CHC Payer Updates (March 2025)

March 2025

March Payer Processing Issues

Summary

When Optum discovers issues or interruptions to transaction processing, the details* will appear below.

If you're looking for a specific payer or specific transaction type, please use Ctrl + F on Windows or ⌘ + F on Mac to find that term within the page.

*These updates can also be found within Optum Customer Care Hub under Payer Processing Issues: https://customercare.optum.com/public/home.html

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New electronic eligibility connection available

Effective February 24, 2025, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 transactions for the below payer:

Payer Name:   ICARE,INDEPENDENT CARE HEALTH
Industry Payer ID:  INDCH
IMN Real Time ID:  INDCH
Exchange Real Time ID:  INDCH
CPID(s):  1907 / 2285
Optum iEDI Real Time ID:  11233
Payer Enrollment Required:   No
Connection Type:   X12

Eligibility Search Options: 

Subscriber

  • Member ID, First Name, Last Name, Date of Birth
  • Member ID, Last Name, First Name
  • Member ID, 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 support ticket.

REF 17083859 3/31/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Oxbridge Health
Institutional CPID:  8502
Professional CPID: 3212
Payer-assigned Payer ID:  RP133
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location:  Texas
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 17083411 3/31/2025

Report Generation Delay for CPID 7543 UPMC Health Plan

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

The payer listed below is experiencing issues affecting Institutional report generation for some claims submitted on March 26, 2025.

Payer impacted: 

  • CPID 7543 UPMC Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09443065.

REF 17081158 3/31/2025

Report Generation Delay for CPID 9457 Buckeye Ohio Medicaid

A payer is experiencing issues affecting Professional report generation for some claims submitted on March 26, 2025.

Payer impacted: 

  • CPID 9457 Buckeye 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 09442826.

REF 17077958 3/31/2025

Report Generation Delay for CPID 7512 Cascade Comprehensive Care

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

Payer impacted: 

  • CPID 7512 Cascade Comprehensive 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 09442850.

REF 17077959 3/31/2025

Report Generation Delay for CPID 7052 OhioRISE - Aetna Better Health of Ohio

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

Payer impacted: 

  • CPID 7052 OhioRISE - Aetna Better Health of Ohio

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09442865.

REF 17077961 3/31/2025

Update: Report Generation Delay for CPIDs 6423 and 5661 RevClaims

Update: A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on March 6, 2025 and March 19, 2025.

Payer impacted: 

  • CPID 5661 RevClaims
  • CPID 6423 RevClaims

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.

Original notify sent March 18, 2025:

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

Payer impacted:

  • CPID 5661 RevClaims

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 09425744.

REF 17079458 16904908   3/31/2025

Update: Healthy Blue Nebraska Electronic Claims/Remittance Connections No Longer Available

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

Payer Name: Healthy Blue Nebraska
Claims and Remittance CPIDs: 5022, 8870
Remittance LOB: K05
Payer-assigned Payer ID: 00544
Reason: Payer no longer in business
Payer will no longer accept paper claims.

Action Required: None.

Original Notice sent 1/9/2025:
Effective immediately, the payers listed below have been temporarily suspended at Optum for claims processing and removed from the payer list.

Payer Name: Healthy Blue Nebraska
CPIDs: 5022 and 8870
Payer ID: 0054
Payer Name: Healthy Blue South Carolina
CPIDs: 5953 and 2121
Payer ID: 00403

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

REF 17073009  3/25/2025

Update: Healthy Blue Nebraska Electronic Claims/Remittance Connections No Longer Available

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

Payer Name: Healthy Blue Nebraska
Claim and Remittance CPIDs: 5022, 8870
Payer-assigned Payer ID: 00544
Reason: Payer no longer in business.

Payer will no longer accept paper claims.

Action Required: None.

Original notice REF# 15772674 sent 1/9/2025:
Effective immediately, the payers listed below have been temporarily suspended at Optum for claims processing and removed from the payer list.

Payer Name: Healthy Blue Nebraska
CPIDs: 5022 and 8870
Payer ID: 00544
Payer Name: Healthy Blue South Carolina
CPIDs: 5953 and 2121
Payer ID: 00403

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

REF 17073008  3/28/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:
Payer Name: Optum Rx
Professional CPID: 2765
Payer-assigned Payer ID: ORXM1
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 17070061  3/28/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Optum Rx
Professional CPID: 2765
Payer-assigned Payer ID: ORXM1
Line of Business (LOB) Code: J3Q
Payer Enrollment Required: Yes
Payer Location: National

Action Required:

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

REF 17070558  3/28/2025

Report Generation Delay for CPID 5036 Collective Health

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

Payer impacted:

  • CPID 5036 Collective 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 09441130.

REF 17061362  3/28/2025

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: Provider Partners Health Plans of North Carolina
Institutional CPID: 8941
Professional CPID: 3408
Payer-assigned Payer ID: 31406
Line of Business(LOB) Code: E08
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: North Carolina
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 17065461  3/28/2025

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: Provider Partners Health Plans of North Carolina
Institutional CPID: 8941
Professional CPID: 3408
Payer-assigned Payer ID: 31406
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: Yes
Payer Location: North Carolina
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 17065460  3/28/2025

Report Generation Delay for CPID 6760 Virgin Islands Medicaid

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

Payer impacted: 

  • CPID 6760 Virgin Islands 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 09441411.

REF 17065358 3/28/2025

Update: Report Generation Delay for CPID 5835 Trilogy Health Network

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 14, 2025 and Feb. 28, 2025.

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

Original notify sent Feb. 24, 2025:
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 17047308  3/28/2025

Electronic Connection No Longer Available

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

Payer Name: UCARE
Claim Status Payer IDs: 55413, MNUCAR,
CPIDs: 1038, 7837
Reason: Payer no longer offers an electronic connection.

Action Required: None.

REF 17041908  3/27/2025

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

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

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

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

Payers affected:

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

Action Required: Please be aware of the invalid error message. Please resubmit any impacted claims.

REF 17046160  3/27/2025

Report Generation Delay for CPID 1532 Select Health

A payer is experiencing issues affecting Institutional report generation for some claims submitted on March 18, 2025.

Payer impacted: 

  • CPID 1532 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 09438185.

REF 17035460 3/26/2025

Electronic Claims Connections Suspended

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

Payer Name: CHC out of State Medicaid
CPIDs: 2006, 8138
Payer ID: 88551

Payer Name: Chino Valley Medical Center
CPID: 6559
Payer ID: CVMC1

Payer Name: Delano IPA
CPID: 2048
Payer ID: 77124

Payer Name: Dialysis TPA
CPIDs: 2040, 8178
Payer ID: 82435

Payer Name: Ingalls Provider Group
CPIDs: 9640, 7471
Payer ID: 85578

Payer Name: Kaweah Delta Medicare Advantage
CPID: 7258
Payer ID: IP084

Payer Name: Northeast Georgia Health Services
CPID: 9689
Payer ID: 58169

Payer Name: Optum Workers Comp Auto
CPID: 1840
Payer ID: OPWCA

Payer Name: TDS/Golden Times
CPID: 9201
Payer ID: RP013

Payer Name: TDS/Mid America ACO
CPIDs: 9210
Payer ID: RP006

Payer Name: TDS/TOP Physicians Group/TP-ACO
CPIDs: 5091, 9140
Payer ID: 35749

Payer Name: VillageMD of Northern Indiana
CPIDs: 8249
Payer ID: 75386

Reason: Payer unavailable electronically

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

REF 17034567 3/26/2025

RESOLVED: Delay in Electronic Remittance Advice (ERA) for CPIDs 4749, 5913 Tricare for Life

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

Original Notice REF# 16860258 sent March 14, 2025:
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 check dates 3/10/2025-3/11/2025:

  • CPID 4749 Tricare for Life
  • CPID 5913 Tricare for Life

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-000002390.

REF 17031467  3/26/2025

Electronic Claims Connection Suspended

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

Payer Name: Tucker Administrators Inc
CPIDs: 9251
Payer ID: 30799
Reason: Payer unavailable electronically

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

REF 17023245 3/26/2025

999 Payer Batch Rejections for CPID 1413 Virginia Anthem Blue Cross Blue Shield

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

  • CPID 1413 Virginia Anthem Blue Cross Blue Shield

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

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09437677.

REF 17022208  3/26/2025

Update: Payer Processing Issue for multiple CPIDs

Update: A resolution has been implemented and the claims were transmitted to the payers March 26, 2025.

Action Required: Please be aware of delays.

Original notify sent March 25, 2025:
Due to a payer processing issue, Professional and Institutional claims transmitted to the payers listed below since March 21, 2025 were not processed by the payers.

Payers impacted:

  • CPID 1473 California Medi-cal
  • CPID 1648 California Medi-cal SNF/Hospice
  • CPID 3510 California Medi-cal
  • CPID 8613 California Medi-cal (Restricted)

This delay affects claims released to Optum since March 20, 2025, 2:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09435411.

REF 17022058  3/26/2025

Report Generation Delay for CPID 3532 Michigan Blue Care Network

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

Payer impacted:

  • CPID 3532 Michigan Blue Care Network

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 09437536.

REF 17020458  3/26/2025

Report Generation Delay for CPID 7499 Sentara Health Plans

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

Payer impacted:

  • CPID 7499 Sentara Health Plans

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09437489.

REF 17019563  3/26/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Parallon-RCPS
Professional CPID: 8803
Payer-assigned Payer ID: PARLN
Payer Enrollment Required: No
Secondary Claims Accepted: No
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 17017409  3/26/2025

Payer Change for CPIDs 2836, 7528 Key Benefit Administrators (Ft. Mill, SC)

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

Payer Name: Key Benefit Administrators (Ft. Mill, SC)
Professional CPID: 2836
Institutional CPID: 7528
Remittance Available: Yes
Payer-assigned Payer ID: 37216

Claims and Remittance must begin using the following payer by April 11, 2025 to avoid claim rejections:

Payer Name: Key Benefit Administrators
Professional CPID: 2821
Institutional CPID:  7505
Remittance Available: Yes
Payer-assigned Payer ID: 37217
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 2821, 7505 Key Benefit Administrators do not need to complete a new enrollment form. 
    • Providers not receiving electronic remittance through Optum for CPIDs 2821, 7505 Key Benefit Administrators 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 17016536 3/26/2025

Payer Change for CPIDs 2836, 7528 Key Benefit Administrators (Ft. Mill, SC)

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

Payer Name: Key Benefit Administrators (Ft. Mill, SC)
Professional CPID: 2836
Professional Edit Master:  PE_E049
Institutional CPID: 7528
Institutional Edit Master: HE9E049
Payer-assigned Payer ID: 37216
Line of Business Code (LOB): U9H

Claims and Remittance must begin using the following payer by April 11, 2025 to avoid claim rejections:

Payer Name: Key Benefit Administrators
Professional CPID: 2821
Professional Edit Master: PE_B800
Institutional CPID: 7505
Institutional Edit Master: HE9B801
Payer-assigned Payer ID: 37217
Line of Business Code (LOB): U7Y

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 2821, 7505 Key Benefit Administrators do not need to complete a new enrollment form. 
    • Providers not receiving electronic remittance through Optum for CPIDs 2821, 7505 Key Benefit Administrators 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 17016535 3/26/2025

Report Generation Delay for CPIDs 4404 and 5563 Washington Labor and Industry Workers Compensation

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted on March 19, 2025.

Payer impacted: 

  • CPID 4404 Washington Labor and Industry Workers Compensation
  • CPID 5563 Washington Labor and Industry Workers Compensation

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 09434681.

