For further updates about the Change Healthcare cybersecurity issue, please visit Change Healthcare Cyber Response.
For imaging solutions, please visit us at Change Healthcare Enterprise Imaging.
Identified - Due to server issues, we have temporarily switched from Guardian to CIAM. Our team is working to resolve this issue as quickly as possible. We will send another notification when we're ready to move back to Sentinel/Guardian. In the meantime, please note that all new users will need to be added in CIAM.
We apologize for any inconvenience this may have caused and appreciate your patience and understanding.
Thank you for your continued support!
REF 17017958
Mar 26, 2025 - 10:19 EDT
We apologize for any inconvenience this may have caused and appreciate your patience and understanding.
Thank you for your continued support!
REF 17017958
Mar 26, 2025 - 10:19 EDT
About This Site
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.
As you may know, Change Healthcare is now combining with Optum. Throughout the brand migration process, both brand identities may be visible in our markets.
Tell us how we're doing.
Change Healthcare Enterprise
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Operational
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Operational
CareSelect®
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Operational
InterQual® AutoReview
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InterQual® Cloud Solutions
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Operational
InterQual® Coordinated Care
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Operational
InterQual® Criteria
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InterQual® Customize
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InterQual® Government Services
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CommonWell
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Cost Transparency
Major Outage
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Major Outage
Provider Directory
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Major Outage
Customer Portals
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ConnectCenter
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Customer Care Hub
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Download Connect
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Dental Network
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Partial Outage
Dental Converge
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Major Outage
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Partial Outage
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Major Outage
Dental Revenue Cycle Insights
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Major Outage
Government Eligibility, Enrollment & Member Engagement
Major Outage
Enrollment Advocate (Dual Enrollment, Advocate & Recert Complete, My Advocate, Part D Complete & Community Advocate, SSI Enrollment Advocate)
Partial Outage
Smart Connect, Smart Appointment Scheduling, & Clinical Care Visits
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Major Outage
Medical Network Services (eligibility, enrollment and clearinghouse)
Major Outage
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Medical Network APIs
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Claims Responses and Reports API
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Claims Status API
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Institutional Claims API
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Payer Finder website and API
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Professional Claims API
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Medical Record Retrieval & Clinical Review
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Medical Record Retrieval
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Patient Engagement & Experience
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Shop Book and Pay
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Major Outage
Virtual Front Desk
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Major Outage
Payer Communications and Payment Services
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Payer Enrollment Services
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Settlement Advocate
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Communications Complete - Payer
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Payment Integrity
Major Outage
DRG Validation
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Hospital Bill Audit
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Hospital Billing Validation/Short Stay Bill Validation
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Pharmacy Benefits & TPA
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Smart Commercial Pharmacy Services
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Pharmacy Solutions
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Absolute AR
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Converge Rx
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Exchange Dx
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Explore Dx
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MedRx
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Rx Edit
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Rx Processor Alerts
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Rx Secure Site
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Turn Rx
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Provider Communications and Payment Services
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Payment Automation
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SmartPay Plus for Providers
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Provider Network Optimization
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Contract Manager
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AccuPost
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Major Outage
Acuity Revenue Cycle Analytics
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Ahi Lobby
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AhiQA
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Degraded Performance
Ambulatory Claims Manager
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Major Outage
Assurance Reimbursement Management
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Operational
Claims & Denials Advisor
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Major Outage
Claims & Denials Management
Major Outage
Clearance Patient Access Suite
Degraded Performance
Clearance Patient Access Suite: Advocate
Operational
Clearance Patient Access Suite: Bi-directional connectivity
Operational
Clearance Patient Access Suite: Estimator
Operational
Clearance Patient Access Suite: HL7
Operational
Clearance Patient Access Suite: Medical Necessity
Operational
Clearance Patient Access Suite: Notice of Admission
Operational
Clearance Patient Access Suite: Patient ID
Operational
Clearance Patient Access Suite: Prior Authorization
Operational
Clearance Patient Access Suite: Propensity to Pay
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Clearance Patient Access Suite: qPay
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Clearance Patient Access Suite: Verifier
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Financial Clearance Services
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Partial Outage
National Payments Connector
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Patient Engagement Suite
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Pulse Revenue Cycle Benchmarking™
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Major Outage
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HealthQx
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Major Outage
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Maintenance
Scheduled Maintenance
Optum Insight's Secure Site - Undergoing Maintenance Nov 25, 2024 16:00-18:00 EST
Optum Insight's Secure Site website is currently undergoing maintenance. During this time, you will be unable to access the secure site (which includes Cardfinder and PPE Override Manager). We expect this outage to be no more than two business hours. Thank you for your patience during this time.
REF 826435
Posted on Nov 25, 2024 - 15:56 EST
REF 826435
Posted on Nov 25, 2024 - 15:56 EST
Reminder: Postage Rate Update Jan 10, 2025 10:30-10:40 EST
Postage Rates
In September 2021, the USPS® announced that beginning in 2023, rate adjustments will be considered twice a year, in January and in July.
USPS Announcement
We are happy to report that for January 2025, the Postal Service has determined that it will not increase postage rates, maintaining prices set in July 2024 until at least July 2025:
Category Rate
Stamped Single-Piece 0.73
MAADC Automation 0.622
AADC Automation 0.593
5-Digit Automation 0.545
We appreciate your business and continue to strive for excellence serving you. Please contact your Account Manager or Senior Client Executive with questions or concerns.
Thank you for your attention to this announcement.
Optum
As you may know, Change Healthcare is now combining with Optum. Throughout the brand migration process, both brand identities may be visible in our markets.
