OptumHealth Electronic Payments and Statements


OptumHealth Financial > EPS Solutions > Payers > Payer FAQs
Frequently Asked Questions from Payers Who is OptumHealth Financial Services? What distinguishes OptumHealth^SM Electronic Payments and Statements? How can we get started with OptumHealth Electronic Payments and Statements? How long will it take to implement? Will we need to modify anything in our claims platform(s)? How do providers enroll? How can I view payments and remittance details? Can we maintain our existing banking and printing relationships? Is OptumHealth Electronic Payments and Statements compliant with the HIPAA 835 standard? Who is OptumHealth Financial Services? OptumHealth Financial Services is a leading provider of financial services to the health care industry. We offer: Payment solutions — helping health plans and heath care providers reduce costs and operate more efficiently Tax-favored accounts — allowing individuals to reduce their taxable income and pay for medical expenses today as well as build health savings for the future Benefits administration — helping employers provide meaningful benefits to their employees while managing their costs OptumHealth Financial Services includes OptumHealth Bank^SM, Member FDIC, one of the largest health savings account (HSA) administrators in the country, and Administration Resources Corporation, specializing in third-party benefits administration for employers. For more information, visit OptumHealthFinancial.com Back to Top What distinguishes OptumHealth^SM Electronic Payments and Statements? OptumHealth Electronic Payments and Statements is the only fully integrated system that combines banking functions, claim payments, and claim remittance. It even integrates with traditional paper processes. This system was designed specifically for the health care industry, with both payer and provider in mind. And, it has been tested and proven with the second-largest health care payer in the nation. The comprehensive user Web site offers flexibility and usability – allowing increased access to remittance information where it can be viewed, printed, downloaded and searched. OptumHealth Financial Services has a proven infrastructure. Our electronic provider network contains more than 366,000 health care professionals and continues to grow. We process more than 8 million claims and over $2 billion in transactions monthly. Our services operate out of Minnesota, Utah and South Carolina. Back to Top How can we get started with OptumHealth Electronic Payments and Statements? To get the process started, please contact us or call 866-427-6804. Back to Top How long will it take to implement? The standard installation providing the fully integrated electronic remittance and reimbursement solution can be implemented in approximately 16 weeks. Back to Top Will we need to modify anything in our claims platform(s)? Our preferred file format is the HIPAA ANSI X-12 835. If your claims adjudication platform has the ability to produce this HIPAA format, no additional work is necessary. If your system is unable to produce this format, we can assist you with alternative solutions. Back to Top How do providers enroll? Providers can enroll online or via mail or fax and must supply contact and banking information. Once a payer has elected to use OptumHealth Electronic Payments and Statements, provider enrollment campaigns can begin on behalf of the payer to providers not yet enrolled in our network. The campaigns are designed to educate providers of the benefits of electronic processing and to motivate them to shift from paper to electronic processing. Back to Top How can I view payments and remittance details? Payers can view both summary information and provider-level detail through the payer Web portal. All payment and remittance details, for both electronic and paper transactions processed by OptumHealth Electronic Payments and Statements, can be retrieved online. The information can be viewed, downloaded, printed and queried. And online reporting presents the data in an easy-to-use format. Back to Top Can we maintain our existing banking and printing relationships? Yes, OptumHealth Electronic Payments and Statements was designed to accommodate payers’ current processes while enabling them to move toward a fully electronic solution. Back to Top Is OptumHealth Electronic Payments and Statements compliant with the HIPAA 835 standard? Yes, Electronic Payments and Statements is fully compliant with the HIPAA 835 standard. Back to Top