REF 17016158 3/26/2025

999 Payer Batch Rejections for CPID 2845 St. Vincent Catholic Medical Center

Some Professional claims transmitted to the payer listed below from Optum March 21, 2025 were not processed by the payer due to a 999 Batch Rejection:

  • CPID 2845 St. Vincent Catholic Medical Center

A resolution has been implemented and the affected claims were retransmitted to the payer March 25, 2025.

Action Required: None.

If you have any questions, please contact Customer Support and refer to Case Number 09436345.

REF 17007972  3/25/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  AHS Plans
Institutional CPID: 8950
Professional CPID: 3409
Payer-assigned Payer ID: 91026
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 17004127 3/25/2025

Update: Remittance (ERA) Delay for multiple CPIDs

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

Original Notice Sent March 21, 2025:

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 check dates of March 14, 2024 through present:

Payers Impacted:

  • CPID 2845 St. Vincent Catholic Medical Center
  • CPID 7542 St. Vincent Catholic Medical Center
  • CPID 4427 Montana Medicaid
  • CPID 5586 Montana Medicaid
  • CPID 5550 District of Columbia Medicaid
  • CPID 4425 District of Columbia Medicaid

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, please contact Customer Support and refer to Case Number 09432840.

REF 16968558 16998996  3/25/2025

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 March 14, 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 09435637.

REF 16999743  3/25/2025

Report Generation Delay for CPIDs 4626 and 6145 CSI Network Services

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted March 12, 2025 and March 13, 2025.

Payer impacted:

  • CPID 4626 CSI Network Services
  • CPID 6145 CSI Network Services

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09435517.

REF 16999713  3/25/2025

Payer Processing Issue for multiple CPIDs

Due to a payer processing issue, Professional and Institutional claims transmitted to the payers listed below since March 21, 2025 were not processed by the payers.

Payers impacted:

  • CPID 1473 California Medi-cal
  • CPID 1648 California Medi-cal SNF/Hospice
  • CPID 3510 California Medi-cal
  • CPID 8613 California Medi-cal (Restricted)

This delay affects claims released to Optum since March 20, 2025, 2:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09435411.

REF 16997958  3/25/2025

Resolved: Delay in Electronic Remittance Advice (ERA) for CPIDs 4427, 5586 Montana Medicaid

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

Original Notice Sent on March 21, 2025:

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 check date of March 17, 2025:

  • CPID 4427 Montana Medicaid
  • CPID 5586 Montana Medicaid

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 date above.

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000002423.

REF 16969258  3/21/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Univera SSA WNY
Professional CPID: 3407
Payer-assigned Payer ID: SX091
Payer Enrollment Required: No
Secondary Claims Accepted: No
Payer Location:  New York
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 16991510 3/24/2025

New Electronic Claims Connections Available

Payer Name:  Univera SSA WNY
Professional CPID: 3407
Payer-assigned Payer ID: SX091
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 16991509 3/24/2025

New electronic eligibility connection available

Effective Feb. 6, 2025, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 transactions for the below payer:

Payer Name: VILLAGECAREMAX
Industry Payer ID: 26545
IMN Real Time ID: 26545
Exchange Real Time ID: X12 - VCMAX
CPID(s): 6834 / 7620
Optum IEDi Real Time ID: 26545
Payer Enrollment Required: No
Connection Type: X12 and PORTAL

Search Options:

Eligibility Subscriber

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

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

REF 16987909  3/24/2025

Parallon-RCPS Electronic Claims Connection No Longer Available

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

Payer Name: Parallon-RCPS
Claim CPID: 4059
Payer-assigned Payer ID: PARLN
Reason: Payer no longer contracted. 

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

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

REF 16989662 3/24/2025

Parallon-RCPS Electronic Claims Connection No Longer Available

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

Payer Name: Parallon-RCPS
Claim CPID: 4059
Payer-assigned Payer ID: PARLN
Reason: Payer no longer contracted. 

Action Required: Claims must be submitted to Optum on paper.

REF 16989660 3/24/2025

Remittance (ERA) Delay for CPID 8250 Old Surety Life Insurance Company

Due to a processing issue, there has been a delay in Professional Electronic Remittance Advice (ERA) for the following payers for Receive dates of March 12, 2025 through present:

Payers Impacted:

  • CPID 8250 Old Surety Life Insurance Company

Additional updates will be forwarded as more information becomes available.

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

If you have any questions, please contact Customer Support and refer to Case Number 09421761.

REF 16988958  3/24/2025

Report Generation Delay for Multiple CPIDs

A payer is experiencing issues affecting Professional report generation for some claims submitted on March 20, 2025.

Payers impacted: 

  • CPID 1800 EVV Health Plan Nevada UHC
  • CPID 1801 EVV Anthem BCBS of Nevada 

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 09434276.

REF 16986858 3/24/2025

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

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

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.

If you have any questions, please contact Customer Support and refer to Case Number 09433931.

REF 16982282  3/24/2025

Report Generation Delay for CPID 7068 Buckeye Ohio Medicaid

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

Payer impacted:

  • CPID 7068 Buckeye 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 09433969.

REF 16982660  3/24/2025

New Payer Name

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

Previous Payer Name: Flume Health
New Payer Name: Vitori Health
Professional CPID: 8273
Institutional CPID: 3024 

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

REF 16979608 3/24/2025

New Payer Name

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

Previous Payer Name: Flume Health
New Payer Name: Vitori Health
Professional CPID: 8273
Institutional CPID: 3024
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 16979609 3/24/2025

Northwest Administrators Electronic Claims Connection No Longer Available

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

Payer Name: Northwest Administrators
Claim CPID: 5652
Payer-assigned Payer ID: NWADM
Reason: Payer no longer offers an electronic connection for institutional claims which Optum can connect.

Action Required: None.

REF 16979658 3/24/2025

First Choice of the Midwest (PPO) Electronic Claims Connection No Longer Available

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

Payer Name: First Choice of the Midwest (PPO)
Claim CPIDs: 2256, 4562
Payer-assigned Payer ID: 75138
Reason: Payer no longer offers an electronic connection under this Payer ID number. 

Action Required: None.

REF 16979858 3/24/2025

Delay in Electronic Remittance Advice (ERA) for CPIDs 4427, 5586 Montana Medicaid

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 check date of March 17, 2025:

  • CPID 4427 Montana Medicaid
  • CPID 5586 Montana Medicaid

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 date above.

If you have any questions, feel free to contact your Customer Support Team and refer to Case Number INC-000002423.

REF 16969258  3/21/2025

Anthem Indiana Home Infusion Therapy and Anthem Indiana Traditional Home Infusion Therapy Electronic Claims Connections No Longer Available

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

Payer Name: Anthem Indiana Home Infusion Therapy
Claims CPID: 5480
Payer-assigned Payer ID: ANTINHIP
Reason: Payer no longer contracted.

Payer Name: Anthem Indiana Traditional Home Infusion Therapy
Claims CPID: 5476
Payer-assigned Payer ID: ANTINTR
Reason: Payer no longer contracted.

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

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

REF 16969058  3/21/2025

Remittance (ERA) Delay for multiple CPIDs

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 check dates of March 14, 2024 through present:

Payers Impacted:

  • CPID 2845 St. Vincent Catholic Medical Center
  • CPID 7542 St. Vincent Catholic Medical Center
  • CPID 4427 Montana Medicaid
  • CPID 5586 Montana Medicaid
  • CPID 5550 District of Columbia Medicaid
  • CPID 4425 District of Columbia Medicaid

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, please contact Customer Support and refer to Case Number 09432840.

REF 16968558  3/21/2025

Electronic Routing Change and Payer Name Change for CPIDs 9408 and 3686 Illumifin Corporation

Effective March 21, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Current Payer Name: illumifin Corporation
New Payer Name: illumifin Prudential Health
Professional CPID: 9408
Edit Master: PE_T007
Institutional CPID: 3686
Edit Master: HE9T007
Payer-assigned Payer ID: 19028

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

REF 16965462  3/21/2025

Electronic Routing Change and Payer Name Change for CPIDs 9408 and 3686 Illumifin Corporation

Effective March 21, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Current Payer Name: illumifin Corporation
New Payer Name: illumifin Prudential Health
Professional CPID: 9408
Institutional CPID: 3686
Payer-assigned Payer ID: 19028
Claims Fee: N/A

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

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

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

REF 16965458  3/21/2025

Iron Road Healthcare Electronic Remittance Connection No Longer Available

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

Payer Name: Iron Road Healthcare
Remittance CPID: 7587
Remittance LOB: H2T
Payer-assigned Payer ID: 87042
Reason: Payer no longer offers an electronic connection.

Action Required: None.

REF 16961362  3/21/2025

Iron Road Healthcare Electronic Remittance Connection No Longer Available

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

Payer Name: Iron Road Healthcare
Remittance CPID: 7587
Payer-assigned Payer ID: 87042
Reason: Payer no longer offers an electronic connection.

Action Required: None.

REF 16961361  3/21/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Community Care Health (CCH)
Institutional CPID: 8906
Professional CPID: 3400
Payer-assigned Payer ID: CCH25
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 16959758  3/21/2025

New Electronic Eligibility and Claim Status Inquiry Connection Available

Effective Jan. 27, 2025 Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 and Claim Status Inquiry and Response for 276/277 for the below payer:

Payer Name: HAP Caresource Michigan Marketplace
Industry Payer ID: MICS1
IMN Real Time ID: MICS1
Exchange Real Time ID: HAPMK
CPID(s): 8095, 2891
Optum IEDi Real Time ID: MICS1
Payer Enrollment Required: No
Connection Type: X12

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

Claim Status Inquiry
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.

REF 16959608  3/21/2025

New Electronic Eligibility and Claim Status Inquiry Connection Available

Effective Jan. 27, 2025 Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 and Claim Status Inquiry and Response for 276/277 for the below payer:

Payer Name: Common Ground Healthcare Cooperative
Industry Payer ID: 77170
IMN Real Time ID: 77170
Exchange Real Time ID: CGHCO
CPID(s): 6674, 6778
Optum IEDi Real Time ID: 12272
Payer Enrollment Required: No
Connection Type: X12

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

Claim Status Inquiry
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 .

REF 16958108  3/21/2025

Update: Report Generation Delay for CPIDs 2593 and 5428 QualChoice of Arkansas

Update: A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since March 4, 2025.

Payer impacted:

  • CPID 5428 QualChoice of Arkansas
  • CPID 2593 QualChoice of Arkansas

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

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

Original Notice Sent 3/18/2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since March 4, 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 09425615.

REF 16957009  3/21/2025

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 21, 2025 and Feb. 28, 2025.

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

Update sent March 12, 2025:
Update: A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 21, 2025.

Payer impacted:

  • CPID 2287 Medicare Plus Blue of MI (MAP)
  • CPID 1913 Medicare Plus Blue of MI (MAP)

Action Required: Please be aware of delays in the report generation for claims submitted during the time frame above.

Original notify sent March 4, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 21, 2025.

Payer impacted:

  • CPID 2287 Medicare Plus Blue of MI (MAP)

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09388641.

