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insurance payer for Optum?

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22 comments

  • Matthew Flynn, Psy.D.

    I use united health care payer id 87726 for all my optum clients in Massachusetts - works fine for me.

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  • Gillian

    Hi Jantiene, what state are you in? Your client's insurance card should list the correct payer information for Optum. 

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  • Lori Strolin

    It would be so great to have SP work for electronic billing/ deposits and EOPB's  w Optum.

    Am I doing something wrong- I don't see Optum in the list?

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  • Gillian

    Hi Lori, Optum often carves out mental health benefits to other payers. Can you let me know what state you're in?

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  • Matthew Flynn, Psy.D.

    In simple practice in MA I use United Health Care payer 87726 as well as how I submit it and get the reports. All the reports come back under it for my united health care, Harvard Pilgrim, and Allways clients. Has worked no problem so far, but just having an optum 87726 ID listed as a payer would be best and easiest. Are there ways to add in those other insurances also under ID 87726?

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  • Jorge W. Dionisio

    Hi Gillian,

    How about the State of Maryland, what payer should I use?

    I used United Health Care Payer 87726 and Amerigroup AMGRP and both worked. I assumed it worked, since Simple Practice sent the claims through without any requests for change.

    Thank you

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  • Gillian

    Hi Jorge, for Optum Maryland Behavioral Health, you can use Payer ID OMDBH. 

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  • Rita L. Gossett

    Gillian,

    United/Optum has requested we submit a claim to:

    Bind Benefits, Payor ID 25463

    PO Box 211758

    Eagen, MN  551221

     

    I am unable to find this one, or even add it.  Do you have a different Payer ID that I'm not aware of?

     

     

     

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  • Gillian

    Hi Rita, apologies for my delayed response. Our team has received an update from our clearinghouse. They’ve confirmed that they’ve established a claims filing connection with Bind Benefits through payer ID 25463.

    Let me know if you have any questions about SimplePractice that I can help with.

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  • Cristal Acosta

    What about Harvard Pilgrim claims for Texas?  They told me to submit claims to United Behavioral Health, but unsure what payer ID to use.

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  • Gillian

    Hi Cristal, UBH's Payer ID is 87726. Let me know if you have any additional questions about this, or anything else SimplePractice. I'm here to help. 

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  • Cristal Acosta

    I initially submitted a claim to Harvard Pilgrim here on sp . How can I correct the info to send it to UBH instead?

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  • Gillian

    Hi Cristal, because you submitted the claim to the incorrect payer, there's no need to file a cancellation claim or submit a corrected claim. All you need to do is delete the claim that was submitted to Harvard Pilgrim, then adjust the client's insurance payer under Edit Details > Billing and Insurance. Then, create and submit a new claim for the sessions that were on the previous claim. 

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  • Akira Stuckey

    Hello.  What about in New Hampshire?  Does UBH, Optum, Harvard Pilgrim takes the same ID? Thank you

     

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  • Gillian

    Hi Akira, we recommend reaching out to payers directly to understand where they'd prefer you to direct claims.

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  • Akira Stuckey

    Thank you!

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  • Amy Blackburn

    Hi,

    I have basically the same question as Akira. I am a provider in New Hampshire and I have taken the steps to enroll with Harvard Pilgrim through Simple Practice. Should I continue to wait on the enrollment process or should I be submitting bills directly to HPHC or UHC or Optum, etc.? It's a little confusing.

    Thanks,

    Amy

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  • Ruth

    Hi Amy - You'll want to contact insurance payers directly to confirm where you should bill your clients' claims to. The best way to do this is by calling the Provider line listed on the back of your clients' insurance cards. You can also refer to our guide for some helpful tips on Selecting the correct insurance provider.

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  • Kellie Perkins

    Hello! I am contracted through Optum in Massachusetts for Harvard Pilgrim and UBH. I am struggling to get my payments from Optum to simplepractice. The Eligible Inc is not listed as a billing service with Optum, on the Optum pay website. Has anyone else encountered this issue and can help me? i know that the correct payer id for all these plans is 87726, but i think i am using the wrong 87726 (cause there is only 50 to pick from!) thanks you!

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  • Jantiene Swinkels-Tratnyek, LMHC

    hi Kellie - I am also contracted with Optum in MA and unfortunately I don't think there is a way to align their payments through SP. Your best bet is to generate a claim and then manually submit claims directly through the Optum site. You'll have to go back to Optum to check when you've been paid and then reconcile the payments in your SP billing. Hope that makes sense. It's a bit of an annoyance but once you get into the swing of it it's OK.

    Tina

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  • Matthew Flynn, Psy.D.

    Im in MA and use optum as I know there is now an optum tab in SP under 87726 but I havent used it. Instead Ive used the one with United Heathcare under 87726 and have no problems gettign paid with UBH and Harvard. Hope that helps - Matt

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  • Ruth

    Hi Everyone, thanks you for contributing to this conversation and sharing your experiences! 

    Kellie, if you're trying to enroll in ERAs through SimplePractice, go to Settings > Insurance > Enrollments and hit the +Enroll button under the Payment Reports row for this payer. You don't want to enroll in ERAs through Optum, or any other insurance payer portal. The 50 payers you see listed on the Settings > Insurance page aren't the only ones that we have a connection with, they're just the first 50 in numero-alphabetical order. Use the search bar to find many payers listed for the Payer ID 87726.

    Note: you must assign this payer to one of your clients in their client file > Edit > Billing and Insurance > Insurance Information section prior to submitting an enrollment. If you're still unable to process an enrollment, please reach out to our Insurance Team by submitting an email Help Request.

     

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