Disclaimer: Optum is a registered trademark of Optum, Inc. in the U.S. and other jurisdictions. All other trademarks are the property of their respective owners. Because we are continuously improving our products and services, Optum reserves the right to change specifications without prior notice. Optum is an equal opportunity employer. © 2025 Optum, Inc. All rights reserved.
REF 15737947 1/10/2025
Posted on Jan 10, 2025 - 10:28 EST
In September 2021, the USPS® announced that beginning in 2023, rate adjustments will be considered twice a year, in January and in July.
USPS Announcement
We are happy to report that for January 2025, the Postal Service has determined that it will not increase postage rates, maintaining prices set in July 2024 until at least July 2025:
Category Rate
Stamped Single-Piece 0.73
MAADC Automation 0.622
AADC Automation 0.593
5-Digit Automation 0.545
We appreciate your business and continue to strive for excellence serving you. Please contact your Account Manager or Senior Client Executive with questions or concerns.
Thank you for your attention to this announcement.
Optum
As you may know, Change Healthcare is now combining with Optum. Throughout the brand migration process, both brand identities may be visible in our markets.
Disclaimer: Optum is a registered trademark of Optum, Inc. in the U.S. and other jurisdictions. All other trademarks are the property of their respective owners. Because we are continuously improving our products and services, Optum reserves the right to change specifications without prior notice. Optum is an equal opportunity employer. © 2025 Optum, Inc. All rights reserved.
REF 15737947 1/10/2025
Posted on Jan 10, 2025 - 10:28 EST
Important Update: Migration to New User Management Application Feb 4, 2025 17:30-17:40 EST
We are excited to announce that we will be migrating from our current user management application CIAM to a new, more robust system called Guardian. This change is part of our ongoing commitment to providing you with the best possible service and enhanced features.
Key Details:
• Migration Date: Early March (We will send definitive dates in the next few weeks)
• Downtime: We anticipate minimal downtime during the migration process. We will send a notification prior to the scheduled deployment.
• New Features: The new application will offer improved security, and a more user-friendly interface to better meet your needs.
• Action Required: No action is required from your side. All your data will be securely transferred to the new system. However, we recommend that you log into Guardian after the migration to familiarize yourself with the new interface.
What to Expect:
1. Seamless Transition: Our team has worked diligently to ensure a smooth transition with minimal disruption to your experience.
2. Support: Our support team will be available to assist you with any questions or issues you may encounter during and after the migration. You can reach us at customercare.changehealthcare.com or clearance.support@optum.com.
3. Training Resources: We will provide comprehensive training materials and online videos in the next few weeks to help you get acquainted with the new system.
We appreciate your understanding and cooperation during this transition. If you have any questions or concerns, please do not hesitate to contact us.
REF 16068961
Posted on Feb 04, 2025 - 17:16 EST
Key Details:
• Migration Date: Early March (We will send definitive dates in the next few weeks)
• Downtime: We anticipate minimal downtime during the migration process. We will send a notification prior to the scheduled deployment.
• New Features: The new application will offer improved security, and a more user-friendly interface to better meet your needs.
• Action Required: No action is required from your side. All your data will be securely transferred to the new system. However, we recommend that you log into Guardian after the migration to familiarize yourself with the new interface.
What to Expect:
1. Seamless Transition: Our team has worked diligently to ensure a smooth transition with minimal disruption to your experience.
2. Support: Our support team will be available to assist you with any questions or issues you may encounter during and after the migration. You can reach us at customercare.changehealthcare.com or clearance.support@optum.com.
3. Training Resources: We will provide comprehensive training materials and online videos in the next few weeks to help you get acquainted with the new system.
We appreciate your understanding and cooperation during this transition. If you have any questions or concerns, please do not hesitate to contact us.
REF 16068961
Posted on Feb 04, 2025 - 17:16 EST
Important Update: Migration to New User Management Application Feb 17, 2025 09:15-09:25 EST
We are excited to announce that we will be migrating from our current user management application CIAM to a new, more robust system called Guardian. This change is part of our ongoing commitment to providing you with the best possible service and enhanced features.
Key Details:
• Migration Date: Early March (We will send definitive dates in the next few weeks)
• Downtime: We anticipate minimal downtime during the migration process. We will send a notification prior to the scheduled deployment.
• New Features: The new application will offer improved security, and a more user-friendly interface to better meet your needs.
• Action Required: No action is required from your side. All your data will be securely transferred to the new system. However, we recommend that you log into Guardian after the migration to familiarize yourself with the new interface.
What to Expect:
1. Seamless Transition: Our team has worked diligently to ensure a smooth transition with minimal disruption to your experience.
2. Support: Our support team will be available to assist you with any questions or issues you may encounter during and after the migration. You can reach us at customercare.changehealthcare.com or clearance.support@optum.com.
3. Training Resources: We will provide comprehensive training materials and online videos in the next few weeks to help you get acquainted with the new system.
We appreciate your understanding and cooperation during this transition. If you have any questions or concerns, please do not hesitate to contact us.
REF 16068961
Posted on Feb 17, 2025 - 09:07 EST
Key Details:
• Migration Date: Early March (We will send definitive dates in the next few weeks)
• Downtime: We anticipate minimal downtime during the migration process. We will send a notification prior to the scheduled deployment.
• New Features: The new application will offer improved security, and a more user-friendly interface to better meet your needs.
• Action Required: No action is required from your side. All your data will be securely transferred to the new system. However, we recommend that you log into Guardian after the migration to familiarize yourself with the new interface.
What to Expect:
1. Seamless Transition: Our team has worked diligently to ensure a smooth transition with minimal disruption to your experience.
2. Support: Our support team will be available to assist you with any questions or issues you may encounter during and after the migration. You can reach us at customercare.changehealthcare.com or clearance.support@optum.com.