REF 16957208  3/21/2025

Payer Change for CPIDs 5049, 8894 Northwestern Medicine Physicians Network

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

Payer Name: Northwestern Medicine Physicians Network
Professional CPID: 8894
Professional Edit Master: PE_T007
Institutional CPID: 5049
Institutional Edit Master: HE9T007
Payer-assigned Payer ID: NWEST
Line of Business Code (LOB): N/A

Claims must begin using the following:
Payer Name: Northwestern Medicine Physicians Network
Professional CPID: 3229
Professional Edit Master: PE_C054
Institutional CPID: 1918
Institutional Edit Master: HE9C054
Payer-assigned Payer ID: 23550
Line of Business Code (LOB): N/A

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

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

  • 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 16957208  3/21/2025

Payer Change for CPIDs 5049, 8894 Northwestern Medicine Physicians Network

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

Payer Name: Northwestern Medicine Physicians Network
Professional CPID: 8894
Institutional CPID: 5049
Remittance Available: No
Payer-assigned Payer ID: NWEST

Claims must begin using the following:

Payer Name: Northwestern Medicine Physicians Network
Professional CPID: 3229
Institutional CPID: 1918
Remittance Available: No
Payer-assigned Payer ID: 23550
Claim Fee: N/A

Enrollment Requirements:
Claims:

  • Payer enrollment for electronic claims is not required.

Action Required:

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

REF 16957209  3/21/2025

Report Generation Delay for CPIDs 1782 and 2931 North American Medical Management

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted March 10, 2025-March 12, 2025.

Payer impacted:

  • CPID 1782 North American Medical Management
  • CPID 2931 North American Medical Management

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 09430078.

REF 16940710  3/20/2025

Report Generation Delay for CPID 7737 Aetna Better Health of Virginia

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

Payer impacted:

  • CPID 7737 Aetna Better Health of Virginia

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09429970.

REF 16940710  3/20/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Unite Here Health
Institutional CPID: 4073
Professional CPID: 8817
Payer-assigned Payer ID: 59144
Line of Business (LOB) Code: H1J
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 16940059  3/20/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Unite Here Health
Institutional CPID: 4073
Professional CPID: 8817
Payer-assigned Payer ID: 59144
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 16940058  3/20/2025

Report Generation Delay for CPID 7499 Sentara Health Plans

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

Payer impacted:

  • CPID 7499 Sentara Health Plans

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09429677.

REF 16937909  3/20/2025

Report Generation Delay for CPID 9458 CareSource Ohio Medicaid

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

Payer impacted:

  • CPID 9458 CareSource 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 09429693.

REF 16938358  3/20/3035

Update: Report Generation Delay for multiple CPIDs

Update: It has been determined that the report delay below was due to a payer claims processing issue. We have retransmitted the impacted claims to the payers March 20, 2025. Reports will be delivered once the claims have successfully processed at the payers.

Action Required: Please be aware of delays.

Original Notice Sent March 17, 2025:
The payers listed below are experiencing issues affecting Institutional and Professional report generation for some claims submitted since March 13, 2025.

Payers impacted:

  • CPID 5529 Massachusetts Medicaid
  • CPID 4492 Massachusetts Medicaid Format 5
  • CPID 4491 Massachusetts Medicaid Format 9
  • CPID 2905 Massachusetts Medicaid Long Term Care

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09423540.

REF 16937808  3/20/3035

Update: Report Generation Delay for CPID 4605 Health Safety Net

Update: It has been determined that the report delay below was due to a payer claims processing issue. We have retransmitted the impacted claims to the payer March 20, 2025. Reports will be delivered once the claims have successfully processed at the payer.

Action Required: Please be aware of delays.

Original Notice Sent March 19, 2025:
A payer is experiencing issues affecting Institutional report generation for some claims submitted March 16, 2025.

Payer impacted:

  • CPID 4605 Health Safety Net

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 09426269.

REF 16937809  3/20/3035

Report Generation Delay for CPIDs 3937 and 1214 AgeRight Advantage Health Plan

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted March 4, 2025.

Payer impacted:

  • CPID 3937 AgeRight Advantage Health Plan
  • CPID 1214 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 09429603.

REF 16927758  3/20/2025

Update: Report Generation Delay for CPID 5547 Arizona Blue Cross Blue Shield

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

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

Original notify sent March 11, 2025:
A payer is experiencing issues affecting Institutional report generation for some claims submitted March 5, 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 09415509.

REF 16927508  3/19/2025

Report Generation Delay for multiple CPIDs

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 12, 2025.

Payer impacted:

  • CPID 6051 TDS/SRRIPA/Amerivantage
  • CPID 9203 TDS/SRRIPA/Wellcare

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 09427726.

REF 16926710  3/19/2025

Report Generation Delay for CPIDs 1865 and 8556 Multiplan New Orleans Division

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 7, 2025.

Payer impacted:

  • CPID 1865 Multiplan New Orleans Division
  • CPID 8556 Multiplan New Orleans Division

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 09419800.

REF 16926709  3/19/2025

Report Generation Delay for CPIDs 1507 and 3887 Veterans Administration Fee Basis Programs

A payer intermediary is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted:

  • CPID 1507 Veterans Administration Fee Basis Programs
  • CPID 3887 Veterans Administration Fee Basis 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 09419928.

REF 16926708  3/19/2025

Report Generation Delay for CPID 8864 NextBlue of North Dakota

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

Payer impacted:

  • CPID 8864 NextBlue of North Dakota

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 09427816.

REF 16924110  3/19/2025

Report Generation Delay for CPID 4253 Prominence Administrative Services

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since March 8, 2025.

Payer impacted:

  • CPID 4253 Prominence Administrative Services

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09427754.

REF 16924109  3/19/2025

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: Chinatown Service Center
Institutional CPID: 8917
Professional CPID: 3403
Payer-assigned Payer ID: R3478
Line of Business (LOB) Code: E06
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No
Payer Location: California
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 16923710  3/19/2025

New Electronic Claims and Remittance Connections Available

Optum has new electronic claims and remittance connections available:

Payer Name: Chinatown Service Center
Institutional CPID: 8917
Professional CPID: 3403
Payer-assigned Payer ID: R3478
Payer Claim Enrollment Required: No
Payer Remittance Enrollment Required: Yes
Secondary Claims Accepted: No
Payer Location: California
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 16923709  3/19/2025

Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting institutional report generation for some claims submitted since March 7, 2025.

Payer impacted:

  • CPID 6671 HealthSun

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09427399.

REF 16921558  3/19/2025

Report Generation Delay for CPIDs 5550 and 4425 District of Columbia Medicaid

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

Payer impacted:

  • CPID 5550 District of Columbia Medicaid
  • CPID 4425 District of Columbia 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 09427282.

REF 16920508  3/19/2025

Report Generation Delay for CPIDs 5036 and 8883 Collective Health

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

Payer impacted:

  • CPID 8883 Collective Health
  • CPID 5036 Collective 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 09427212.

REF 16920008  3/19/2025

Report Generation Delay for CPIDs 4427 and 5586 Montana Medicaid

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 17, 2025.

Payer impacted:

  • CPID 4427 Montana Medicaid
  • CPID 5586 Montana 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 09427298.

REF 16919911  3/19/2025

Report Generation Delay for CPIDs 3509 and 2481 Ohio Medicaid

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 13, 2025.

Payer impacted:

  • CPID 3509 Ohio Medicaid
  • CPID 2481 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 09427316.

REF 16919912  3/19/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Anthem Blue Cross and Blue Shield HP MLTC
Institutional CPID: 9527
Professional CPID: 1117
Payer-assigned Payer ID: 45302
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: New York

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 16918558  3/19/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Anthem Blue Cross and Blue Shield HP MLTC
Institutional CPID: 9527
Professional CPID: 1117
Payer-assigned Payer ID: 45302
Line of Business (LOB) Code: E07
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: New York

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 16918559  3/19/2025

Consumers Choice of South Carolina/HealthSCOPE Benefits Remittance Connection No Longer Available

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

Payer Name: Consumers Choice of South Carolina/HealthSCOPE Benefits
Remittance CPIDs: 6814, 6994
Payer-assigned Payer ID: 45321
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: None.

REF 16918758  3/19/2025

Consumers Choice of South Carolina/HealthSCOPE Benefits Remittance Connection No Longer Available

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

Payer Name: Consumers Choice of South Carolina/HealthSCOPE Benefits
Remittance CPIDs: 6814, 6994
Remittance LOB: J3Z
Reason: Payer no longer offers an electronic connection to which Optum can connect.

Action Required: None.

REF 16918759  3/19/2025

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 14, 2025, Feb. 15, 2025, and March 4, 2025.

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

Update sent March 12, 2025:
Update: A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Feb. 14, 2025, Feb. 15, 2025, and March 4, 2025.

Payer impacted:

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

Action Required: Please be aware of delays in the report generation for claims submitted during the time frame above.

Original notify sent Feb. 26, 2025:
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 16919708  3/19/2025

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

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 14, 2025, Feb. 15, 2025, and March 4, 2025.

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

Update sent March 12, 2025:
Update: A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Feb. 14, 2025, Feb. 15, 2025, and March 4, 2025.

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

Original notify sent Feb. 26, 2025:
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 16919408  3/19/2025

Report Generation Delay for CPID 4605 Health Safety Net

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

Payer impacted:

  • CPID 4605 Health Safety Net

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 09426269.

REF 16919558  3/19/2025

Payer Transmit Delay for multiple CPIDs

Due to a system issue, a delay occurred in some of the transmissions to the following payers between March 7, 2025 and March 13, 2025.

Payers impacted: 

  • CPID 5460 California Blue Shield Home Infusion Therapy
  • CPID 5464 Anthem Ohio Home Infusion Therapy
  • CPID 5467 Anthem Missouri BC Home Infusion Therapy 
  • CPID 5482 Anthem Indiana HMO Home Infusion Therapy

A resolution has been implemented and the claims were transmitted to the payers on March 18, 2025.

This delay affected claims released to Optum between 4 p.m. CT on March 7, 2025 and 4 p.m. CT on March 13, 2025. 

Action Required: Be aware of the transmit delay above.

If you have any questions, please contact Customer Support and refer to Case Number 09426695.

REF 16914058 3/18/2025

Report Generation Delay for CPID 5661 RevClaims

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

Payer impacted:

  • CPID 5661 RevClaims

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 09425744.

REF 16904908  3/18/2025

Report Generation Delay for CPIDs 1995 and 7435 FirstCare Health Plans

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted March 6, 2025 and March 7, 2025.

Payer impacted:

  • CPID 1995 FirstCare Health Plans
  • CPID 7435 FirstCare Health Plans

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09425698.

REF 16903222  3/18/2025

Report Generation Delay for CPID 5428 QualChoice of Arkansas

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since March 4, 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 09425615.

REF 16903958  3/18/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Prominence Health Plan of Texas
Institutional CPID: 8636
Professional CPID: 7219
Payer-assigned Payer ID: 80095
Line of Business (LOB) Code: H5B
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Texas

Action Required:

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

REF 16902859  3/18/2025

New Electronic Remittance Connections Available

Optum has new electronic remittance connections available:

Payer Name: Prominence Health Plan of Texas
Institutional CPID: 8636
Professional CPID: 7219
Payer-assigned Payer ID: 80095
Payer Enrollment Required: Yes
Remittance Fee: N/A
Payer Location: Texas

Action Required:

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

REF 16902858  3/18/2025

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 March 4, 2025.

Payer impacted: 

  • CPID 3935 NHC Advantage
  • CPID 1213 NHC Advantage

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 09425422.

REF 16902208 3/18/2025

Payer Processing Issue for CPID 2845 St. Vincent Catholic Medical Center

Due to a payer processing issue, some Professional claims transmitted to the payer listed below on March 14, 2025 were not processed by the payer.

