to accommodate the routing change:

• Revalidate unreleased claims to edit correctly under new edit master.

REF 16161909  2/11/2025

---

Electronic Routing Change for CPID 2098 Physicians Medical Group of San Jose

Effective Feb. 11, 2025, Optum is reactivating and changing electronic claims routing for the following payer:

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

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.

REF 16161908  2/11/2025

---

Update: Report Generation Delay for CPIDs 9615 and 7292 CorrectCare Integrated Health- Louisiana

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Dec. 23, 2024 through Jan. 17, 2025.

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

Original notify sent Jan. 8, 2025:

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Dec. 23, 2024.

Payer impacted:

• CPID 9615 CorrectCare Integrated Health- Louisiana
• CPID 7292 CorrectCare Integrated Health- Louisiana

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.

REF 15771673 / 16160809 2/11/2025

---

Update: Report Generation Delay for CPID 1733 Doctors Professional Services Consultants (DPSC)

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted from Nov. 21, 2024 through Feb. 3, 2025.

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

Original notify sent Nov. 14, 2024:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Oct. 28, 2024.

Payer impacted:

• CPID 1733 Doctors Professional Services Consultants (DPSC)

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.

REF 819704 / 16161258 2/11/2025

---

Report Generation Delay for CPID 4876 International Medical Group

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

Payer impacted:

• CPID 4876 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 09360294.

REF 16151059  2/10/2025

---

Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Jan. 31, 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 09360276.

REF 16151058 2/10/2025

---

Invalid Error Message for Sanford Health claims

Due to a payer processing issue, professional claims for Sanford Health (91184) may have received the following invalid error message on the Payer/Trading Partner report level:

A3:21 ACK,RETURND AS UNPRCESSBLE CLM- CLM,ENCNTER BEEN REJECTD AND NOT ENTERD INTO ADJUDICATION SYS.:MISSING OR INVALID INFORMATION
R THE SERVICE FACILITY LOCATION INFORMATION (LOOP 2310C) IS REQUIRED.

This issue began January 8, 2025, and was resolved by the payer January 27, 2025.

Action Required:
Please resubmit any impacted claims.

REF 16144546  2/10/2025

---

Report Generation Delay for CPIDs 1064 and 7892 Minnesota Blue Cross Blue Shield Health Care Programs

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Jan. 28, 2025 and Jan. 29, 2025.

Payer impacted:

• CPID 1064 Minnesota Blue Cross Blue Shield Health Care Programs
• CPID 7892 Minnesota Blue Cross Blue Shield Health Care Programs

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 09359741.

REF 16144858 2/10/2025

---

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

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

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09359639.

REF 16142412 2/10/2025

---

Payer Change for CPID 4709 Sutter Connect – SIP, SMG, SWMG - 2nd notice

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

Payer Name: Sutter Connect - SIP,SMG,SWMG
Professional CPID:  4709
Professional Edit Master:  PE_T007
Payer-assigned Payer ID: 77306

Both Encounters and Fee For Service claims must use the following:

Previous Payer Name: Sutter Connect - SIP,SMG,SWMG encounters
New Payer Name: Sutter Connect - SIP,SMG,SWMG
Professional CPID: 4708
Professional Edit Master: PE_T007
Institutional CPID: 7956
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: 77306

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required.

Sutter Connect - SIP,SMG,SWMG, CPID 4709 will be terminated on February 14, 2025

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.

REF 16145240 2/10/2025

---

Payer Change for CPID 4709 Sutter Connect – SIP, SMG, SWMG - 2nd notice

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

Payer Name: Sutter Connect - SIP,SMG,SWMG
Professional CPID: 4709
Remittance Available: No
Payer-assigned Payer ID: 77306

Both Encounters and Fee For Service claims must use the following:

Previous Payer Name: Sutter Connect - SIP,SMG,SWMG encounters
New Payer Name: Sutter Connect - SIP,SMG,SWMG
Professional CPID: 4708
Institutional CPID: 7956
Remittance Available: No
Payer-assigned Payer ID: 77306
Claim Fee: N/A

Enrollment Requirements: 

Claims:

• Payer enrollment for electronic claims is not required.