3. Training Resources: We will provide comprehensive training materials and online videos in the next few weeks to help you get acquainted with the new system.
We appreciate your understanding and cooperation during this transition. If you have any questions or concerns, please do not hesitate to contact us.
REF 16068961
Posted on Feb 17, 2025 - 09:07 EST
Branding Enhancements to SmartPay Plus Provider Portal Feb 20, 2025 14:30-14:40 EST
To improve your user experience, we have enhanced the SmartPay Plus Provider portal. You can access the updated portal at https://smartpayplus.optum.com/v2.1/login.html.
What's New:
• Refreshed branding for a more modern and consistent look.
• Improved user interface for better navigation and usability.
• Enhanced visual elements to align with our brand identity.
We encourage you to explore the updated portal and experience the new enhancements. If you have any questions or need assistance, please reach out to our support team.
REF 16290908
Posted on Feb 20, 2025 - 14:28 EST
What's New:
• Refreshed branding for a more modern and consistent look.
• Improved user interface for better navigation and usability.
• Enhanced visual elements to align with our brand identity.
We encourage you to explore the updated portal and experience the new enhancements. If you have any questions or need assistance, please reach out to our support team.
REF 16290908
Posted on Feb 20, 2025 - 14:28 EST
InterQual® Cloud Solutions Software Release Mar 13, 2025 23:00-23:10 EDT
We are pleased to announce the release of the InterQual® Cloud solutions version 417 to production and 418 to non-production (integ). These releases include the following updates:
• Updates to user interface to align colors, fonts, and visual style with Optum branding standards.
• Updates to support benchmark setting information at the CPT® code level based on aggregate claims data and CMS setting determinations.
• InterQual® Medical Review Service for payer utilization management workflows now supports displaying different criteria based on the member’s line of business.
• Additional enhancements and details are listed on the InterQual® Resource Center What’s New page.
These releases will be deployed to the production and non-production (integ) environments Thursday, March 13, 2025, 11:00 p.m. ET.
Contact Information
For additional information or assistance, log in to the Customer Care Hub and submit a new case to Product Support.
REF 16810168
Posted on Mar 11, 2025 - 15:30 EDT
• Updates to user interface to align colors, fonts, and visual style with Optum branding standards.
• Updates to support benchmark setting information at the CPT® code level based on aggregate claims data and CMS setting determinations.
• InterQual® Medical Review Service for payer utilization management workflows now supports displaying different criteria based on the member’s line of business.
• Additional enhancements and details are listed on the InterQual® Resource Center What’s New page.
These releases will be deployed to the production and non-production (integ) environments Thursday, March 13, 2025, 11:00 p.m. ET.
Contact Information
For additional information or assistance, log in to the Customer Care Hub and submit a new case to Product Support.
REF 16810168
Posted on Mar 11, 2025 - 15:30 EDT
Coming March 18: Updated Optum URLs for RPA Mar 18, 2025 00:00-00:10 EDT
On March 18, the Revenue Performance Advisor URL and document resource URL will be updated to Optum URLs as follows:
• The new production URL for Revenue Performance Advisor is https://portal.rpa.optum.com.
• The documents URL for Revenue Performance Advisor resources is https://docs.rpa.optum.com.
Set your bookmarks!
For quick access, bookmark these new Optum URLs.
• Note: Although the old Change Healthcare URL for Revenue Performance Advisor will redirect to the new Optum URL for several months, go ahead and bookmark them now!
Actions required
• Bookmark the new Optum URLs!
• Delete the Change Healthcare URLs.
Supplemental information & support
• Support: For support, contact the Optum Client Management team or submit a request for support on the Customer Care Hub.
-If you don’t have a Customer Care Hub account, click the Register button on the Customer Care Hub page.
• Community: For related resources, visit the Revenue Performance Advisor community in the Optum community.
-If you don't have a Community account, use these instructions to register for an account.
REF 16569708
Posted on Mar 03, 2025 - 17:23 EST
• The new production URL for Revenue Performance Advisor is https://portal.rpa.optum.com.
• The documents URL for Revenue Performance Advisor resources is https://docs.rpa.optum.com.
Set your bookmarks!
For quick access, bookmark these new Optum URLs.
• Note: Although the old Change Healthcare URL for Revenue Performance Advisor will redirect to the new Optum URL for several months, go ahead and bookmark them now!
Actions required
• Bookmark the new Optum URLs!
• Delete the Change Healthcare URLs.
Supplemental information & support
• Support: For support, contact the Optum Client Management team or submit a request for support on the Customer Care Hub.
-If you don’t have a Customer Care Hub account, click the Register button on the Customer Care Hub page.
• Community: For related resources, visit the Revenue Performance Advisor community in the Optum community.
-If you don't have a Community account, use these instructions to register for an account.
REF 16569708
Posted on Mar 03, 2025 - 17:23 EST
InterQual® 2025 March content release Mar 21, 2025 11:00-11:10 EDT
We are pleased to announce that the InterQual 2025 March content release is now available for InterQual® Cloud Solution customers.