Payer impacted: 

  • CPID 2845 St. Vincent Catholic Medical Center

A resolution has been implemented and the claims were retransmitted to the payer on March 18, 2025.

This delay affected claims released to Optum between 11 a.m. and 9 p.m. CT on March 14, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09425501.

REF 16902527 3/18/2025

Report Generation Delay for CPIDs 1985 and 4246 Capital Health Plan

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since March 4, 2025.

Payer impacted:

  • CPID 1985 Capital Health Plan
  • CPID 4246 Capital Health Plan

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09425381.

REF 16901320  3/18/2025

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 on March 4, 2025.

Payer impacted: 

  • CPID 5077 Perennial Advantage
  • CPID 9123 Perennial Advantage

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 09425256.

REF 16899638 3/18/2025

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 March 4, 2025.

Payer impacted: 

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

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 09425312.

REF 16901308 3/18/2025

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

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 11, 2025.

Payer impacted:

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

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09425202.

REF 16900208  3/18/2025

Update: Report Generation Delay for CPID 1214 AgeRight Advantage Health Plan

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

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

Original notify sent Feb. 26, 2025:
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 16898740  3/18/2025

ArmadaCare Electronic Remittance Connection No Longer Available

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

Payer Name: ArmadaCare
Remittance CPIDs: 3082, 8710
Payer-assigned Payer ID: 90886
Reason: Payer no longer offers an electronic connection. 

Action Required: None.

REF 16897808 3/18/2025

ArmadaCare Electronic Remittance Connection No Longer Available

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

Payer Name: ArmadaCare
Remittance CPIDs: 3082, 8710
Remittance LOB: U1K
Payer-assigned Payer ID: 90886
Reason: Payer no longer offers an electronic connection.  

Action Required: None.

REF 16897809 3/18/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Coachella Medical Group
Institutional CPID: 8901
Professional CPID: 3404
Payer-assigned Payer ID: COMG1
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 16898253 3/18/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name: TRU Community Care
Institutional CPID: 8928
Professional CPID: 3406
Payer-assigned Payer ID: TRUCO
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location:  Colorado
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 16898254 3/18/2025

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

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

Original notice sent Feb 17, 2025:
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.

REF 16892136  3/17/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  illumifin Corporation
Institutional CPID: 8912
Professional CPID: 7722
Payer-assigned Payer ID: 26119
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location:  National
Claims Fee: N/A

Plans accepted with this connection:

  • Bankers Reserve/Wellcare
  • Combined Insurance Company of America      
  • Companion Life Insurance Company   
  • Forethought Life Insurance Company  
  • Liberty Bankers Life Insurance Company
  • Shenandoah Life Insurance Company (AIA) 
  • Standard Life and Casualty Insurance Company           
  • Thrivent
  • Western Catholic Union              

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 16886773 3/17/2025

Report Generation Delay for multiple CPIDs

The payers listed below are experiencing issues affecting Institutional and Professional report generation for some claims submitted since March 13, 2025.

Payers impacted:

  • CPID 5529 Massachusetts Medicaid
  • CPID 4492 Massachusetts Medicaid Format 5
  • CPID 4491 Massachusetts Medicaid Format 9
  • CPID 2905 Massachusetts Medicaid Long Term Care

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09423540.

REF 16881959  3/17/2025

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below March 14, 2025 were not processed by the payers.

Payers impacted:

CPID

Payer Name 

1214

AgeRight Advantage Health Plan

2842

Alexian PACE

9409

Align Senior Care of California

8454

Align Senior Care of Michigan

4101

AllCare Advantage

2113

Allcare Health Plan

9278

Ambetter from Nebraska Total Care

9431

Ambetter from WellCare of Kentucky

9775

Ambetter of Alabama

9433

Ambetter of Oklahoma

9142

American Health Advantage of Mississippi

1741

Amerigroup

1412

Anthem Blue Cross and Blue Shield - Indiana

1413

Anthem Blue Cross and Blue Shield (Virginia)

2418

Anthem Blue Cross and Blue Shield of Ohio

4437

Anthem Blue Cross Blue Shield New York

6220

Arizona Priority Care Plus

7794

Associated Hispanic Physicians IPA

4881

Asuris Northwest Regence

7272

Axminster Medical Group

3845

Banner Health Network

1415

Blue Cross Blue Shield of Colorado

1407

Blue Cross Blue Shield of Georgia

7496

Blue Cross Blue Shield of Nevada

1243

Blue Cross Community Centennial

1167

Blue Cross Medicare Advantage PPO/HMO

9162

Blue Medicare Advantage

6779

Bridgespan Regence

4246

Capital Health Plan

2810

Capitol Administrators

8146

Care N Care Insurance Co.

4743

Carelon Behavioral Health

2164

Carelon Behavioral Health Maryland

6127

Carelon Behavioral Health, MBHP

3293

Carelon Health

2830

CarePlus Health Plans

9722

CareSource North Carolina

1194

CareSource of Georgia

7143

CareSource of Indiana

3826

CareSource of Ohio

9297

Cenpatico Behavioral Health - Nebraska

6777

Centers Plan for Healthy Living

9765

Central Valley Medical Providers

7275

Citrus Valley Physicians Group

8123

Clear Health Alliance

7416

Colorado Anthem Blue Cross Blue Shield HMO

7763

Columbine Health Plan

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

6795

Contra Costa Health Plan

7738

CountyCare Health Plan

2433

Denver Health and Hospital Authority

1232

Denver Health Medical Plan, Inc. - Medicare Choice

8135

Doctors HealthCare Plans

1733

Doctors Professional Services Consultants (DPSC)

1119

Easy Choice Health Plan of California

7294

Eberle Vivian

4279

El Paso Health-STAR

5483

Employee Benefit Management Services (EBMS)

8137

Empower Healthcare Solutions

1795

Envolve Benefit Options

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

2150

Florida Health Care Plans

5440

Fox Valley Medicine

2720

GlobalCare

1772

HAP CareSource

1797

HAP CareSource Michigan Dual Medicare/Medicaid

5243

Healthcare Management Administrators

1723

HealthCare Partners IPA

4448

HealthLink PPO

4740

Healthways WholeHealth Networks

7760

Healthy Blue Louisiana

8867

Healthy Blue Missouri

9133

Healthy Blue North Carolina

7715

Hopkins Health Advantage

6259

Humana - CareSource of Kentucky

7426

Idaho Regence Blue Shield

1405

Illinois Blue Cross Blue Shield

3757

IMAGINE360 ADMINISTRATORS (GPA)

4445

Insurance Management Services TX

4116

IntegraNet Health

1404

Iowa Wellmark Blue Cross Blue Shield

6733

Iowa Wellmark Blue Cross Blue Shield Crossover

5479

IU Health Plan Medicare Advantage

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

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

1429

Minnesota Blue Cross Blue Shield HMO

1408

Missouri Anthem Blue Cross Blue Shield

7450

Montana Blue Cross Blue Shield

7422

New Hampshire Anthem Blue Cross Blue Shield

7403

New Mexico Blue Cross Blue Shield

8864

NextBlue of North Dakota

1213

NHC Advantage

2411

North Dakota Blue Cross Blue Shield

1403

Oklahoma Blue Cross Blue Shield

2404

Oregon Regence Blue Cross Blue Shield

7829

Passport Advantage

5838

Preferred Administrators

4252

Presbyterian Salud

2807

Professional Benefit Administrators (Oakbrook, Illinois)

4253

Prominence Administrative Services

5428

QualChoice of Arkansas

7264

Quartz ASO

1209

Regence Group Administrators

4270

Resurrection Physicians Provider Group

4464

SCAN Health Plan

2254

Scott & White Health Plan

7225

Sharp Community Medical Group

8124

Simply Healthcare Plans, Inc.

8816

SOMOS Emblem

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

8763

U.S. Networks and Administrative Services

8473

Unicare

2412

Utah Regence Blue Cross Blue Shield

2788

Utah Regence Blue Cross Blue Shield Federal Employee Program

7493

Vermont Blue Cross Blue Shield

4258

VNS Health

7451

Washington Regence Blue Shield

1844

Wellcare Health Plans

3211

Wellcare Health Plans (Encounters)

1775

Wellpoint

1401

Wisconsin Anthem Blue Cross Blue Shield

7489

Wyoming Blue Cross Blue Shield

A resolution has been implemented and the claims were retransmitted to the payer intermediary March 17, 2025.

This delay affected claims released to Optum March 14, 2025, 10:00 a.m.-2:00 p.m. CT.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09423457.

REF 16881758  3/17/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Anthem Indiana HMO Home Infusion Therapy
Professional CPID: 5482
Payer-assigned Payer ID: ANTINHP
Payer Location: Indiana

Payer Name: Anthem Missouri BC Home Infusion Therapy
Professional CPID: 5467
Payer-assigned Payer ID: 12
Payer Location: Missouri

Payer Name: Anthem Ohio Home Infusion Therapy
Professional CPID: 5464
Payer-assigned Payer ID: ANTOHPayer Location: Ohio

Payer Name: California Blue Shield Home Infusion Therapy
Professional CPID: 5460
Payer-assigned Payer ID: BSC
Payer Location: California

Payer Enrollment Required: No
Secondary Claims Accepted: Yes
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 16863712  3/14/2025

New electronic eligibility connection available

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

Payer Name: NEW YORK MEDICAID
Industry Payer ID: SKNY0
IMN Real Time ID: SKNY0
Exchange Real Time ID: NYCAID
CPID(s): 1422 / 1501 / 1502 /1500
Optum iEDI Real Time ID: NYMCD
Payer Enrollment Required: No
Connection Type: X12

Search Options: 

Eligibility Subscriber:

  • Member ID, First Name, Last Name, Date of Birth
  • SSN, First Name, Last Name, Date of Birth
  • Member ID
  • Subscriber ID Card Number

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 16860360 3/14/2025

New electronic eligibility connection available

Effective February 07, 2025, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 transactions for the below payer:

Payer Name: NHC ADVANTAGE
Industry Payer ID: NHC01
IMN Real Time ID: NHC01
Exchange Real Time ID: NHCADV
CPID(s): 1213 / 3935
Optum IEDi Real Time ID: NHC01
Payer Enrollment Required: No
Connection Type: X12

Search Options: 

Eligibility Subscriber

  • Member ID, First Name, Last Name, Date of Birth
  • Member ID, Last Name, Date of Birth
  • Member ID, First name, Last Name
  • Member ID, 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 16860361 3/14/2025

New electronic eligibility connection available

Effective Feb. 25, 2025, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 transactions for the below payer:

Payer Name: GEISINGER HEALTH PLAN
Industry Payer ID: 75273
IMN Real Time ID: 75273
Exchange Real Time ID: GEISHP
CPID(s): 2559 / 5473 / 4872
Optum IEDi Real Time ID: 75273
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, Date of Birth
  • First Name, Last Name, Date of Birth

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

REF 16860359  3/14/2025

New electronic eligibility connection available

Effective Jan. 24, 2025, Optum is pleased to announce the availability of Real-time Eligibility Inquiry and Response 270/271 transactions for the below payer:

Payer Name: ATRIO HEALTH PLANS
Industry Payer ID: ATRIO
IMN Real Time ID: MPCHA
Exchange Real Time ID: ATRIO
CPID(s): 4799 / 5934
Optum IEDi Real Time ID: 12269
Payer Enrollment Required: No
Connection Type: X12

Search Options:
Eligibility Subscriber

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

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

REF 16860358  3/14/2025

Delay in Electronic Remittance Advice (ERA) for CPIDs 4749, 5913  Tricare for Life

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 check dates March 10, 2025-March 11, 2025:

  • CPID 4749 Tricare for Life
  • CPID 5913 Tricare for Life

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-000002390

REF 16860258  3/14/2025

Electronic Claims Connection Suspended

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

Payer Name: First Health Network (Coventry Care National Network)
CPIDs: 4557, 2875
Payer ID: 73159
Reason: Payer unavailable electronically

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

REF 16859658  3/14/2025

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

Action Required: Please refrain from submitting claims until further notice

REF 16858819 3/14/2025

First Health Network - 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: First Health Network (Coventry Health Care National Network)
CPIDs: 2875, 4557
Payer ID: 73159

Action Required: Please refrain from submitting claims until further notice

REF 16859558 3/14/2025

Report Generation Delay for CPID 3218 Harmony

A payer is experiencing issues affecting Professional report generation for some claims submitted since March 07, 2025.

