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Investigating - Optum Insight Rx Connect is experiencing sporadic connectivity issues to Data Rx and Medicaid Oklahoma BINs impacting inbound pharmacy transactions starting Sept. 17, 2025. Pharmacies may experience ERX02 or ERX03 error messages.
Optum Insight is troubleshooting this issue and will update once resolved.
Sep 18, 2025 - 08:58 EDT
Optum Insight is troubleshooting this issue and will update once resolved.
Sep 18, 2025 - 08:58 EDT
Identified - This message is intended for Pharmacy Network MedRX customers.
Optum Insight has identified an issue causing duplicate line items for MedRX products on August invoices resulting in an erroneous total amount due. Please disregard these erroneous invoices, as corrected invoices are being generated and will be sent to customers as soon as possible. We apologize for any inconvenience and are implementing steps to prevent this issue from recurring in the future.
Sep 17, 2025 - 12:53 EDT
Optum Insight has identified an issue causing duplicate line items for MedRX products on August invoices resulting in an erroneous total amount due. Please disregard these erroneous invoices, as corrected invoices are being generated and will be sent to customers as soon as possible. We apologize for any inconvenience and are implementing steps to prevent this issue from recurring in the future.
Sep 17, 2025 - 12:53 EDT
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If you are experiencing an issue not listed here, please contact Optum support. This site may not reflect status in real time, since status could be delayed.
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Optum Rebranded URL Sep 30, 2025 00:00-00:05 EDT
Dear valued customer,
We are pleased to announce that the SmartPay Plus provider portal has a new URL: smartpayplus.optum.com
The site's content and functionality remain unchanged; and it will remain your SmartPay Plus provider resource.
Start using the new URL immediately. The Change Healthcare URL (smartpayplus.changehealthcare.com) will be deprecated by 9/30/25.
Update any bookmarks with the new URL.
Share the new URL with your team(s).
This URL change is part of the continued integration work between Change Healthcare and Optum.
Posted on Jul 10, 2025 - 07:39 EDT
We are pleased to announce that the SmartPay Plus provider portal has a new URL: smartpayplus.optum.com
The site's content and functionality remain unchanged; and it will remain your SmartPay Plus provider resource.
Start using the new URL immediately. The Change Healthcare URL (smartpayplus.changehealthcare.com) will be deprecated by 9/30/25.
Update any bookmarks with the new URL.
Share the new URL with your team(s).
This URL change is part of the continued integration work between Change Healthcare and Optum.
Posted on Jul 10, 2025 - 07:39 EDT
PrEP for HIV: Billing for Yeztugo® (lenacapavir) for Pre-exposure Prophylaxis Oct 1, 2025 00:00-00:05 EDT
This message is intended for MedRx customers.
CMS has published guidelines for a new HIV PrEP drug, Lenacapavir.
Beginning October 1st, 2025 this drug will be billable through Optum Insight Medicare MedRX.
Additional information including access to the ASP Drug Pricing Files can be viewed here: PrEP | CMS
How Do I Bill for Lenacapavir?
From June 18-September 30, 2025, use this code:
Code: J0799
Descriptor: FDA approved prescription drug, only for use as hiv pre-exposure prophylaxis, not otherwise classified
Payment Limit: Unless specified on the ASP Drug Pricing Files, the MACs determine pricing her 42 CFR 410.152(o)
Starting October 1, 2025, use these codes:
Code: J0738
Descriptor: Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Payment Limit: View ASP Drug Pricing Files for October 2025 and later
Code: J0752
Descriptor: Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Payment Limit: View ASP Drug Pricing Files for October 2025 and later
Posted on Sep 17, 2025 - 11:17 EDT
CMS has published guidelines for a new HIV PrEP drug, Lenacapavir.
Beginning October 1st, 2025 this drug will be billable through Optum Insight Medicare MedRX.
Additional information including access to the ASP Drug Pricing Files can be viewed here: PrEP | CMS
How Do I Bill for Lenacapavir?
From June 18-September 30, 2025, use this code:
Code: J0799
Descriptor: FDA approved prescription drug, only for use as hiv pre-exposure prophylaxis, not otherwise classified
Payment Limit: Unless specified on the ASP Drug Pricing Files, the MACs determine pricing her 42 CFR 410.152(o)
Starting October 1, 2025, use these codes:
Code: J0738
Descriptor: Injection, lenacapavir, 1 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Payment Limit: View ASP Drug Pricing Files for October 2025 and later
Code: J0752
Descriptor: Oral, lenacapavir, 300 mg, fda approved prescription, only for use as hiv pre-exposure prophylaxis (not for use as treatment for hiv)
Payment Limit: View ASP Drug Pricing Files for October 2025 and later
Posted on Sep 17, 2025 - 11:17 EDT