This content release includes updates to the following modules:
• InterQual® Acute Adult Criteria
• InterQual® Acute Pediatric Criteria
• InterQual® Long-Term Acute Care Criteria
• InterQual® Inpatient Rehabilitation Criteria
• InterQual® Subacute and Skilled Nursing Criteria
• InterQual® Home Care Criteria
• InterQual® Outpatient Rehabilitation and Chiropractic Criteria
• InterQual® Adult and Geriatric Psychiatry Criteria
• InterQual® Child and Adolescent Psychiatry Criteria
• InterQual® Substance Use Disorders Criteria
• InterQual® Behavioral Health Services Criteria
• InterQual® Durable Medical Equipment Criteria
• InterQual® Imaging Criteria
• InterQual® Molecular Diagnostics Criteria
• InterQual® Procedures Criteria
• InterQual® Specialty Rx Non Oncology Criteria
• InterQual® Specialty Rx Oncology Criteria
• InterQual® Specialty Referral Criteria
• InterQual® Retrospective Monitoring Criteria
• The ASAM Criteria® Navigator
• Concert Genetics Navigator
• Medicare Behavioral Health Navigator
• Medicare Imaging Navigator
• Medicare Molecular Diagnostics and Lab Navigator
• Medicare Pharmacy Navigator
• Medicare Post-Acute and Durable Medical Equipment Navigator
• Medicare Procedures Navigator
• InterQual® Coordinated Care
For clinical revisions and additional details about this release, go to the What’s New page on the InterQual® Resource Center and then select InterQual Content.
InterQual® Cloud Solutions updates
If your organization has configured your environment to disable new criteria releases by default, you will need to log in to the Administration module and enable the criteria when you are ready to start using it.
InterQual® Review Manager and InterQual® View
The InterQual 2025 content release is the final content release supported by both InterQual Review Manager and InterQual View.
The content update package file with release notes and upgrade instructions will be available April 4, 2025, on Download Connect. For customers using InterQual Review Manager in a Change Healthcare-hosted environment, updates will begin April 4, 2025, 8:00 p.m. ET.
Multiple options have been established to help Review Manager and InterQual View customers migrate to alternative InterQual software solutions before the InterQual 2026 content release. Contact your account manager or Product Support to learn more about these options.
InterQual® Community
The new InterQual Community is now available! As a Community member you will:
• Have access to InterQual clinical documentation and resources.
• Have access to active discussion forums with Optum product experts and fellow customers.
• Find and connect with your peers by product and role.
The InterQual® Resource Center is being retired. Register now for the InterQual Community to stay connected and informed, and to ensure you don’t lose access to vital documentation and resources.
You should have already received an email from donotreply@optum.com with the subject line: “Complete Your Registration to Access Optum Enterprise Customer Community”. This email will include your unique registration link. Click the link to complete your setup using your One Healthcare ID (OHID). Note: the unique registration link will be active for a limited time, so please access the link to complete registration immediately upon receipt.
If you do not receive a unique registration link, or if it has expired, you can self-register by following the directions posted here.
Don’t have an OHID yet?
No problem! You can create one now at One Healthcare ID or follow the instructions in the registration invitation.
New enhancements
Decision Reasons
Decision Reasons content for the Medicare Post Acute and Durable Medical Equipment (DME) Navigator, Medicare Behavioral Health Navigator, and Behavioral Health Services modules is now available. Decision Reasons helps primary and secondary reviewers, case managers, medical directors, and others to author consistent communications to members, patients, and providers that include clear and specific clinical reasons for decisions regarding medical necessity. Decision Reasons content is available in InterQual® Cloud Solutions only and only if the organization licenses this content add-on module. For more information about licensing Decision Reasons content, contact your Account Manager.
Site of Service
To allow for a more data-driven and patient-specific approach to determining the appropriate setting of a service, InterQual Acute Adult Criteria, InterQual Acute Pediatric Criteria, InterQual Behavioral Health Services Criteria, and InterQual Procedures Criteria were updated to include a benchmark setting provided at the CPT® code level. The setting, based on the selection of a CPT code, will appear on the InterQual® Review Summary to support clear communication of both the medical review and setting outcomes, and to improve organizational workflow.
Contact information
For any additional information or assistance, log in to the Customer Care Hub and submit a new case to Product Support. Product Support is also available by email at interqualsupport@optum.com and by phone at 1-800-CRITERIA (274-8374).
REF 16959663
Posted on Mar 21, 2025 - 10:59 EDT
This content release includes updates to the following modules:
• InterQual® Acute Adult Criteria
• InterQual® Acute Pediatric Criteria
• InterQual® Long-Term Acute Care Criteria
• InterQual® Inpatient Rehabilitation Criteria
• InterQual® Subacute and Skilled Nursing Criteria
• InterQual® Home Care Criteria
• InterQual® Outpatient Rehabilitation and Chiropractic Criteria
• InterQual® Adult and Geriatric Psychiatry Criteria
• InterQual® Child and Adolescent Psychiatry Criteria
• InterQual® Substance Use Disorders Criteria
• InterQual® Behavioral Health Services Criteria
• InterQual® Durable Medical Equipment Criteria
• InterQual® Imaging Criteria
• InterQual® Molecular Diagnostics Criteria
• InterQual® Procedures Criteria
• InterQual® Specialty Rx Non Oncology Criteria
• InterQual® Specialty Rx Oncology Criteria
• InterQual® Specialty Referral Criteria
• InterQual® Retrospective Monitoring Criteria
• The ASAM Criteria® Navigator
• Concert Genetics Navigator
• Medicare Behavioral Health Navigator
• Medicare Imaging Navigator
• Medicare Molecular Diagnostics and Lab Navigator
• Medicare Pharmacy Navigator
• Medicare Post-Acute and Durable Medical Equipment Navigator
• Medicare Procedures Navigator
• InterQual® Coordinated Care
For clinical revisions and additional details about this release, go to the What’s New page on the InterQual® Resource Center and then select InterQual Content.
InterQual® Cloud Solutions updates
If your organization has configured your environment to disable new criteria releases by default, you will need to log in to the Administration module and enable the criteria when you are ready to start using it.
InterQual® Review Manager and InterQual® View
The InterQual 2025 content release is the final content release supported by both InterQual Review Manager and InterQual View.