Payer impacted: 

  • CPID 3218 Harmony

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 09416466.

REF 16845308 3/13/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Life Armstrong DOS after 10/31/24
Institutional CPID: 8581
Professional CPID: 2862
Payer-assigned Payer ID: R3476
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Pennsylvania

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 16842604  3/13/2025

Report Generation Delay for CPIDs 2017 and 8152 Altura MSO

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

Payer impacted:

  • CPID 2017 Altura MSO
  • CPID 8152 Altura MSO

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 09419471.

REF 16839959  3/13/2025

Report Generation Delay for CPID 2589 Alliant Health Plans

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

Payer impacted:

  • CPID 2589 Alliant Health Plans

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 09419467.

REF 16839958  3/13/2025

Remittance Reactivation for CPIDs 7693, 7148 Highmark BCBS DE Health Options

Optum recently restored electronic remittance connectivity for the following payer:

Payer Name: Highmark BCBS DE Health Options
Professional CPID: 7148
Institutional CPID: 7693
Industry Payer ID: 74181
Line of Business (LOB) Code: J1V

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 16838059 3/13/2025

PAR Status Change for Eligibility Payers

Effective 4/1/25, the PAR Status for following eligibility payers will change:

Payer Name: UCare Plans
Industry ID: 55413
Exchange RT ID: MNUCAR
Current PAR Status: Gateway
New PAR Status: Non Par

Payer Name: Aspirus Medicare Advantage
Industry ID: 36483
Exchange RT ID: ASPRS
Current PAR Status: Gateway
New PAR Status: Non Par

Action Required: Please be aware of the upcoming changes.

REF 16832869 3/13/2025

PAR Status Change for Eligibility Payers

Effective 4/1/25, the PAR Status for following eligibility payers will change:

Payer Name: UCare Plans
Industry ID: 55413
IMN ID: SX178
Current PAR Status: Transitional
New PAR Status: Non Par


Payer Name: Aspirus Medicare Advantage
Industry ID: 36483
IMN ID: 36483
Current PAR Status: Transitional
New PAR Status: Non Par

Action Required: Please be aware of the upcoming changes.

REF 16832868 3/13/2025

Report Generation Delay for multiple CPIDs

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since March 7, 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 09418937.

REF 16832858  3/12/2025

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below on March 11, 2025 were not processed by the payers.

Payers impacted: 

CPID

Payer Name 

9267

Align Senior Care of Florida

4101

AllCare Advantage

2113

Allcare Health Plan

8714

Allstate - Except New Jersey

1764

Ambetter From Absolute Total Care

9278

Ambetter from Nebraska Total Care

9431

Ambetter from WellCare of Kentucky

9775

Ambetter of Alabama

9433

Ambetter of Oklahoma

9712

American Health Advantage of Florida

9429

American Health Advantage of Idaho & Utah

7854

American Health Advantage of Oklahoma

1741

Amerigroup

4437

Anthem Blue Cross Blue Shield New York

8749

Anthem MaineHealth

6220

Arizona Priority Care Plus

4477

Asuris Northwest Medadvantage Regence

4881

Asuris Northwest Regence

7272

Axminster Medical Group

3845

Banner Health Network

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

9162

Blue Medicare Advantage

4110

Bollinger Inc

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

6777

Centers Plan for Healthy Living

7275

Citrus Valley Physicians Group

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

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

3420

Connecticut Medicare Blue (Risk)

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)

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)

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

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

1797

HAP CareSource Michigan Dual Medicare/Medicaid

1723

HealthCare Partners IPA

4448

HealthLink PPO

5243

Healthcare Management Administrators

3224

Healthy Blue Kansas

7760

Healthy Blue Louisiana

8867

Healthy Blue Missouri

9133

Healthy Blue North Carolina

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

1412

Indiana Anthem Blue Cross Blue Shield

4116

IntegraNet Health

1107

Integrated Health Partners (IHP)

8814

Integrated Homecare Services

4876

International Medical Group

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

2863

Longevity Health Plan of Colorado

8723

MN BCBS Health Care Programs Non Emergent Transportation

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

5871

Mission Community IPA Medical Group

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

9406

Ochsner Health Plan

2418

Ohio Anthem Blue Cross Blue Shield

1403

Oklahoma Blue Cross Blue Shield

2404

Oregon Regence Blue Cross Blue Shield

7829

Passport Advantage

3280

Pool Administrators Oregon Secondary

7168

Premier Healthcare Exchange (PHX)

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

4464

SCAN Health Plan

8816

SOMOS Emblem

2254

Scott & White Health Plan

7499

Sentara Health Plans

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

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 March 12, 2025.

This delay affected claims released to Optum between 2 p.m. and 6 p.m. CT on March 11, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09418391.

REF 16831979 3/12/2025

Report Generation Delay for CPID 1209 Regence Group Administrators

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted since Feb. 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 09418841.

REF 16831964 3/12/2025

Report Generation Delay for CPIDs 4936 and 3476 Masters, Mates and Pilots

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

Payer impacted: 

  • CPID 4936 Masters, Mates and Pilots
  • CPID 3476 Masters, Mates and Pilots

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 09418796.

REF 16831608 3/12/2025

Update: Delay in Electronic Remittance Advice (ERA) for CPIDs 6286/5648 TRICARE West Region

Due to a payer processing issue, there has been a delay in Electronic Remittance Advices (ERA) for the following payers for January 23, 2025 through present:

  • CPID 6286 TRICARE West Region
  • CPID 5648 TRICARE West Region

The January dated ERAs are all uploaded to the payer portal now and providers can go there to download them.

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

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

REF 16829075  3/12/2025

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

Update: A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Feb. 21, 2025.

Payer impacted:

  • CPID 2287 Medicare Plus Blue of MI(MAP)
  • CPID 1913 Medicare Plus Blue of MI(MAP)

Action Required: Please be aware of delays in the report generation for claims submitted during the time frame above.

Original notify sent March 4, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted Feb. 21, 2025.

Payer impacted:

  • CPID 2287 Medicare Plus Blue of MI(MAP)

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09388641.

REF 16829158  3/12/2025

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

Update: A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Feb. 14, 2025, Feb. 15, 2025, and March 4, 2025.

Payer impacted:

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

Action Required: Please be aware of delays in the report generation for claims submitted during the time frame above.

Original notify sent Feb. 26, 2025:
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 16824508  3/12/2025

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

Update: A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Feb. 14, 2025, Feb. 15, 2025, and March 4, 2025.

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

Original notify sent Feb. 26, 2025:
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 16822460  3/12/2025

Update: Report Generation Delay for CPID 9769 Brain and Spine Network

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 13, 2025.

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

Original notify sent Feb. 24, 2025:
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 16822459  3/12/2025

Report Generation Delay for Multiple CPIDs

Novitas is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 3, 2025.

Payers impacted:

CPID

Payer Name 

1526

Arkansas Medicare

2161

Arkansas Medicare

2455

Arkansas Medicare

1449

Colorado Medicare

1547

Colorado Medicare

2456

Delaware Medicare

5912

Delaware Medicare

1522

District of Columbia Medicare

2165

District of Columbia Metropolitan Area (DCMA) Medicare

2459

District of Columbia Metropolitan Area (DCMA) Medicare

1448

Florida Medicare

3518

Florida Medicare

1460

Louisiana Medicare

2171

Louisiana Medicare

3579

Louisiana Medicare

2201

Maryland Medicare

5554

Maryland Medicare

7402

Maryland Medicare

1465

New Jersey Medicare

5503

New Jersey Medicare

1457

New Mexico Medicare

2204

New Mexico Medicare

1458

Oklahoma Medicare

1558

Oklahoma Medicare

2207

Pennsylvania Medicare

2457

Pennsylvania Medicare

4944

Pennsylvania Medicare

5598

Pennsylvania Medicare

2785

Puerto Rico Medicare 

1440

Texas Medicare

2208

Texas Medicare

5502

Texas Medicare

1527

Utah Medicare

4487

Virgin Islands Medicare

5094

Virgin Islands Medicare

Optum is working diligently with Novitas 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 09417510.

REF 16820410  3/12/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: BoldAge PACE IN Evansville
Institutional CPID: 8585
Professional CPID: 2873
Payer-assigned Payer ID: 65433
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Indiana
Claims Fee: N/A

Payer Name: BoldAge PACE KY Owensboro
Institutional CPID: 8905
Professional CPID: 3238
Payer-assigned Payer ID: 65435
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location: Kentucky
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 16819358  3/12/2025

New Electronic Claim Status Connection Available

Effective January 30, 2025, Optum is pleased to announce the availability of Real-time Claim Status Inquiry 276/277 for the below payer:

Payer Name:  Wellstar Health Plan

Industry Payer ID:  RP129

IMN Real Time ID:   RP129

Exchange Real Time ID:   WELST

CPID(s):   2813, 7955

Optum IEDi Real Time ID:   RP129

Payer Enrollment Required:  No

Connection Type:   X12

Search Options:

Subscriber

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

Dependent

  • Member ID, Subscriber Last Name, 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 16816461 3/12/2025

New Electronic Eligibility and Claim Status Connection Available

Effective February 27, 2025, Optum is pleased to announce the availability of Real-Time Eligibility Inquiry and Response 270/271 and Real-Time Claim Status Inquiry 276/277 for the below payer:

Payer Name:   Molina Healthcare of Nebraska

Industry Payer ID:   MLNNE

IMN Real Time ID:   MLNNE

Exchange Real Time ID:   MLNNE

CPID(s):   3626, 1835

Optum IEDi Real Time ID:   MLNNE

Payer Enrollment Required:    No          

Connection Type:   X12      

Search Options: 

Subscriber

  • Member ID, First Name, Last Name, Date of Birth
  • Member ID, Last Name, Date of Birth
  • Member ID, First name, Last Name
  • First Name, Last Name, Date of Birth
  • Member ID, 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 16813309 3/11/2025

Report Generation Delay for CPID 6284 Trillium Health Resources

A payer is experiencing issues affecting Professional report generation for some claims submitted since Feb. 28, 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 09416564.

REF 16811261 3/11/2025

Report Generation Delay for CPIDs 2785 PR Medicare and CPID 4487 PR Medicare

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

Payer impacted: 

  • CPID 4487 PR Medicare
  • CPID 2785 PR Medicare 

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 09416254.

REF 16809761 3/12/2025

Report Generation Delay for CPID 8796 Liberty Advantage Health Plan

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

Payer impacted: 

  • CPID 8796 Liberty Advantage 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 09416487.