Sutter Connect - SIP,SMG,SWMG, CPID 4709 will be terminated on February 14, 2025

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.

REF 16145212 2/10/2025

---

Resolved: Processing Issue for Electronic Remittance Advice (ERA) for CPID 3507 Ohio Medicare

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

Original Notice Sent on January 23, 2025:

Due to a payer processing issue, there has been a processing issue for Institutional Electronic Remittance Advice (ERA) for the following payers for check dates of January 3, 2025 through January 8, 2025.

• CPID 3507 Ohio Medicare

This could result in: 

• Discrepancies between the deposit amount and the ERA amount

Additional updates will be forwarded as more information becomes available.

Action Required: Please be aware of a processing issue for 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-000002181.

REF 15933158/16140558 2/10/2025

---

Electronic Routing Change for CPIDs 7499 and 7567 Sentara Health/Optima Health

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

Payer Name: Sentara Health/Optima Health
Professional CPID: 7499
Institutional CPID: 7567
Payer-assigned Payer ID: 54154, 00453
Line of Business Code (LOB): U97

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.

REF 16130264  2/7/2025

---

Electronic Routing Change for CPIDs 7499 and 7567 Sentara Health/Optima Health

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

Payer Name: Sentara Health/Optima Health
Professional CPID: 7499
Institutional CPID: 7567
Payer-assigned Payer ID: 54154, 00453

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.

REF 16130263  2/7/2025

---

Report Generation Delay for CPID 1209 Regence Group Administrators

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Jan. 27, 2025.

Payer impacted: 

• CPID 1209 Regence Group Administrators

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09357268.

REF 16125858 2/7/2025

---

New Electronic Medical Attachment Connections Available

Optum has new electronic medical attachment connections available:

Payer Name: Keystone First
Professional CPID: 8475
Institutional CPID: 6531
Payer-assigned Payer ID: 23284
Accepted Attachment Types: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Pennsylvania

Payer Name: AmeriHealth Caritas Pennsylvania
Professional CPID: 1710
Institutional CPID: 4547
Payer-assigned Payer ID: 22248
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Pennsylvania

Payer Name: First Choice by Select Health of South Carolina
Professional CPID: 2890
Institutional CPID: 7544
Payer-assigned Payer ID: 23285
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: South Carolina

Payer Name: AmeriHealth Caritas Delaware
Professional CPID: 7746
Institutional CPID: 7507
Payer-assigned Payer ID: 77799
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Delaware

Payer Name: AmeriHealth Caritas Louisiana
Professional CPID: 6156
Institutional CPID: 4638
Payer-assigned Payer ID: 27357
Accepted Attachment Types: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Louisiana

Payer Name: AmeriHealth Caritas District of Columbia
Professional CPID: 6441
Institutional CPID: 5670
Payer-assigned Payer ID: 77002
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: District of Columbia

Payer Name: AmeriHealth Caritas New Hampshire
Professional CPID: 8238
Institutional CPID: 2090
Payer-assigned Payer ID: 87716
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: New Hampshire

Payer Name: Blue Cross Complete of Michigan
Professional CPID:7409
Institutional CPID: 5096
Payer-assigned Payer ID: 32002
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Michigan

Payer Name: AmeriHealth Caritas North Carolina
Professional CPID: 8859
Institutional CPID: 4083
Payer-assigned Payer ID: 81671
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: North Carolina

Payer Name: PerformCare
Professional CPID: 6183
Institutional CPID: 4657
Payer-assigned Payer ID: 65391
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Pennsylvania

Payer Name: AmeriHealth Caritas Florida
Professional CPID: 2106
Institutional CPID: 8963
Payer-assigned Payer ID: 77003
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Florida

