OptumHealth Provider - Manage Claims

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Claims Sent Electronically (Preferred Method)

OptumHealth accepts claims electronically through OptumInsight/ENS (www.enshealth.com).

Please use payer ID # 41194 when submitting claims electronically.

For any questions regarding EDI submission, please call our toll-free number: (877) 801-3507, option 3 (Health Care Provider).

Where to Submit Claims

Claims should be filed electronically in an 837 HIPAA complaint format or on paper using CMS standard forms using industry standard coding.

OptumHealth Care Solutions
PO Box 30758
Salt Lake City, Utah 84130

In cases of emergency, your facility can submit claims to OptumHealth using overnight delivery. Please call our toll-free number to obtain the designated overnight delivery address and to provide notification of overnight claims delivery.

Customer Service Inquiries

Phone: (877) 801-3507
Prompt: 3
Health Care Provider

Fax: 888-905-9492

Email: cmc.customer.service@optum.com

Select the following links to access the claims lists for a particular patient. Search to locate claims within a specific date range or for a specific payer.

Customer Service Questions
Phone: (877) 801-3507
Prompt: 3
Health Care Provider

Fax: 888-905-9492

Email: cmc.customer.service@optum.com

Please review our claim inquiry guidelines below.

Customer Service Guidelines

OptumHealth has enhanced its customer service model to streamline your requests for service. Our Customer Service Call Center is equipped to handle your inquiries, and when necessary, escalate resolution of your request to your Network Services Representative. Please use the following guidelines and submission methods to have your inquiries tracked for resolution. Links:

Member Claim Status Fax Template

Claims Status Spreadsheet Template

Patient List - View entire list of patients.

Closed/Rejected Claims - View closed/rejected claims.

Search Claims

To view all your claims, simply click the Search Claims button.

By Patient

	First Name		Last Name

By Date of Service

See all claims with a beginning or end DOS (Date Of Service) between:

and

mm/dd/yyyy

(Please note that the claim search is limited to 500 records.
The record number can be reduced by adding additional search criteria.)

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