REF 16811260 3/12/2025

Payer Change for CPIDs 8910, 7134 Lakewood IPA

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

Payer Name: Lakewood IPA

Professional CPID:  7134

Professional Edit Master:  PE_T007

Institutional CPID:  8910

Institutional Edit Master: HE9O007

Payer-assigned Payer ID: LIPAZ

Claims must begin using the following:

Payer Name: Conifer Health Solutions

Professional CPID:  6704

Current Professional Edit Master:  PE_O007

New Professional Edit Master:  PE_T007

Institutional CPID:  9576

Current Institutional Edit Master: HE9O007

New Institutional Edit Master: HE9T007

Payer-assigned Payer ID: 95399

Line of Business Code (LOB): H6M

 Enrollment Requirements: 

Claims:

  • Payer enrollment for electronic claims is not required.

Remittance:

  • Payer enrollment for electronic remittance is required.

o Providers currently receiving electronic remittance through Optum for CPIDs 6704 and 9576 do not need to complete a new enrollment form.

o 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 16809909 3/12/2025

Payer Change for CPIDs 8910, 7134 Lakewood IPA

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

Payer Name: Lakewood IPA

Professional CPID:  7134

Institutional CPID:  8910

Remittance Available: No

Payer-assigned Payer ID: LIPAZ

Claims must begin using the following:

Payer Name: Conifer Health Solutions

Professional CPID:  6704

Institutional CPID:   9576

Remittance Available: Yes

Payer-assigned Payer ID: 95399

Claim Fee:  N/A

Enrollment Requirements: 

Claims:

  • Payer enrollment for electronic claims is not required.

Remittance:

  • Payer enrollment for electronic remittance is required.

o Providers currently receiving electronic remittance through Optum for CPIDs 6704 and 9576 do not need to complete a new enrollment form.

o 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 16809908 3/12/2025

Report Generation Delay for CPID 7931 Verdegard Employee Plan

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

Payer impacted:

  • CPID 7931 Verdegard Employee 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 09416251.

REF 16809810  3/11/2025

Report Generation Delay for CPID 2460 First Managed Care Options, Inc.

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

Payer impacted:

  • CPID 2460 First Managed Care Options, Inc.

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09415805.

REF 16809760  3/11/2025

Report Generation Delay for CPID 7110 Community Health Group

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

Payer impacted:

  • CPID 7110 Community Health Group

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09415803.

REF 16809759  3/11/2025

Report Generation Delay for CPID 6876 Aetna Better Health of Ohio

A payer is experiencing issues affecting Professional report generation for some claims submitted March 4, 2025.

Payer impacted:

  • CPID 6876 Aetna Better Health of Ohio

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09415807.

REF 16809758  3/11/2025

Report Generation Delay for CPID 1871 Aetna Employee Assistance Program

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

Payer impacted:

  • CPID 1871 Aetna Employee Assistance Program

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 09394755.

REF 16803810  3/11/2025

Block Vision Electronic Claims Connection No Longer Available

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

Assurance Reimbursement Management:

Payer Name: Block Vision
Claims and Remittance CPID: 3402
Payer-assigned Payer ID: 41352
LOB Code: H3P 

Reason: There is no available electronic claim routes for which Optum can connect at this time. 

Action Required: None.

REF 16803470 3/11/2025

Block Vision Electronic Claims Connection No Longer Available

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

Assurance EDI: 

Payer Name: Block Vision
Claims and Remittance CPID: 3402
Payer-assigned Payer ID: 41352
Remittance LOB: H3P 

Reason: There is no available electronic claim routes for which Optum can connect at this time. 

Action Required: None.

REF 16803471 3/11/2025

Report Generation Delay for CPID 5428 QualChoice of Arkansas

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on March 3, 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 09415667.

REF 16803358 3/11/2025

Update: Report Generation Delay for CPID 3271 Medcom

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

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

Original notify sent Feb. 24, 2025:

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 4, 2025.

Payer impacted: 

  • CPID 3271 Medcom

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 09378127.

REF 16802609 3/11/2025

Update: Report Generation Delay for CPID 7493 Vermont Blue Cross Blue Shield

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Feb. 11, 2025.

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

Original notify sent Feb. 21, 2025:
A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted 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 16801659  3/11/2025

Report Generation Delay for Multiple CPIDs

The payers listed below are experiencing issues affecting Institutional and Professional report generation for some claims submitted March 6, 2025.

Payers impacted:

  • CPID 2423 Alabama Blue Cross Blue Shield
  • CPID 5558 Alabama Blue Cross Blue Shield
  • CPID 1002 Alabama Blue Cross Blue Shield Medicare Advantage

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09415534.

REF 16802158  3/11/2025

Report Generation Delay for CPID 5547 Arizona Blue Cross Blue Shield

A payer is experiencing issues affecting Institutional report generation for some claims submitted March 5, 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 09415509.

REF 16802108  3/11/2025

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, claims enrollment is not required for Sentara Health Plans CPIDs 7499, 7567.

Action Required: Providers who previously submitted claims to Sentara Health Plans do not need to enroll.  New providers are encouraged to enroll directly with Sentara Health Plans prior to submitting electronic claims to avoid processing delays.   

3rd notify sent Feb. 25, 2025:

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 16797710  3/11/2025

Update: Report Generation Delay for CPID 9685 Direct Care Administrators

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

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

Original notify sent Feb. 24, 2025:
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 16795360  3/10/2025

Report Generation Delay for CPIDs 3410 and 8578 Preferred One of Minnesota

The payer below is experiencing issues affecting Institutional and Professional report generation for claims submitted since Feb. 28, 2025.

Payer impacted: 

  • CPID 3410 Preferred One of Minnesota 
  • CPID 8578 Preferred One of Minnesota 

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 09393699.

REF 16791858 3/10/2025

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

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

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

Original notify sent Feb. 24, 2025:
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 16789958  3/10/2025

Report Generation Delay for CPID 5554 Maryland Medicare

A payer is experiencing issues affecting Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted:

  • CPID 5554 Maryland Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414398.

REF 16788519  3/10/2025

Update: Report Generation Delay for CPID 2712 The Alliance

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

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

Original notify sent Feb. 24, 2025:

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  16789275 3/10/2025

Report Generation Delay for CPID 5598 Pennsylvania Medicare

A payer is experiencing issues affecting Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted: 

  • CPID 5598 Pennsylvania Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414434.

REF 16788520 3/10/2025

Optum Alert: Report Generation Delay for CPID 1448 Florida Medicare

A payer is experiencing issues affecting Professional report generation for some claims submitted since March 4, 2025.

Payer impacted: 

  • CPID 1448 Florida Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414384.

REF 16788521 3/10/2025

Report Generation Delay for CPID 3579 Louisiana Medicare

A payer is experiencing issues affecting Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted:

  • CPID 3579 Louisiana Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414392.

REF 16788518  3/10/2025

Report Generation Delay for CPIDs 1458 and 1558 Oklahoma Medicare

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted:

  • CPID 1458 Oklahoma Medicare
  • CPID 1558 Oklahoma Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414421.

REF 16788516  3/10/2025

Report Generation Delay for CPID 1547 Colorado Medicare

A payer is experiencing issues affecting Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted:

  • CPID 1547 Colorado Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414351.

REF 16788517  3/10/2025

Report Generation Delay for CPIDs 1522 and 2459 District of Columbia Medicare

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted: 

  • CPID 1522 District of Columbia Medicare
  • CPID 2459 District of Columbia Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414360.

REF 16788513 3/10/2025

Report Generation Delay for CPIDs 2455 and 1526 Arkansas Medicare

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted: 

  • CPID 2455 Arkansas Medicare
  • CPID 1526 Arkansas Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414341.

REF 16788512 3/10/2025

Report Generation Delay for CPIDs 5912 and 2456 Delaware Medicare

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted: 

  • CPID 5912 Delaware Medicare
  • CPID 2456 Delaware Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414375.

REF 16788514 3/10/2025

Report Generation Delay for CPIDs 1465 and 5503 New Jersey Medicare

A payer is experiencing issues affecting Professional and Institutional report generation for some claims submitted since March 4, 2025.

Payer impacted:

  • CPID 1465 New Jersey Medicare
  • CPID 5503 New Jersey Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09414408.

REF 16776312  3/10/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  Best Doctors Insurance Services
Institutional CPID: 8545
Professional CPID: 2820
Payer-assigned Payer ID: BDIUS
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location:  National 

Action Required: 

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

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 16785660 3/10/2025

Report Generation Delay for CPIDs 8029 and 9745 El Paso Health Advantage Dual SNP

A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted Feb. 27, 2025 and March 3, 2025.

Payer impacted:

  • CPID 8029 El Paso Health Advantage Dual SNP
  • CPID 9745 El Paso Health Advantage Dual SNP

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 09414234.

REF 16785858  3/10/2025

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 Feb. 25, 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 09414178.

REF 16785109  3/10/2025

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

Update: The payer has been unable to generate and deliver the reports for some claims submitted between Feb. 22, 2025 and Feb. 25, 2025.

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

Original notify sent Feb. 28, 2025:

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 16784354 3/10/2025

Update: Report Generation Delay for CPID 1209 Regence Group Administrators

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Jan. 27, 2025-Feb. 24, 2025.

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

Original notify sent Feb. 7, 2025:
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 16781913  3/10/2025

Update: Report Generation Delay for CPIDs 4936 and 3476 Masters, Mates and Pilots

Update: The payer intermediary has been unable to generate and deliver the reports for some claims submitted Dec. 23, 2024-Feb. 21, 2025.

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

Original notify sent Dec. 6, 2024:
A payer intermediary is experiencing issues affecting Institutional and Professional report generation for some claims submitted since Nov. 25, 2024.

Payer impacted:

  • CPID 4936 Masters, Mates and Pilots
  • CPID 3476 Masters, Mates and Pilots

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 09284587.

REF 16781508  3/10/2025

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below March 6, 2025 were not processed by the payers.

Payers impacted:

CPID

Payer Name 

9267

Align Senior Care of Florida

1764

Ambetter From Absolute Total Care

9278

Ambetter from Nebraska Total Care

9775

Ambetter of Alabama

9433

Ambetter of Oklahoma

9429

American Health Advantage of Idaho & Utah

7280

American Health Advantage of Missouri

7854

American Health Advantage of Oklahoma

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

4881

Asuris Northwest Regence

7272

Axminster Medical Group

3845

Banner Health Network

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

6165

Bridgeview

4246

Capital Health Plan

2810

Capitol Administrators

8146

Care N Care Insurance Co.

9759

Care1st Health Plan of Arizona Medicaid DOS before 12/01/2022

9762

Care1st Health Plan of Arizona Medicare

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

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)

7137

Concordia Plan Services

1420

Connecticut Anthem Blue Cross Blue Shield

3419

Connecticut Federal Employee Health Benefits

3420

Connecticut Medicare Blue (Risk)

6795

Contra Costa Health Plan

5862

CorrectCare Integrated Health

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

9745

El Paso Health Advantage Dual SNP

4289

El Paso Health-CHIP

5483

Employee Benefit Management Services (EBMS)

1834

Employee Plans

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

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

4445

Insurance Management Services TX

4116

IntegraNet Health

1107

Integrated Health Partners (IHP)

8814

Integrated Homecare Services

4876

International Medical Group

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

1205

Lifeworks Advantage (ISNP Plan)

2863

Longevity Health Plan of Colorado

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

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

9406

Ochsner Health Plan

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

3280

Pool Administrators Oregon Secondary

8128

Pool Administrators, Inc.