The content update package file with release notes and upgrade instructions will be available April 4, 2025, on Download Connect. For customers using InterQual Review Manager in a Change Healthcare-hosted environment, updates will begin April 4, 2025, 8:00 p.m. ET.
Multiple options have been established to help Review Manager and InterQual View customers migrate to alternative InterQual software solutions before the InterQual 2026 content release. Contact your account manager or Product Support to learn more about these options.
InterQual® Community
The new InterQual Community is now available! As a Community member you will:
• Have access to InterQual clinical documentation and resources.
• Have access to active discussion forums with Optum product experts and fellow customers.
• Find and connect with your peers by product and role.
The InterQual® Resource Center is being retired. Register now for the InterQual Community to stay connected and informed, and to ensure you don’t lose access to vital documentation and resources.
You should have already received an email from donotreply@optum.com with the subject line: “Complete Your Registration to Access Optum Enterprise Customer Community”. This email will include your unique registration link. Click the link to complete your setup using your One Healthcare ID (OHID). Note: the unique registration link will be active for a limited time, so please access the link to complete registration immediately upon receipt.
If you do not receive a unique registration link, or if it has expired, you can self-register by following the directions posted here.
Don’t have an OHID yet?
No problem! You can create one now at One Healthcare ID or follow the instructions in the registration invitation.
New enhancements
Decision Reasons
Decision Reasons content for the Medicare Post Acute and Durable Medical Equipment (DME) Navigator, Medicare Behavioral Health Navigator, and Behavioral Health Services modules is now available. Decision Reasons helps primary and secondary reviewers, case managers, medical directors, and others to author consistent communications to members, patients, and providers that include clear and specific clinical reasons for decisions regarding medical necessity. Decision Reasons content is available in InterQual® Cloud Solutions only and only if the organization licenses this content add-on module. For more information about licensing Decision Reasons content, contact your Account Manager.
Site of Service
To allow for a more data-driven and patient-specific approach to determining the appropriate setting of a service, InterQual Acute Adult Criteria, InterQual Acute Pediatric Criteria, InterQual Behavioral Health Services Criteria, and InterQual Procedures Criteria were updated to include a benchmark setting provided at the CPT® code level. The setting, based on the selection of a CPT code, will appear on the InterQual® Review Summary to support clear communication of both the medical review and setting outcomes, and to improve organizational workflow.
Contact information
For any additional information or assistance, log in to the Customer Care Hub and submit a new case to Product Support. Product Support is also available by email at interqualsupport@optum.com and by phone at 1-800-CRITERIA (274-8374).
REF 16959663
Posted on Mar 21, 2025 - 10:59 EDT
InterQual® Review Manager and InterQual® View updates Apr 4, 2025 00:00-00:10 EDT
The InterQual 2025 content release will be the final content release supported by both InterQual Review Manager and InterQual View. It will be available for download April 4, 2025, on Download Connect.
For Review Manager customers, multiple paths have been established to help customers migrate to alternative InterQual® software solutions before the InterQual® 2026 content release. Contact your account manager or product support to learn more about these options.
For InterQual View customers, InterQual® Mobile is included in your license and supports most of the functionality of InterQual View. It provides access to all licensed InterQual content through a desktop or mobile web browser. For more information, see InterQual Mobile Getting Started.
In addition, a new InterQual solution will be launched later in 2025, offering alternate access methods during scheduled maintenance downtime or other disruptions. Additional information on this new offering will be shared later in the year.
Contact information
For any additional information or assistance, log in to the Customer Care Hub and submit a new case to Product Support. Product Support is also available by email at interqualsupport@optum.com and by phone at 1-800-CRITERIA (274-8374).
REF 16929360
Posted on Mar 20, 2025 - 11:32 EDT
For Review Manager customers, multiple paths have been established to help customers migrate to alternative InterQual® software solutions before the InterQual® 2026 content release. Contact your account manager or product support to learn more about these options.
For InterQual View customers, InterQual® Mobile is included in your license and supports most of the functionality of InterQual View. It provides access to all licensed InterQual content through a desktop or mobile web browser. For more information, see InterQual Mobile Getting Started.
In addition, a new InterQual solution will be launched later in 2025, offering alternate access methods during scheduled maintenance downtime or other disruptions. Additional information on this new offering will be shared later in the year.
Contact information
For any additional information or assistance, log in to the Customer Care Hub and submit a new case to Product Support. Product Support is also available by email at interqualsupport@optum.com and by phone at 1-800-CRITERIA (274-8374).
REF 16929360
Posted on Mar 20, 2025 - 11:32 EDT
Optum Announcement Update: Medicare HETS2025-1 System Release April 5, 2025 Apr 5, 2025 09:00-13:00 EDT
This message is intended for Clearance Patient Access, Clearance EDI, and AhiQA customers.
Update: CMS announces the scheduled installation of the HETS2025-1 release. The release is scheduled to be installed beginning Saturday, April 5, 2025, 9:00 a.m. ET. The HETS 270/271 system will remain available during the installation. CMS estimates that the installation will be completed and verified by Saturday, April 5, 2025, 1:00 p.m. ET. Please note that this installation will not cause an outage to the Medicare HETS 270/271 eligibility system however, submitters may notice minor performance or connectivity issues during the installation.
The HETS2025-1 system release will introduce changes to the HETS 270 request and the HETS 271 response. HETS 270/271 Submitters MUST act and modify your 270 request to continue receiving all available eligibility information.
HETS 270/271 Submitters should carefully review the linked documentation (below) to prepare for this release.