Payer Name: AmeriHealth Caritas Ohio
Professional CPID: 9428
Institutional CPID: 7045
Payer-assigned Payer ID: 84243
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Ohio

Payer Name: Keystone First VIP Choice
Professional CPID: 6751
Institutional CPID: 6649
Payer-assigned Payer ID: 77741
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Pennsylvania

Payer Name: AmeriHealth Caritas VIP Care PA CommHealthChoices
Professional CPID: 1268
Institutional CPID: 6501
Payer-assigned Payer ID: 77062
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Pennsylvania

Payer Name: Keystone First Community HealthChoices
Professional CPID: 8121
Institutional CPID: 1093
Payer-assigned Payer ID: 42344
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Pennsylvania

Payer Name: First Choice VIP Care
Professional CPID: 9248
Institutional CPID: 6087
Payer-assigned Payer ID: 32456
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: South Carolina

Payer Name: First Choice VIP Care Plus by Select Health of SC
Professional CPID: 7193
Institutional CPID: 8631
Payer-assigned Payer ID: 77009
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: South Carolina

Payer Name: AmeriHealth Caritas VIP Care Plus Michigan
Professional CPID: 7212
Institutional CPID: 8656
Payer-assigned Payer ID: 77013
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Michigan

Payer Name: AmeriHealth Caritas Next North Carolina
Professional CPID: 9192
Institutional CPID: 6038
Payer-assigned Payer ID: 83148
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: North Carolina

Payer Name: AmeriHealth Caritas Next A Product of AmeriHealth Caritas VIP Next, Inc.
Professional CPID: 9426
Institutional CPID: 7043
Payer-assigned Payer ID: 47073
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Delaware

Payer Name: First Choice Next A Product of Select Health of South Carolina, Inc.
Professional CPID: 9425
Institutional CPID: 7042
Payer-assigned Payer ID: 57103
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: South Carolina

Payer Name: AmeriHealth Caritas Next A Product of AmeriHealth Caritas Florida, Inc.
Professional CPID: 9427
Institutional CPID: 7044
Payer-assigned Payer ID: 45408
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Florida

Payer Name: AmeriHealth Caritas VIP Care - Delaware DSNP
Professional CPID: 9484
Institutional CPID: 7081
Payer-assigned Payer ID: 87406
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Delaware

Payer Name: AmeriHealth Caritas VIP Care - Florida DSNP
Professional CPID: 9485
Institutional CPID: 7082
Payer-assigned Payer ID: 88232
Accepted Attachment Type: Solicited 275 and Unsolicited 275
Payer Enrollment Required: No
Payer Location: Florida

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 IDs are for Medical Attachments and may require Providers and/or their vendor be contracted with Optum for the Medical Attachment transaction services.

REF 16124810  2/7/2025

---

Report Generation Delay for CPIDs 9774 and 8055 Curative

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

Payer impacted: 

• CPID 9774 Curative
• CPID 8055 Curative

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 09352825.

REF 16112160 2/6/2025

---

Report Generation Delay for CPIDs 4410 and 8654 Educators Mutual Insurance Association

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since Dec. 10, 2024.

Payer impacted: 

• CPID 4410 Educators Mutual Insurance Association
• CPID 8654 Educators Mutual Insurance Association

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 09315938.

REF 16112858 2/6/2025

---

Report Generation Delay for CPID 8985 Health Choice Pathway

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

Payer impacted: 

• CPID 8985 Health Choice Pathway

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 09352783.

REF 16113308 2/6/2025

---

Payer Change for CPIDs 1579, 6467 Government Employees Health Association

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

Payer Name: Government Employees Health Association
Professional CPID: 6467
Institutional CPID: 1579
Remittance Available: Yes
Payer-assigned Payer ID: 44054

Providers must begin using the following for claims and remittance:

Payer Name: United Medical Resources
Professional CPID: 5402
Institutional CPID: 4590
Remittance Available: Yes
Payer-assigned Payer ID: 39026
Claim Fee: No

Enrollment Requirements:
Claims:

• Payer enrollment for electronic claims is not required.

