ConnectCenter FAQs

How can I access the ConnectCenter?

You will get access to the ConnectCenter when you contract with us. For general training videos in the ConnectCenter, visit the Customer Education.

What are the steps to get access for demo ConnectCenter?

The demo version of the ConnectCenter site is typically reserved for internal users only. When using the Eligibility API for testing in the sandbox, you can edit the request body and send it to the API engine to view what kinds of responses you will get. You can use these values as the tradingPartnerServiceId (this is the Payer ID; this will vary based on the payer you want to connect to) to change the responses. These range from a canned response that returns a single coverage plan, Low Deductible High Premium with many different copayments, and even sample responses for Humana along side multiple other payers.

Testing claims in the sandbox is limited to predefined data values. In the production environment, you can submit test transactions through two methods:

• The first option is, send the value of '9496' as the tradingPartnerServiceId; this allows for a claim submitted with live data, to run through clearinghouse edits without being submitted to a payer.
• The other option is, add a value of "usageIndicator":"T" to the claim; this allows you to test against different Trading Partner Service IDs and any payer-specific edits they may have.

{
  "controlNumber": "000000001",
  "tradingPartnerServiceId": "9496",
  "usageIndicator":"T",
  "submitter": {

How do we present ConnectCenter in an iframe in our site?

There is no iFrame capability for ConnectCenter right now. If you want to give your customers access to ConnectCenter, let us know during your implementation and we will set it up accordingly.

What is the difference between the List, Revenue Performance Advisor Payer List, ConnectCenter Payer List, Attachment Payer List?

Each of these payer lists represents different products or services that customers can purchase from Optum. There are plans to consolidate all of the payer lists but that will not be available for some time. The payer lists may have some overlap but customers should only use the payer lists for the products/services they are contracted to, or testing with.

When doing a payer search (accessed via Connect Center > Payer Tools > Payer Search) and selecting for Claims and Eligibility products, I get 3 different IDs. These are CPID, Real Time ID, and Payer ID. Why are they not particularly unique?

• The CPID is for claims process only. We have this unique identifier that is setup to process claims with payers. Per the Claims type column, you can tell if it is a Professional Claims CPID, or an Institutional Claims CPID. You should use that for submitting the claim, the tradingPartnerServiceId field.
• Eligibility or Claims status uses the Realtime Payer ID.
• The Payer ID is found on the back of the insurance card. If it is not available, you can use the Realtime Payer ID.

When we try to edit a claim in ConnectCenter to add Remarks on locator 80, we are seeing them being wiped out during claim validation. How do we submit a claim with Remarks?

This might be happening due to ConnectCenter requiring both the qualifier and the associated values in box 80. The field containing "QC" must contain one of the values provided below and the associated detailed information will go in the "remark" section.

ALG ‐ Allergies
DCP ‐ Goals, Rehabilitation Potential, or Discharge Plans
DGN ‐ Diagnosis Description
DME ‐ Durable Medical Equipment (DME) and Supplies
MED ‐ Medications
NTR ‐ Nutritional Requirements
ODT ‐ Orders for Disciplines and Treatments
RHB ‐ Functional Limitations, Reason Homebound, or Both
RLH ‐ Reasons Patient Leaves Home
RNH ‐ Times and Reasons Patient Not at Home
SET ‐ Unusual Home, Social Environment, or Both
SFM ‐ Safety Measures
SPT ‐ Supplementary Plan of Treatment
UPI ‐ Updated Information
ADD ‐ Additional Information

Is it possible for a payer's name, Payer ID, or Eligibility ID to change in the ConnectCenter Payer List? If so, does anything happen with that change; is any kind of notification or update sent to customers?

Yes, it is not likely but possible. Especially, if a payer is bought by another payer.
We send out customer service announcements (CSAs) through email to customers who enroll for notifications. Be sure to ask your implementation analyst to help you get set up for those notifications.

My provider is in network with Aetna and would like to submit claims using your APIs. When I try to enroll a payer in ConnectCenter, I find many different payer names with the word Aetna in it.

(Which payer should I select? I want to use Optum APIs for Eligibility, Claims, Claim Status, and ERA. For example, most payers require enrollment to get ERAs through ConnectCenter. In this case, if our provider is in-network with Aetna, which of the above Aetnas I enroll with?)

The best way to know which payer to submit claims to, is to look at the back of the insurance card. That ID should correlate to the Payer ID field.
If you do not have any other identifiable information for Aetna such as, if it is a part of a Better Health plan or an address, use the AETNA/60054 payer IDs.

Do we need to integrate the payer enrollment API also to launch an end-to-end claims and billing feature?

Enrollments for customers using the Medical Network APIs are submitted via ConnectCenter under Payer Tools >> Enrollment Central. If you are unable to login to the application please reach out to ConnectCenter MFA Support: 800-527-8133 opt., '7' or [email protected].

When trying to determine if a specific payer requires enrollment, this can be found on our payer list. The Exchange Claims & Remittance Payer List would contain a list of all of the active payers for those transaction types. Once downloaded, please locate the Enrollment column (if enrolling after 2/21/2024). A "Y" would indicate that an enrollment is required for the associated payer ID/CPIDs.

Related topics

• You can find a list of service type codes on Connect Center >> under Verification >> New Eligibility Request >> drop-down list under Service Information >> Service Type.
• Here is the detailed ConnectCenter support-related information.