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Optum - Complex Medical Conditions (CMC)

medical

Summary

Optum - Complex Medical Conditions (CMC) is a medical payer. Claims route under payer ID 41194, with 4 alternate IDs in use across clearinghouses. Through clearinghouses it supports professional claims, institutional claims, and electronic remittance (ERA); ERA enrollment is required and takes several weeks.

At a glance

Payer ID
41194Also seen as 3824, 41194MA, 9513, UNTDRN
Also known as
OptumHealth Care Solutions, United Resource Networks

Clearinghouse transaction setup

Which EDI transactions this payer supports, and how long clearinghouse enrollment typically takes when it is required.

TransactionEnrollmentTypical setup
Professional claims (837P)Not requiredImmediate
Institutional claims (837I)Not requiredImmediate
ERA / remittance (835)RequiredSeveral weeks

Common questions

What is the payer ID for Optum - Complex Medical Conditions (CMC)?
The payer ID for Optum - Complex Medical Conditions (CMC) is 41194. Alternate IDs seen across clearinghouses include 3824, 41194MA, 9513, UNTDRN.
Does Optum - Complex Medical Conditions (CMC) require ERA enrollment?
Yes. Optum - Complex Medical Conditions (CMC) requires a separate ERA (835) enrollment before electronic remittances flow, and setup typically takes several weeks.
What types of coverage does Optum - Complex Medical Conditions (CMC) offer?
Optum - Complex Medical Conditions (CMC) covers medical.
Can I submit claims to Optum - Complex Medical Conditions (CMC) electronically?
Yes. Optum - Complex Medical Conditions (CMC) is reachable through clearinghouses for professional claims, institutional claims, and electronic remittance. Electronic claims are supported for professional (837P) and institutional (837I).

Compiled from public payer resources and clearinghouse catalogs. Details change often, so confirm with the payer before relying on them. Spot something out of date? Tell us and we will fix it.