Remittance:

• Payer enrollment for electronic remittance is required.
  • Providers currently receiving electronic remittance through Optum for CPIDs 5402, 4590 United Medical Resources do not need to complete a new enrollment form.
  • Providers not receiving electronic remittance through Optum for CPIDs 5402, 4590 United Medical 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.

REF 16112708

---

Remittance Reactivation for CPIDs 3678, 4279 El Paso Health-STAR

Optum recently restored electronic remittance connectivity for the following payer: 

Payer Name: El Paso Health-STAR 

Professional CPID: 4279 

Institutional CPID: 3678 

Industry Payer ID: EPF02 

Line of Business (LOB) Code: H3V 

Remittance Enrollment Requirements: 

Payer enrollment for electronic remittance is required: 

Providers currently receiving electronic remittance for this payer do not need to complete a new enrollment form. 

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.

REF 16105208 2/6/2025

---

Remittance Reactivation for CPIDs 3678, 4279 El Paso Health-STAR

Optum recently restored electronic remittance connectivity for the following payer: 

Payer Name: El Paso Health-STAR 

Professional CPID: 4279 

Institutional CPID: 3678 

Industry Payer ID: EPF02 

Remittance Enrollment Requirements: 

Payer enrollment for electronic remittance is required: 

Providers currently receiving electronic remittance for this payer do not need to complete a new enrollment form. 

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.

REF 16105209 2/6/2025

---

Report Generation Delay for CPIDs 9774 and 8055 Curative

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

Payer impacted: 

• CPID 9774 CurativeCPID 8055 Curative

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 09352825.

REF 16112160 2/6/2025

---

Optum Alert: Report Generation Delay for CPID 5428 QualChoice of Arkansas

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Jan. 25, 2025.

Payer impacted:

• CPID 5428 QualChoice of Arkansas

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09355654.

REF 16106808  2/6/2025

---

System Maintenance – Clearinghouse Database Maintenance

Optum will be doing maintenance on our database. As part of that maintenance, claims and remit processing will be unavailable Feb. 21, 2025, 10:00 p.m.-Feb. 22, 2025, 4:00 p.m. CT.

Assurance EDI and ConnectCenter customers need to be aware of the following: 

• The ConnectCenter application will not be available during the event.
• The Enrollment Central application will not be available during the event.
• All transaction processing will be unavailable during the maintenance. This includes:
  • Claims
  • Remittance
  • Claim Status
  • Eligibility
  • Authorization/Referral
• The InfoExchange application will not be available during the event.
• API clients that use our Claims Submission and Claims Validation API will not be able to utilize that API until the event has completed.
• API clients that use our Claims Response and Reports API to pick up reports can retrieve reports created prior to the event start but no new reports will be available until the event has completed.
• Claims will not be delivered to the payer until the event has completed.
• Remits will not be retrieved or processed from payers until the event has completed.

Begin: Friday, Feb. 21, 2025, 10:00 p.m. CT
End: Saturday, Feb. 22, 2025, 4:00 p.m. CT

Action Required by You
Please be advised of the maintenance schedule above and adjust your processes accordingly. Please follow your normal escalation path in the unlikely event you experience issues.

For additional information or assistance, please contact product support at [email protected] or by phone at 800-527-8133, option 2.

REF 16095260  2/5/2025

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Report Generation Delay for multiple CPIDs

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

Payers impacted:

• CPID 5475 Tufts Health Public Plans
• CPID 2438 Tufts Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09354015.

REF 16088958  2/5/2025

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PAR Status Change – Molina

Effective Mar. 1, 2025, the PAR status for the attached list of Molina payers will change from PAR to NON-PAR.