5838

Preferred Administrators

4252

Presbyterian Salud

2807

Professional Benefit Administrators (Oakbrook, Illinois)

7281

PruittHealth Premier Medicare Advantage

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

7499

Sentara Health Plans

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)

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 March 7, 2025.

This delay affected claims released to Optum March 6, 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 09395307.

REF 16771563  3/7/2025

Electronic Remittance Connection Suspended

Effective March 3, 2025, the payer listed below has been temporarily suspended at Optum for remittance processing and removed from the payer list.

Payer Name: Healthy Blue South Carolina
CPIDs: 5953, 2121
Payer ID: 00403
LOB: U2O

Action Required: None.

REF 16771309 3/7/2025

Electronic Remittance Connection Suspended

Effective March 3, 2025, the payer listed below has been temporarily suspended at Optum for remittance processing and removed from the payer list.

Payer Name: Healthy Blue South Carolina
CPIDs: 5953, 2121
Payer ID: 00403

Action Required: None.

REF 16771308 3/7/2025

VA Payer Attachments Mismatching

The VA payer has asked that we publish a reminder to submitters of attachments for VA Fee Basis Program that in order for the payer systems to properly match up an attachment to the claim the member ID must match on both transactions.

The Patient ID submitted on 275 transactions, NM109 Loop 1000D, must match the Subscriber ID submitted on the 837 transactions, NM109 Loop 2010BA.  The Veteran’s 17 alpha-numeric (10 digits + "V" + 6 digits) VA-assigned internal control number (ICN) must be used on both the 837 and 275. 

Failure to provide the correct member ID on both transactions will cause orphaned attachments and could cause delays and or processing issues of claims.

REF 16768410 3/7/2025

Update: Payer Transmit Delay for CPID 2904 Texas Medicaid Long Term Care

Update: A resolution has been implemented and the claims were transmitted to the payer March 7, 2025.

This delay affected claims released to Optum between March 3, 2025, 3:00 p.m.-March 6, 2025, 3:00 p.m. CT.

Action Required: Please be aware of the transmit delay.

Original Notify sent March 6, 2025:
Due to a system issue, a delay occurred in some of the transmissions to the following payer since March 3, 2025.

Payer impacted:

  • CPID 2904 Texas Medicaid Long Term Care

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

This delay affected claims released to Optum since March 3, 2025, 3:00 p.m. CT.

Action Required: Be aware of the transmit delay above.

If you have any questions, please contact Customer Support and refer to Case Number 09393635.

REF 16765960  3/7/2025

Report Generation Delay for CPIDs 1440 and 5502 Texas Medicare

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

Payer impacted: 

  • CPID 1440 Texas Medicare
  • CPID 5502 Texas Medicare

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09394686.

REF 16763158 3/7/2025

Payer Transmit Delay for CPID 2904 Texas Medicaid Long Term Care

Due to a system issue, a delay occurred in some of the transmissions to the following payer since March 3, 2025.

Payer impacted:

  • CPID 2904 Texas Medicaid Long Term Care

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

This delay affected claims released to Optum since March 3, 2025, 3:00 p.m. CT.

Action Required: Be aware of the transmit delay above.

If you have any questions, please contact Customer Support and refer to Case Number 09393635.

REF 16753910  3/6/2025

Block Vision Electronic Claims Connection No Longer Available

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

Payer Name: Block Vision
Claim CPID: 3402
Payer-assigned Payer ID: 41352
Reason: There is no available electronic claim routes to which Optum can connect at this time.

Action Required: None.

REF 16748658  3/6/2025

Report Generation Delay for CPID 5013 Aetna Better Health of Illinois

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

Payer impacted:

  • CPID 5013 Aetna Better Health of Illinois

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 09392993.

REF 16747560  3/6/2025

Electronic Routing Change for CPIDs 9669 and 4713 Sutter Gould Medical Foundation

Effective March 6, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name: Sutter Gould Medical Foundation
Professional CPID: 4713
Institutional CPID: 9669
Payer-assigned Payer ID: 77302 

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 16743311 3/6/2025

Electronic Routing Change for CPIDs 9669 and 4713 Sutter Gould Medical Foundation

Effective March 6, 2025, Optum will be reactivating and changing electronic claims routing for the following payer:

Payer Name:  Sutter Gould Medical Foundation
Professional CPID:  4713
Current Edit Master:  PE_N000
New Edit Master:  PE_T007
Institutional CPID:  9669
Current Edit Master:  HE9E049
New Edit Master:  HE9T007
Payer-assigned Payer ID: 77302  

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 16743312 3/6/2025

Report Generation Delay for CPID 3433 Mercy Care Plan

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

Payer impacted: 

  • CPID 3433 Mercy Care 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 09381335.

REF 16742510 3/6/2025

HETS Rules of Behavior

CMS would like to remind all HETS Submitters and your clients to review the HIPAA Eligibility Transaction System (HETS) Rules of Behavior. Please review the rules and share them with the parties that use your services to connect to HETS listed under “Who Needs to Follow These Rules.”

As a reminder, the rules clearly state that HETS is for enrolled Medicare Fee-for-Service (FFS) health care providers and suppliers with a FFS electronic data interchange enrollment to submit Medicare claims to a Medicare Administrative Contractor. Submitters may not use HETS to verify eligibility or coverage for Medicare Advantage (Part C) or Medicare drug (Part D) plans. For Part C, please submit your eligibility inquiry to the Plan and for Part D, please use E1.

Any violations of the HETS Rules of Behavior may result in the possible suspension of your organization’s Submitter ID, placement of your organization on a corrective action plan, or a referral of your organization for investigation. Your organization could be subject to penalties, including civil or criminal actions.

Please contact the MCARE Help Desk if you have questions.

REF 16703565 3/6/2025

Peoples Health Network - Update on real time transactions

Effective immediately, Peoples Health Network is no longer active for real time transactions and all traffic should be submitted under United Healthcare (Payer ID: 87726) as the active payer ID.

REF 16704308 3/5/2025

Delay in Electronic Remittance Advice (ERA) for CPIDs 7518, 2419, 1509, 2425 Maryland CareFirst Blue Cross Blue Shield and District of Columbia CareFirst Blue Cross Blue Shield

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 May 2024 through present:

Payers Impacted:

  • CPID 7518 Maryland CareFirst Blue Cross Blue Shield
  • CPID 2419 Maryland CareFirst Blue Cross Blue Shield
  • CPID 1509 District of Columbia CareFirst Blue Cross Blue Shield
  • CPID 2425 District of Columbia CareFirst Blue Cross Blue Shield

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.

The payer does not have an estimated time to fix this issue. If for some reason, the payer is not able to issue the ERA files, you will need to contact the payer for an Explanation of Benefits (EOB) for manual posting.

If you have any questions, feel free to contact your Customer Support Team and refer to Case INC-000001893.

REF 16684008  3/5/2025

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below on March 4, 2025 were not processed by the payers.

Payers impacted: 

CPID

Payer Name 

8454

Align Senior Care of Michigan

2113

Allcare Health Plan

1764

Ambetter From Absolute Total Care

9278

Ambetter from Nebraska Total Care

9431

Ambetter from WellCare of Kentucky

9432

Ambetter from WellCare of New Jersey

9775

Ambetter of Alabama

9433

Ambetter of Oklahoma

2138

American Family Insurance

9429

American Health Advantage of Idaho & Utah

9731

American Health Advantage of Louisiana

9142

American Health Advantage of Mississippi

7280

American Health Advantage of Missouri

7854

American Health Advantage of Oklahoma

4468

Americas Choice Healthplan

1741

Amerigroup

4437

Anthem Blue Cross Blue Shield New York

8749

Anthem MaineHealth

6220

Arizona Priority Care Plus

7794

Associated Hispanic Physicians IPA

4881

Asuris Northwest Regence

7272

Axminster Medical Group

3845

Banner Health Network

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

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

9762

Care1st Health Plan of Arizona Medicare

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

6777

Centers Plan for Healthy Living

9765

Central Valley Medical Providers

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

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

3419

Connecticut Federal Employee Health Benefits

6795

Contra Costa Health Plan

5862

CorrectCare Integrated Health

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

4279

El Paso Health-STAR

5483

Employee Benefit Management Services (EBMS)

1834

Employee Plans

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

6851

Friday Health Plans

5853

GMS Insurance

8189

Gemcare IPA

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

8750

Healthy Blue Dual Advantage Louisiana

3224

Healthy Blue Kansas

7760

Healthy Blue Louisiana

8867

Healthy Blue Missouri

9133

Healthy Blue North Carolina

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

4445

Insurance Management Services TX

4116

IntegraNet Health

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

8723

MN BCBS Health Care Programs Non Emergent Transportation

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

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

5838

Preferred Administrators

4252

Presbyterian Salud

4253

Prominence Administrative Services

5428

QualChoice of Arkansas

7264

Quartz

1776

RIS Rx

1209

Regence Group Administrators

6423

RevClaims

6246

Riverside Medical Clinic

4464

SCAN Health Plan

8708

SOMOS Anthem

8816

SOMOS Emblem

2254

Scott & White Health Plan

7499

Sentara Health Plans

9438

Shared Health Mississippi

8124

Simply Healthcare Plans, Inc.

1740

Sonder Health Plans

2490

South Dakota Blue Cross Blue Shield

8134

Summit Community Care

7795

Team Choice - Alpha Care Gold

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

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

9430

Wellcare by Allwell of Oklahoma

1775

Wellpoint

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 March 5, 2025.

This delay affected claims released to Optum between 6 p.m. and 10 p.m. CT on March 4, 2025.

Action Required: Be aware of the processing issue above.

If you have any questions, please contact Customer Support and refer to Case Number 09390730.

REF 16699458 3/5/2025

Update: Report Generation Delay for multiple CPIDs

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

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.

Original notify sent Feb. 28, 2025:
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 16684008  3/5/2025

Report Generation Delay for CPID 9270 American Benefit Corporation

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 26, 2025.

Payer impacted: 

  • CPID 9270 American Benefit Corporation

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 09390658.

REF 16690261 3/5/2024

Report Generation Delay for CPIDs 3807 and 1503 CHAMPVA

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

Payer impacted: 

  • CPID 1503 CHAMPVA
  • CPID 3807 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 09390651.

REF 16689660 3/5/2025

Report Generation Delay for CPID 2164 Carelon Behavioral Health Maryland

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 21, 2025 and Feb. 25, 2025.

Payer impacted: 

  • CPID 2164 Carelon Behavioral Health Maryland

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09390523.

REF 16683121 3/5/2025

Report Generation Delay for CPID 4876 International Medical Group

A payer intermediary is experiencing issues affecting Professional report generation for some claims submitted on Feb. 25, 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 09390589.

REF 16688158 3/5/2025

Report Generation Delay for CPID 6671 HealthSun

A payer intermediary is experiencing issues affecting Institutional report generation for some claims submitted on Feb. 25, 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 09390605.

REF 16690258 3/5/2025

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

Update: The payer has been unable to generate and deliver the reports for some claims submitted Dec. 10, 2024-Feb. 10, 2025.

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

Original notify sent Feb. 6, 2025:
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 16655009  3/4/2025

Report Generation Delay for CPID 7105 Harvard Pilgrim Medicare Advantage

A payer is experiencing issues affecting Professional report generation for some claims submitted since Feb. 20, 2025.

Payer impacted:

  • CPID 7105 Harvard Pilgrim Medicare Advantage

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 09389616.