HETS2025-1 Release Summary: https://www.cms.gov/files/document/hets2025-1-hets-270/271-release-summary.pdf (version 2.0)
HETS2025-1 Companion Guide: https://www.cms.gov/files/document/hets2025-1-hets-270/271-companion-guide-v11-0.pdf (version 11-0)
Action Required: Review updated details on the potential changes that are linked above and distribute as appropriate within your facility.
REF 16966484
Posted on Mar 25, 2025 - 10:30 EDT
Update: CMS announces the scheduled installation of the HETS2025-1 release. The release is scheduled to be installed beginning Saturday, April 5, 2025, 9:00 a.m. ET. The HETS 270/271 system will remain available during the installation. CMS estimates that the installation will be completed and verified by Saturday, April 5, 2025, 1:00 p.m. ET. Please note that this installation will not cause an outage to the Medicare HETS 270/271 eligibility system however, submitters may notice minor performance or connectivity issues during the installation.
The HETS2025-1 system release will introduce changes to the HETS 270 request and the HETS 271 response. HETS 270/271 Submitters MUST act and modify your 270 request to continue receiving all available eligibility information.
HETS 270/271 Submitters should carefully review the linked documentation (below) to prepare for this release.
HETS2025-1 Release Summary: https://www.cms.gov/files/document/hets2025-1-hets-270/271-release-summary.pdf (version 2.0)
HETS2025-1 Companion Guide: https://www.cms.gov/files/document/hets2025-1-hets-270/271-companion-guide-v11-0.pdf (version 11-0)
Action Required: Review updated details on the potential changes that are linked above and distribute as appropriate within your facility.
REF 16966484
Posted on Mar 25, 2025 - 10:30 EDT
InterQual end of support for Internet Explorer Apr 10, 2025 00:00-00:05 EDT
This message is intended for InterQual Cloud Solutions customers.
Starting April 10, 2025, InterQual Cloud Solutions will no longer support Internet Explorer. This change is part of required security updates that will introduce breaking changes for users accessing InterQual with Internet Explorer, including users leveraging Microsoft Edge with Internet Explorer (IE) mode enabled.
All users currently accessing InterQual with Internet Explorer must switch to a supported browser (Microsoft Edge, Google Chrome, or Mozilla Firefox) by April 10, 2025 to avoid losing access to InterQual. For organizations accessing InterQual Connect Medical Review Service integrated with a partner application that has a dependency on Internet Explorer or an Internet Explorer-based custom browser, that partner application must be updated to remove Internet Explorer dependencies by April 10, 2025 to avoid losing access to InterQual.
Additional details will be communicated to organizations and users still using Internet Explorer as April 10, 2025 approaches. If your organization is not using Internet Explorer, no action is required.
Contact Information
For any additional information or assistance, sign in to the Customer Care Hub and submit a new case to Product Support.
REF 15840587
Posted on Jan 16, 2025 - 14:52 EST
Starting April 10, 2025, InterQual Cloud Solutions will no longer support Internet Explorer. This change is part of required security updates that will introduce breaking changes for users accessing InterQual with Internet Explorer, including users leveraging Microsoft Edge with Internet Explorer (IE) mode enabled.
All users currently accessing InterQual with Internet Explorer must switch to a supported browser (Microsoft Edge, Google Chrome, or Mozilla Firefox) by April 10, 2025 to avoid losing access to InterQual. For organizations accessing InterQual Connect Medical Review Service integrated with a partner application that has a dependency on Internet Explorer or an Internet Explorer-based custom browser, that partner application must be updated to remove Internet Explorer dependencies by April 10, 2025 to avoid losing access to InterQual.
Additional details will be communicated to organizations and users still using Internet Explorer as April 10, 2025 approaches. If your organization is not using Internet Explorer, no action is required.
Contact Information
For any additional information or assistance, sign in to the Customer Care Hub and submit a new case to Product Support.
REF 15840587
Posted on Jan 16, 2025 - 14:52 EST
Reminder: Claim submission change for HCFA print images effective Apr. 15 Apr 15, 2025 00:00-00:05 EDT
Update -
This message is intended for Revenue Performance Advisor (RPA) customers.
As communicated in February, two options will be available for submitting professional claims into RPA as of Apr. 15, 2025. These two options are using the Direct Data Entry (DDE) tool in RPA or using a batch file in the ANSI 837 professional claim format.
If you have not determined which submission option is better for your organization, open a case in Customer Care Hub to be contacted by RPA support. The RPA representative can discuss the options with you. After you decide which option your organization will use, inform RPA support to start the process.
Reason for the change
Our vendor for print-image functionality no longer supports the software.
Initial communication date
The initial communication was sent Feb. 10, 2025.
Actions required
• Notify your team of the upcoming change and share the following learning resources:
o Create New Professional Claim video
- In RPA, click the Support menu and click the Learning Center option. When the Learning Center opens, scroll to the Claims Management section and find the “Create New Professional Claim” video.
o 5010 Claims 837 companion guide
- On the RPA home page, scroll down to the Resource Center. Click the Companion Guides tab and click the hyperlink for the “5010 Claims 837 Companion Guide.”
• If you don’t already have an Optum User Community account, use these instructions to request access to the User Community. Upon approval, follow the instructions to complete registration and sign in.
• RPA support information: For all questions (including which submission method is better for your organization), issues, and general inquiries for RPA, submit a case in Customer Care Hub.
REF 16169910
Mar 12, 2025 - 14:23 EDT
As communicated in February, two options will be available for submitting professional claims into RPA as of Apr. 15, 2025. These two options are using the Direct Data Entry (DDE) tool in RPA or using a batch file in the ANSI 837 professional claim format.
If you have not determined which submission option is better for your organization, open a case in Customer Care Hub to be contacted by RPA support. The RPA representative can discuss the options with you. After you decide which option your organization will use, inform RPA support to start the process.