Payer Name	Industry ID	CPIDs	IMN RT ID	EXCH RT ID
Molina Complete Care of Arizona	MCC01	1098,8127	MLNAZ	MLNAZ
Molina Complete Care of Virginia	MCC02	3042,8291	26176	MLNVA
Molina Healthcare of California	38333	3539,1423	38333	CAMLNA
Molina Healthcare of California (Encounters Only)	33373	1019,7844	n/a	n/a
Molina Healthcare of Florida	51062	8913,4879	51062	FLMLNA
Molina Healthcare of Florida Encounters	00513	1718	n/a	n/a
Molina Healthcare of Idaho	61799	1018,7842	61799	MLNID
Molina Healthcare of Illinois	20934	6907,6806	20934	MOLIL
Molina Healthcare of Michigan	38334	3551,5443	38334	MIMLNA
Molina Healthcare Of Nevada	MLNNV	6086,9247	MLNNV	MLNNV
Molina Healthcare of New Mexico	09824	8914,3848	09824	NMMLNA
Molina Healthcare of Ohio	20149	1908,2286	20149	OHMLNA
Molina Healthcare of South Carolina	46299	6998,6794	MLNSC	SCMLNA
Molina Healthcare of Texas	20554	4957,4226	20554	TXMLNA
Molina Healthcare of Utah	12X09, SX109	3611,4237	SX109	UTMLNA
Molina Healthcare of Virginia Encounters	10101	1965,1756	n/a	n/a
Molina Healthcare of Washington	38336	2561,1863	38336	WAMLNA
Molina Healthcare of Washington (Encounters Only)	43174	8212	n/a	n/a
Molina Healthcare of Wisconsin	ABRI1	5951,2119	ABRI1	MLNAWI
Passport Health Plan by Molina Healthcare	61325	5015,8863	MLNKY	MLNKY
Senior Whole Health of Massachusetts	SWHMA	6085,9246	SWHMA	SWHMA

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

REF 16086558  2/5/2025

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Enrollment Form Change for CPIDs 6704, 9576-Payer ID 95399-Payer Name: Conifer Health Solutions

The following payers have changed their Remittance enrollment form:

• CPID 6704 / Payer ID 95399 / Conifer Health Solutions
• CPID 9576 / Payer ID 95399 / Conifer Health Solutions

Providers already approved to submit and receive transactions through Optum do not need to complete a new enrollment form.
To access the new enrollment form, please visit Enrollment Central.

Action Required: None for existing providers. New providers should begin using the new enrollment form immediately.

Customers who have completed an enrollment prior to Feb. 5, 2025 are NOT required to take action. And enrollment record has been created and the form has been uploaded to Availity on your behalf.

Customers submitting an enrollment going forward will be required to link themselves to CHC1 as their Clearinghouse within Availity’s Transaction Enrollment portal, as well as upload the completed form.

Instructions can be found within Enrollment Central.

REF 16089709  2/5/2025

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Report Generation Delay for CPIDs 5909 and 4743 Carelon Behavioral Health

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Jan. 24, 2025.

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09353922.

REF 16087608  2/5/2025

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Report Generation Delay for CPIDs 1532 and 4480 Select Health

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted Jan. 28, 2025 and Jan. 29, 2025.

Payer impacted:

• CPID 1532 Select Health
• CPID 4480 Select 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 09352959.

REF 16076712  2/4/2025

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Blue Shield of California Rejections for New 1/1/2025 HCPC Codes

Blue Shield of California experienced a delay in their code load for January, resulting in a high volume of claims and encounters being rejected with error code 0x3939612 for HCPC Codes effective 1/1/2025. We are unable to reprocess these records internally and request providers to resubmit any rejected claims.

Timeframe: 

Process dates of 1/1/25 – 2/2/25 but only if the date of service is 1/1/25 or after. 

For all BS CA plans:

All BS CA plans payer ids 94036 BS CA commercial, 94032 BS CA HMO encounters, 99105 BS CA Medicare encounters, 57115 BS CA Promise Health Plan.