REF 16655008  3/4/2025

MedAdmin Solutions (ADS) Electronic Claims Connection No Longer Available

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

Payer Name: MedAdmin Solutions (ADS)
Claim CPIDs: 1707, 8975
Payer-assigned Payer ID: 58202
Reason: Payer no longer contracted.

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

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

REF 16648860  3/4/2025

MedAdmin Solutions (ADS) Electronic Claims Connection No Longer Available

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

Payer Name: MedAdmin Solutions (ADS)
Claim CPIDs: 1707, 8975
Payer-assigned Payer ID: 58202
Reason: Payer no longer contracted.

Action Required: Claims must be submitted to Optum on paper.

REF 16648859  3/4/2025

Report Generation Delay for CPID 1486 Utah Medicaid

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

Payer impacted:

  • CPID 1486 Utah 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 09389416.

REF 16648610  3/4/2025

Payer Processing Issue for multiple CPIDs

Due to a payer intermediary processing issue, some Professional claims transmitted to the payers listed below March 3, 2025 were not processed by the payers.

Payers impacted:

CPID

Payer Name 

9409

Align Senior Care of California

4101

AllCare Advantage

2113

Allcare Health Plan

8714

Allstate - Except New Jersey

1764

Ambetter From Absolute Total Care

9278

Ambetter from Nebraska Total Care

9431

Ambetter from WellCare of Kentucky

9432

Ambetter from WellCare of New Jersey

9775

Ambetter of Alabama

9433

Ambetter of Oklahoma

9429

American Health Advantage of Idaho & Utah

9731

American Health Advantage of Louisiana

7280

American Health Advantage of Missouri

9117

American Health Advantage of Texas

1741

Amerigroup

4437

Anthem Blue Cross Blue Shield New York

6220

Arizona Priority Care Plus

7794

Associated Hispanic Physicians IPA

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

6165

Bridgeview

4246

Capital Health Plan

2810

Capitol Administrators

2289

Care1st Health Plan of Arizona Medicaid DOS after 11/30/2022

2830

CarePlus Health Plans

9226

CareSource PASSE of Arkansas

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

9765

Central Valley Medical Providers

1415

Colorado Anthem Blue Cross Blue Shield

6778

Common Ground Healthcare Cooperative

8834

Commonwealth Care Alliance DOS after 3/31/2023

8477

Community Care Plan

2160

Community Care Plan (Commercial)

6865

Community Care Plan (Medicaid)

1420

Connecticut Anthem Blue Cross Blue Shield

3420

Connecticut Medicare Blue (Risk)

6795

Contra Costa Health Plan

5862

CorrectCare Integrated Health

7292

CorrectCare Integrated Health- Louisiana

7738

CountyCare Health Plan

2433

Denver Health and Hospital Authority

8135

Doctors HealthCare Plans

1733

Doctors Professional Services Consultants (DPSC)

1119

Easy Choice Health Plan of California

7787

El Paso First Health Plans - Health Care Options (HCO)

9745

El Paso Health Advantage Dual SNP

4279

El Paso Health-STAR

5483

Employee Benefit Management Services (EBMS)

2805

Employer Driven Insurance Services, Inc.

8137

Empower Healthcare Solutions

5238

Evolent Specialty Cardiology

9414

Evry Health

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

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

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

1412

Indiana Anthem Blue Cross Blue Shield

4445

Insurance Management Services TX

4116

IntegraNet Health

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

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

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

2418

Ohio Anthem Blue Cross Blue Shield

1403

Oklahoma Blue Cross Blue Shield

2404

Oregon Regence Blue Cross Blue Shield

7829

Passport Advantage

4252

Presbyterian Salud

2807

Professional Benefit Administrators (Oakbrook, Illinois)

4253

Prominence Administrative Services

7281

PruittHealth Premier Medicare Advantage

5428

QualChoice of Arkansas

7264

Quartz

1209

Regence Group Administrators

3257

ResourceOne Administrators

6246

Riverside Medical Clinic

4464

SCAN Health Plan

8816

SOMOS Emblem

2254

Scott & White Health Plan

7499

Sentara Health Plans

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

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)

9430

Wellcare by Allwell of Oklahoma

1775

Wellpoint

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 March 4, 2025.

This delay affected claims released to Optum March 3, 2025, 6:00 p.m.-10:00 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 09388691.

REF 16640408  3/4/2025

Update: Report Generation Delay for CPID 3509 Ohio Medicaid

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

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

Original notify sent Feb. 26, 2025:

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 16637608 3/4/2025

Update: Report Generation Delay for CPID 5547 Arizona Blue Cross Blue Shield

Update: It has been determined that the report delay below was due to a payer claims processing issue. We have retransmitted the impacted claims to the payer on March 4, 2025.  Reports will be delivered once the claims have successfully processed at the payer.

Action Required: Please be aware of delays.

Original Notice Sent 2/27/25:

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 16637559 3/4/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: Optum RX
Professional CPID: 2765
Payer-assigned Payer ID: ORXM1
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 16639908  3/4/2025

Notice of Real-Time Eligibility Termination

Effective immediately, electronic eligibility for the payer listed below is no longer available at Optum.

Payer Name: EMHS Employee Health Plan
Real Time ID: 16565
Optum IEDi Real Time ID: 16565
Exchange ID: EMHSP

Reason: Payer no longer offers an electronic connection.

REF 16637712  3/4/2025

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

Update: Effective immediately, eligibility transactions for the following payer must also use a different payer ID to avoid rejections at Optum.

Payer Name: Government Employees Health Association
Old Optum Payer ID: GEHA
New Optum Payer ID: UMRWAU

Enrollment Requirements for Payer ID UMRWAU:

  • Payer enrollment for electronic eligibility is not required.

Action Required:

  • Please update your system immediately with the new eligibility Payer ID to avoid transactions rejecting for the payer list above.
  • 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.

Reminder sent Feb. 26, 2025: 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 16634959  3/4/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: American Health Resources
Institutional CPID: 7545
Professional CPID: 1893
Payer-assigned Payer ID: AHR01
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 16632159  3/4/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available:

Payer Name: American Health Resources
Institutional CPID: 7545
Professional CPID: 1893
Payer-assigned Payer ID: AHR01
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 16632158  3/4/3035

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. 21, 2025.

Payer impacted:

  • CPID 2287 Medicare Plus Blue of MI(MAP)

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

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

If you have any questions, please contact Customer Support and refer to Case Number 09388641.

REF 16631158  3/4/2025

Claims Reactivation for CPIDs 8480, 3070 Northwest Community Health Partners

Effective immediately, the payer listed below has been reactivated at Optum for electronic claims processing and will be added back to the payer list. The Trading Partner confirmed there was an issue with invalid rejections that has now been corrected.

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

Rejected claims received Jan. 23, 2025-Feb. 18, 2025 will be resubmitted by Optum. The invalid rejection message was: THE PAYER ID IS NOT VALID. PLEASE CORRECT AND RESUBMIT THE FAILED TRANSACTIONS.

Action Required: None.

REF 16629558  3/4/2025

Report Generation Delay for CPIDs 1942 and 3764 IMCare

The payer listed below is experiencing issues affecting Institutional and Professional report generation for some claims submitted on Feb. 25, 2025.

Payer impacted: 

  • CPID 1942 IMCare
  • CPID 3764 IMCare

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 09388156.

REF 16581208 3/3/2025

Medicaid Alabama 276/277 Claim Status Inquiry Errors E0:21

Gainwell Medicaid Alabama recommends to resolve error STC*E0:21 that you submit your claim status inquiry 276 with the 2200D REF*1K Payer Claim Control Number(ICN) for best results. 

Payer Name: Medicaid Alabama

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 open a Optum Customer Care Hub ticket.

REF 16576472 3/3/2025

Payer Processing Issue for multiple CPIDs

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

Payers Impacted: 

CPID

Payer Name 

9267

Align Senior Care of Florida

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

9432

Ambetter from WellCare of New Jersey

9775

Ambetter of Alabama

9433

Ambetter of Oklahoma

4298

AmeraPlan

9429

American Health Advantage of Idaho & Utah

7854

American Health Advantage of Oklahoma

9117

American Health Advantage of Texas

4468

Americas Choice Healthplan

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

1169

Blue Cross Blue Shield of Western New York Medicaid/CHP

1243

Blue Cross Community Centennial

1167

Blue Cross Medicare Advantage PPO/HMO

9162

Blue Medicare Advantage

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

9762

Care1st Health Plan of Arizona Medicare

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

7763

Columbine Health Plan

6778

Common Ground Healthcare Cooperative

8834

Commonwealth Care Alliance DOS after 3/31/2023

8477

Community Care Plan

6865

Community Care Plan (Medicaid)

8147

Community Care Plan (Palm Beach Health District)

1420

Connecticut Anthem Blue Cross Blue Shield

6795

Contra Costa Health Plan

7292

CorrectCare Integrated Health- Louisiana

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)

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

1797

HAP CareSource Michigan Dual Medicare/Medicaid

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

4445

Insurance Management Services TX

4116

IntegraNet Health

1107

Integrated Health Partners (IHP)

4876

International Medical Group

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

8467

Keycare

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

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

9406

Ochsner Health Plan

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

3280

Pool Administrators Oregon Secondary

5838

Preferred Administrators

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

3257

ResourceOne Administrators

6423

RevClaims

6246

Riverside Medical Clinic

4464

SCAN Health Plan

8708

SOMOS Anthem

8816

SOMOS Emblem

2254

Scott & White Health Plan

7499

Sentara Health Plans

9438

Shared Health Mississippi

7225

Sharp Community Medical Group

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

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 March 3, 2025.

This delay affected claims released to Optum Feb. 28, 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 09387465.

REF 16573858  3/3/2025

Update: Report Generation Delay for CPID 6284 Trillium Health Resources

Update: The payer has been unable to generate and deliver the reports for some claims submitted from Feb. 14, 2025 through Feb. 21, 2025.

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

Original notify sent Feb. 25, 2025:

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 16571858  3/3/2025

New Electronic Claims Connections Available

Optum has new electronic claims connections available: 

Payer Name:  EOB TPA
Institutional CPID:  7550
Professional CPID:  2763
Payer-assigned Payer ID:  TBL38
Payer Enrollment Required: No
Secondary Claims Accepted: Yes
Payer Location:  National
Claims Fee: N/A
Other Associated payer name: Thin Blue Line

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 16568061 3/3/2025

Resolved: Mercy Care | Claims | Transmit Delay

Update: A resolution has been implemented and the claims were transmitted March 3, 2025.

Original message:

Due to a system issue, a delay occurred in the claims transmission to the following payers for claims to be submitted March 3, 2025.

Payers Impacted:

Payer ID 33628 ( CPID 6717 )

Payer ID 86052 ( CPID 3433 ) 

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

REF 16568418 16573558 3/3/2025

Report Generation Delay for CPID 2433 Denver Health and Hospital Authority

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

Payer impacted:

  • CPID 2433 Denver Health and Hospital Authority

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 09387387.

REF 16567858  3/3/2025

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 Feb. 7, 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 09387012.

REF 16562710  3/3/2025

Update: Payer Transmit Delay for multiple CPIDs

Update: A resolution has been implemented and the claims were transmitted to the payers March 3, 2025.

Action Required: Please be aware of the transmit delay.

Original Notify sent Feb. 26, 2025:
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 16562659  3/3/2025

Older Payer Updates

Click the link below to access payer updates prior to March 1st, 2025.

GET OLDER UPDATES
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