Reason for the change
Our vendor for print-image functionality no longer supports the software.
Initial communication date
The initial communication was sent Feb. 10, 2025.
Actions required
• Notify your team of the upcoming change and share the following learning resources:
o Create New Professional Claim video
- In RPA, click the Support menu and click the Learning Center option. When the Learning Center opens, scroll to the Claims Management section and find the “Create New Professional Claim” video.
o 5010 Claims 837 companion guide
- On the RPA home page, scroll down to the Resource Center. Click the Companion Guides tab and click the hyperlink for the “5010 Claims 837 Companion Guide.”
• If you don’t already have an Optum User Community account, use these instructions to request access to the User Community. Upon approval, follow the instructions to complete registration and sign in.
• RPA support information: For all questions (including which submission method is better for your organization), issues, and general inquiries for RPA, submit a case in Customer Care Hub.
REF 16169910
Mar 12, 2025 - 14:23 EDT
Update -
This message is intended for Revenue Performance Advisor (RPA) customers.
Effective Apr. 15, 2025, the print-image functionality to submit HCFA batch claims into RPA will no longer be available. However, …
RPA customers who have been using this print-image functionality will have two options for submitting professional claims:
• using the Direct Data Entry (DDE) tool, which resides in the RPA portal
• using a batch file in the ANSI 837 professional claim format
What’s the difference between these two options?
DDE tool: The DDE tool allows users to create and submit 837s directly in RPA.
Batch file: A batch file can be submitted from an external source. The file can be manually uploaded into the RPA portal or automatically by a file picked up from a Secure File Transfer Protocol (SFTP) site.
• Organizations that want to use the batch file option need to consult their electronic medical record (EMR) vendors about creating a data extract file.
Which option is better for my organization?
Contact your RPA account representative to discuss which option is better for your organization.
How do we learn more?
Optum is working to contact customers that are currently using the print functionality. We will send communications to inform customers of the change. The announcements will also be available on Optum's Solution Status Page.
Why is this change happening?
Our vendor for print-image functionality no longer supports the software.
Actions required
• Decide whether you’ll use the DDE tool in RPA or submit external batch files.
̶ If you want to submit external batch files, contact your EMR vendor to see if the data extracts can be created in the ANSI 837 professional claim format with your EMR.
• Inform your RPA account representative of your decision.
• Notify your team of the change.
• Review and share the “Create New Professional Claim” video in the Learning Center:
̶ In RPA, click the Support menu and click the Learning Center option. When the Learning Center opens, scroll to the Claims Management section and find the “Create New Professional Claim” video.
• For additional information on submitting an ANSI 837 batch file, refer to the “5010 Claims 837 Companion Guide.”
̶ On the RPA home page, scroll down to the Resource Center. Click the Companion Guides tab and click the hyperlink for the “5010 Claims 837 Companion Guide.”
• If you don’t already have an Optum User Community account, use these instructions to request access to the User Community. Upon approval, follow the instructions to complete registration and sign in.
• Submit a ticket through the Customer Care Hub to request support.
Feb 17, 2025 - 11:07 EST
Effective Apr. 15, 2025, the print-image functionality to submit HCFA batch claims into RPA will no longer be available. However, …
RPA customers who have been using this print-image functionality will have two options for submitting professional claims:
• using the Direct Data Entry (DDE) tool, which resides in the RPA portal
• using a batch file in the ANSI 837 professional claim format
What’s the difference between these two options?
DDE tool: The DDE tool allows users to create and submit 837s directly in RPA.
Batch file: A batch file can be submitted from an external source. The file can be manually uploaded into the RPA portal or automatically by a file picked up from a Secure File Transfer Protocol (SFTP) site.
• Organizations that want to use the batch file option need to consult their electronic medical record (EMR) vendors about creating a data extract file.
Which option is better for my organization?
Contact your RPA account representative to discuss which option is better for your organization.
How do we learn more?
Optum is working to contact customers that are currently using the print functionality. We will send communications to inform customers of the change. The announcements will also be available on Optum's Solution Status Page.
Why is this change happening?
Our vendor for print-image functionality no longer supports the software.
Actions required
• Decide whether you’ll use the DDE tool in RPA or submit external batch files.
̶ If you want to submit external batch files, contact your EMR vendor to see if the data extracts can be created in the ANSI 837 professional claim format with your EMR.
• Inform your RPA account representative of your decision.
• Notify your team of the change.
• Review and share the “Create New Professional Claim” video in the Learning Center:
̶ In RPA, click the Support menu and click the Learning Center option. When the Learning Center opens, scroll to the Claims Management section and find the “Create New Professional Claim” video.
• For additional information on submitting an ANSI 837 batch file, refer to the “5010 Claims 837 Companion Guide.”
̶ On the RPA home page, scroll down to the Resource Center. Click the Companion Guides tab and click the hyperlink for the “5010 Claims 837 Companion Guide.”
• If you don’t already have an Optum User Community account, use these instructions to request access to the User Community. Upon approval, follow the instructions to complete registration and sign in.
• Submit a ticket through the Customer Care Hub to request support.
Feb 17, 2025 - 11:07 EST
Scheduled -
This message is intended for Revenue Performance Advisor (RPA) customers.
Effective Apr. 15, 2025, the print-image functionality to submit HCFA batch claims into RPA will no longer be available. However, …
RPA customers who have been using this print-image functionality will have two options for submitting professional claims:
• using the Direct Data Entry (DDE) tool, which resides in the RPA portal
• using a batch file in the ANSI 837 professional claim format
What’s the difference between these two options?