Rejection:

BS CA claim Rejection Error code 0x3939612 for HCPC Codes effective 1/1/2025

Provider action:

BS CA is not able to reprocess these records internally and request providers to resubmit any rejected claims for this rejection in this timeframe.

REF 16071748 2/4/2025

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Electronic Routing Change for CPIDs 8892 and 5046 Banner Medicare Advantage Plus PPO (BMAP)

Effective February 4, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Current Payer Name: Banner Medicare Advantage Plus PPO (BMAP)

New Payer Name: Banner Medicare Advantage Plus 

Professional CPID: 8892

Institutional CPID: 5046

Payer-assigned Payer ID: 84324

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 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.

REF 16071908 2/4/2025

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Electronic Routing Change for CPIDs 8892 and 5046 Banner Medicare Advantage Plus PPO (BMAP)

Effective February 4, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Current Payer Name: Banner Medicare Advantage Plus PPO (BMAP)
New Payer Name: Banner Medicare Advantage Plus
Professional CPID: 8892
Edit Master: PE_T007
Institutional CPID: 5046Edit Master: HE9T007

Payer-assigned Payer ID: 84324

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

REF 16071909 2/4/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available: 

Payer Name: CVS Accountable Care
Professional and Institutional CPID: 3258
Payer-assigned Payer ID: CVSACO
Line of Business (LOB) Code: K4V
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.

REF 16071412  2/4/2025

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New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:  

Payer Name: CVS Accountable Care
Professional and Institutional CPID: 3258
Payer-assigned Payer ID: CVSACO
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.

REF 16071413  2/4/2025

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Payer Deactivation Notice - HealthSCOPE Benefits

Effective immediately, Institutional and Professional Claims for the following payer has been deactivated on the Revenue Performance Advisor system:

Payer Name: HealthSCOPE Benefits
Payer ID: 71063
Reason: Payer no longer in business.

Action Required: Please discontinue use of the above Payer ID. Providers should review the patient's current insurance ID card for claim filing information.

REF 16068780  2/4/2025

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Report Generation Delay for CPID 2481 Ohio Medicaid

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

Payer impacted:

• CPID 2481 Ohio Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09352208.

REF 16068608  2/4/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name:  Wellcare by Allwell of Missouri
Institutional CPID: 8537
Professional CPID: 3248 

Payer-assigned Payer ID: 68069
Payer Enrollment Required:  No
Secondary Claims Accepted: Yes
Payer Location: Missouri 

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.

REF 16062458 2/3/2025

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New Electronic Claims Connections Available

Optum has new electronic claims connections available:  

Payer Name:  Wellcare by Allwell of Missouri
Institutional CPID: 8537
Professional CPID: 3248
Payer-assigned Payer ID: 68069
Payer Enrollment Required:  No
Secondary Claims Accepted: Yes
Payer Location: Missouri
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.

REF 16062459 2/3/2025

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Electronic Routing Change for CPIDs 6613 and 4619 ProviDRs Care Network

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

Payer Name: ProviDRs Care Network  
Professional CPID: 6133
Institutional CPID: 4619
Payer-assigned Payer ID: 48100

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.

REF 16061458 2/3/2025

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Electronic Routing Change for CPIDs 6613 and 4619 ProviDRs Care Network

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

Payer Name: ProviDRs Care Network
Professional CPID: 6133
Edit Master: PE_T007
Institutional CPID: 4619
Edit Master: HE9T007
Payer-assigned Payer ID: 48100

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

REF 16061459 2/3/2025

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Update: Report Generation Delay for CPID 1592 Johns Hopkins Healthcare / Priority Partners

This message is intended for Assurance Reimbursement Management and Assurance EDI customers.

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

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

Original notify REF 15826913 sent Jan. 14, 2025:
A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted Jan. 2, 2025.

