Payer ID 41161: OptumHealth Physical Health

Where payer ID 41161 goes on a claim

On an electronic professional (837P) or institutional (837I) claim, the payer is identified in loop 2010BB, the payer name loop. The NM1 segment there carries entity identifier code PR (payer), the payer's name, the qualifier PI in NM108, and the payer ID itself in NM109:

NM1*PR*2*OPTUMHEALTH PHYSICAL HEALTH*****PI*41161~

The same NM1*PR structure names the payer in loop 2100A of 270 eligibility and 276 claim status requests. Many clearinghouses use one payer ID for claims, eligibility, and claim status, but some assign a separate ID per transaction, so check the payer list for each transaction type you send.

Before you submit to payer ID 41161

1. 1

   Read the member's ID card

   The claims payer ID or claims address printed on the card is the most specific source for that member's plan. Where it differs from a directory listing, the card generally reflects how that plan wants claims sent.

2. 2

   Check whether a third-party administrator runs the plan

   Self-funded employer plans route claims to their administrator's payer ID, which is often different from the network or carrier name printed on the card.

3. 3

   Confirm the ID on your clearinghouse's payer list

   Payer IDs are assigned per clearinghouse. Large national payers tend to use the same ID nearly everywhere; regional plans and administrators often do not. Search your clearinghouse's list for 41161 and confirm it maps to OptumHealth Physical Health.

4. 4

   Watch the acknowledgments, not just the remittance

   A wrong payer ID fails at the clearinghouse or on the 277CA claim acknowledgment, not as a denial on the 835. A rejected claim was never received by the payer, so the timely filing clock keeps running until a corrected claim is accepted.

OptumHealth Physical Health billing reference

• OptumHealth Physical Health writes medical coverage nationally. Rette indexes 2 OptumHealth Physical Health policy documents - coverage criteria, prior authorization requirements, and billing guidelines.

  OptumHealth Physical Health timely filing, prior auth, and appeals

Payer ID 41161 questions

Which insurance company uses payer ID 41161?

Payer ID 41161 belongs to OptumHealth Physical Health in the Stedi payer network directory. Payer IDs are assigned per clearinghouse, so check 41161 against your own clearinghouse's payer list before submitting.

What is the OptumHealth Physical Health payer ID?

The OptumHealth Physical Health electronic payer ID is 41161. It goes in loop 2010BB of the 837 claim. Payer IDs are assigned per clearinghouse, so confirm 41161 against your own clearinghouse's payer list before relying on it.

Where do I enter payer ID 41161 on an 837 claim?

In loop 2010BB, the payer name loop: the NM1 segment with entity identifier PR, qualifier PI in NM108, and 41161 in NM109. The same NM1*PR structure identifies the payer in loop 2100A of 270 eligibility and 276 claim status requests, though some clearinghouses assign a different payer ID for those transactions.

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