DDE tool: The DDE tool allows users to create and submit 837s directly in RPA.
Batch file: A batch file can be submitted from an external source. The file can be manually uploaded into the RPA portal or automatically by a file picked up from a Secure File Transfer Protocol (SFTP) site.
• Organizations that want to use the batch file option need to consult their electronic medical record (EMR) vendors about creating a data extract file.
Which option is better for my organization?
Contact your RPA account representative to discuss which option is better for your organization.
How do we learn more?
Optum is working to contact customers that are currently using the print functionality. We will send communications to inform customers of the change. The announcements will also be available on Optum's Solution Status Page.
Why is this change happening?
Our vendor for print-image functionality no longer supports the software.
Actions required
• Decide whether you’ll use the DDE tool in RPA or submit external batch files.
̶ If you want to submit external batch files, contact your EMR vendor to see if the data extracts can be created in the ANSI 837 professional claim format with your EMR.
• Inform your RPA account representative of your decision.
• Notify your team of the change.
• Review and share the “Create New Professional Claim” video in the Learning Center:
̶ In RPA, click the Support menu and click the Learning Center option. When the Learning Center opens, scroll to the Claims Management section and find the “Create New Professional Claim” video.
• For additional information on submitting an ANSI 837 batch file, refer to the “5010 Claims 837 Companion Guide.”
̶ On the RPA home page, scroll down to the Resource Center. Click the Companion Guides tab and click the hyperlink for the “5010 Claims 837 Companion Guide.”
• If you don’t already have an Optum User Community account, use these instructions to request access to the User Community. Upon approval, follow the instructions to complete registration and sign in.
• Contact your RPA account representative with additional questions.
REF 16112218
Feb 10, 2025 - 11:39 EST
Effective Apr. 15, 2025, the print-image functionality to submit HCFA batch claims into RPA will no longer be available. However, …
RPA customers who have been using this print-image functionality will have two options for submitting professional claims:
• using the Direct Data Entry (DDE) tool, which resides in the RPA portal
• using a batch file in the ANSI 837 professional claim format
What’s the difference between these two options?
DDE tool: The DDE tool allows users to create and submit 837s directly in RPA.
Batch file: A batch file can be submitted from an external source. The file can be manually uploaded into the RPA portal or automatically by a file picked up from a Secure File Transfer Protocol (SFTP) site.
• Organizations that want to use the batch file option need to consult their electronic medical record (EMR) vendors about creating a data extract file.
Which option is better for my organization?
Contact your RPA account representative to discuss which option is better for your organization.
How do we learn more?
Optum is working to contact customers that are currently using the print functionality. We will send communications to inform customers of the change. The announcements will also be available on Optum's Solution Status Page.
Why is this change happening?
Our vendor for print-image functionality no longer supports the software.
Actions required
• Decide whether you’ll use the DDE tool in RPA or submit external batch files.
̶ If you want to submit external batch files, contact your EMR vendor to see if the data extracts can be created in the ANSI 837 professional claim format with your EMR.
• Inform your RPA account representative of your decision.
• Notify your team of the change.
• Review and share the “Create New Professional Claim” video in the Learning Center:
̶ In RPA, click the Support menu and click the Learning Center option. When the Learning Center opens, scroll to the Claims Management section and find the “Create New Professional Claim” video.
• For additional information on submitting an ANSI 837 batch file, refer to the “5010 Claims 837 Companion Guide.”
̶ On the RPA home page, scroll down to the Resource Center. Click the Companion Guides tab and click the hyperlink for the “5010 Claims 837 Companion Guide.”
• If you don’t already have an Optum User Community account, use these instructions to request access to the User Community. Upon approval, follow the instructions to complete registration and sign in.
• Contact your RPA account representative with additional questions.
REF 16112218
Feb 10, 2025 - 11:39 EST
SmartPay Historic Data Unavailable after April 30, 2025 Apr 30, 2025 00:00-00:05 EDT
Update -
Reminder: Effective April 30, 2025, historic SmartPay transaction data will no longer be available. After this date we will not be able to support any requests for transaction data.
All transaction data requests must be submitted by March 28, 2025, to bipharmacy@optum.com to allow adequate time to be processed.
Questions can be directed to bipharmacy@optum.com.
Mar 13, 2025 - 15:14 EDT
All transaction data requests must be submitted by March 28, 2025, to bipharmacy@optum.com to allow adequate time to be processed.
Questions can be directed to bipharmacy@optum.com.
Mar 13, 2025 - 15:14 EDT
Update -
Reminder: Effective April 30, 2025, historic SmartPay transaction data will no longer be available. After this date we will not be able to support any requests for transaction data.
All transaction data requests must be submitted by March 28, 2025, to bipharmacy@optum.com to allow adequate time to be processed.
Questions can be directed to bipharmacy@optum.com.
REF 15682769
Jan 22, 2025 - 16:16 EST
All transaction data requests must be submitted by March 28, 2025, to bipharmacy@optum.com to allow adequate time to be processed.
Questions can be directed to bipharmacy@optum.com.
REF 15682769
Jan 22, 2025 - 16:16 EST
Scheduled -
Effective April 30, 2025, historic SmartPay transaction data will no longer be available. After this date we will not be able to support any requests for transaction data.
All transaction data requests must be submitted by March 28, 2025, to bipharmacy@optum.com to allow adequate time to be processed.
Questions can be directed to bipharmacy@optum.com.
REF 15682769
Jan 03, 2025 - 11:00 EST
All transaction data requests must be submitted by March 28, 2025, to bipharmacy@optum.com to allow adequate time to be processed.
Questions can be directed to bipharmacy@optum.com.
REF 15682769
Jan 03, 2025 - 11:00 EST