Payer impacted:

• CPID 1592 Johns Hopkins Healthcare / Priority Partners

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

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

REF 15826913 1/14/2025  REF 16056708  2/3/2025

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Electronic Routing Change for CPIDs 8893 and 5047 Banner Medicare Advantage Plus Prime HMO (BMAH)

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

Current Payer Name: Banner Medicare Advantage Prime HMO (BMAH)
New Payer Name: Banner Medicare Advantage Prime
Professional CPID: 8893
Edit Master: PE_T007
Institutional CPID: 5047
Edit Master: HE9T007
Payer-assigned Payer ID: 84323

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

REF 16054110  2/3/2025

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OptumCare Network of Connecticut Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: OptumCare Network of Connecticut
Claim and Remittance CPIDs: 1068, 7895
Payer-assigned Payer ID:  E3287
Reason: Payer will no longer be accepting or processing claims.

Payer will no longer accept paper claims.

Action Required: None.

REF 16053660 2/3/2025

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OptumCare Network of Connecticut Electronic Claims and Remittance Connections No Longer Available

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

Payer Name: OptumCare Network of Connecticut
Claim CPIDs: 1068, 7895
Remittance LOB: H5S
Payer-assigned Payer ID:  E3287
Reason: Payer will no longer be accepting or processing claims.

Payer will no longer accept paper claims.

Action Required: None.

REF 16053661 2/3/2025

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New Electronic Remittance (ERA) Connections Available on RPA

This message is intended for Revenue Performance Advisor (RPA) customers.

ERA (Remittance) transactions have recently been added for the following payers:

26212 – IU Health Plans
37279 – Insurance Administrators of America (IAA)
MPSAB – Meridian PACE Solutions

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

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

REF 16052660 2/3/2025

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New Electronic Claim Connections Available on Revenue Performance Advisor (RPA)

This message is intended for Revenue Performance Advisor (RPA) customers.

Institutional claim transactions have recently been added for the following payers:

27590 – JVHL - Aetna Better Health of MI (Coventry/Omni) **enrollment required
72700 – JVHL - Aetna Better Health Premier Plan **enrollment required
77052 – Coastal TPA
88987 – Northwell Direct
91064 – Wenatchee Valley Medical Center
ACN90 – Altais Care Network
BHOMD – Carelon Behavioral Health Maryland
FCS01 – Family Care Specialist IPA
LV371 – MCA-Sedgwick WTCHP NPN
RP129 – Wellstar Health Plan
RP130 – NLIA (Ningen Dock)

Professional claim transactions have recently been added for the following payers:

77052 – Coastal TPA
88987 – Northwell Direct
91064 – Wenatchee Valley Medical Center
ACN90 – Altais Care Network
BHOMD – Carelon Behavioral Health Maryland
LV371 – MCA-Sedgwick WTCHP NPN
OPNC1 – Oncology Physicians Network
RP129 – Wellstar Health Plan
RP130 – NLIA (Ningen Dock)

REF 16052659 2/3/2025

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Electronic Routing Change for CPIDs 8893 and 5047 Banner Medicare Advantage Plus Prime HMO (BMAH)

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

Current Payer Name: Banner Medicare Advantage Plus Prime HMO (BMAH)
New Payer Name: Banner Medicare Advantage Prime
Professional CPID: 8893
Institutional CPID: 5047
Payer-assigned Payer ID: 84323
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 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.

REF 16054109  2/3/2025

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Update: Report Generation Delay for CPID 7074 UnitedHealthcare Ohio Medicaid

Update: The payer has been unable to generate and deliver the reports for some claims submitted Jan. 24, 2025.

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

Original notify REF 16031610 sent Jan. 31, 2025:
A payer is experiencing issues affecting Institutional report generation for some claims submitted Jan. 24, 2025.

Payer impacted: 

• CPID 7074 UnitedHealthcare Ohio Medicaid

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09348590.

REF 16031610 1/31/2025  REF 16051758  2/3/2025