ATTENTION: UTAH MEDICAID PROVIDERS
From: Mast, Carolyn J [mailto:Carolyn.Mast@optum.com]
Sent: Monday, November 19, 2012 12:47 PM
Subject: OptumInsight System Notification:
IMPORANT! UTAH MEDICAID PROVIDERS RE-ENROLLMENT REQUIRED DECEMBER 12TH, 13TH AND 14TH / TRANSITION DATE DECEMBER 17TH
Date / Time (Time Zone): November 19, 2012 1:00 pm MST
On December 17, 2012, OptumInsight will have a direct connection to Utah Medicaid in X12 5010 format version. Unfortunately, re-enrollment will be required for this direct connection and provider action is required. OptumInsight has scheduled a re-enrollment period in which all Utah Medicaid providers must complete their online re-enrollment on December 12th through December 14th. Re-enrollment completed on December 14th must be completed prior to 4:00 PM MST so that there is no further interruption with your claim submissions.
Providers may continue to submit inbound claims to OptumInsight on December 12th through December 14th however; these claims will not be submitted to Utah Medicaid until the December 17th Go-Live date.
Instructions for the online enrollment:
Providers will need to complete the online payer agreement @ https://mmcs.health.utah.gov/hcfenroll2/index.jsp
1) Go to Utah Medicaid Electronic Data Interchange (EDI) and enter either your 12 digit Medicaid Provider Contract number or your 10 digit NPI.
2) Then enter your Tax ID.
3) Click the Submit button.
4) On the next page you will need to verify if the provider’s information. If correct click yes, you will forwarded to the next page.
5) Complete all information from 1-14. Within box 15 enter Trading Partner number HT005191-001 next to the transaction you wish to send. Transactions available are 837P Professional claims, 837I Institutional claim and 835 Electronic Remittance Advice (ERA). Verify accuracy of screen then click Submit.
6) Approval is immediate.
Should you have any regarding this form, contact the Utah Medicaid EDI team at (801) 538-6155, option 3, option 5, and option 2.
Trading Partner number: HT005191-001
Transactions supported under the new direct connection to Utah Medicaid are:
837P
837I
835
We apologize for any inconvenience this may cause.
Please do not respond to this email with questions.
OptumInsight Claims Integrity & Connectivity Solutions
1755 Telstar Drive, Suite 400
Colorado Springs, CO 80920
Phone: 719.277.7545
Fax: 719.277.0254