OptumInsight: CA Medicaid Medi-Cal Changes

ATTENTION: 837I California Medicaid (Medi-Cal) Providers

Effective 11/17/14, Optum will be moving to a direct connection for 837i California Medicaid (MEDI-CAL) Outpatient claims only. In order to submit claims, the payer ID and payer name must be changed to the following:

The payer id for this payer will change from 57106 to MDCAL.

The payer name will also need to change to “MEDI-CAL OP”.

Failure to make these required changes will disrupt your claim submissions. Existing providers will need to complete required re-enrollment. New providers will need to complete enrollment. Do not send claims prior to receiving enrollment approval by payer.

Important Note: Optum has not been approved to submit for Inpatient or Long Term Care claims due to lack of claims for testing. Optum will allow test claims for these payers. In order to submit claims for these two lines of business, the payer ID and payer name must be changed to the following:

The payer id for both payers will change from 57106 to MDCAL

The payer name for Inpatient claims will need to change to ‘MEDI-CAL IP’.

Payer name for Long Term Care claims will need to be changed to ‘MEDI-CAL LTC’

Payers affected:

837I:

• CALIFORNIA MEDICAID (MEDI-CAL)

Provider action is required at this time to complete re-enrollment\enrollment.

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: 877-309-4256

Fax: 888.567.8880