OptumHealth Updates

Stuck in Forward Claims (New)

A few weeks ago TSO doctors were notified that OptumHealth Vision had identified a system problem affecting various providers across their provider network described as “Stuck in Forward” claims.  These claims have been corrected and all TSO “Stuck in Forward” claims will be paid by the end of March.  Please verify that you have received payment for your “0” paid claims and continue to review your EOBs for future “0” paid claims.  OptumHealth has not confirmed that the problem has been fixed only that TSO offices will be paid for back claims by the end of March.   

Please direct your question or inquiries to Ann Deen at 214-704-1181 or cadeen@tso.com.  

 New Notice from OptumHealth

There two statement errors that OHV is aware of as of March 26.  Not every provider is impacted.  For the period ending 2/29/2012:

  • EOB statements reflected zeros across the board.
    • For providers who are paid by paper check, revised statements were mailed Friday, 3/16.  There will be a cover letter, but not a new check.
    • For those providers who receive electronic payments, OHV is still working to correct those statements and get them re-posted as soon as possible.   You’ll probably want to use the traditional statement to reconcile the payment.
  • Appearing on the statement for the period ending 2/15/2012:
    • An error that involves adjustments, OHV is investigating.  Offices will be notified as progress is made.


New Notice from OptumHealth

OptumHealth is working to improve security procedures on their website, OHV is changing the website password requirements.  OHV will gradually deploy the password resets over four weeks beginning March 29.

New Password Requirements:

  • Minimum 8 characters long
  • Requires a mix of numbers and letters
  • Requires a mix of capital and lowercase letters
  • Cannot contain your provider ID
  • Cannot be one of the last 10 passwords used
  • You’ll be prompted to change the password every 6 months


Each location will be able to create individual user IDs within the office if they choose; this capability is not governed by OHV.

Each office will be able to call customer service for a password reset, should it be forgotten.  If you prefer that individual locations not use this feature, please cascade that message through your organization.  OHV standard process is to verify specific provider data with the caller and then reset the password. 

There are FAQs attached, and these will also be posted on the OHV website.


OptumHealth Online Training in April

OptumHealth is offering providers and staff online training sessions every other month.  The next session is scheduled in April.  To enroll in the next and future sessions go to the OptumHealth website 


Topics Covered

  • Overview of the online services
  • New enhancements added to the site
  • Live online demonstration
  • Q&A

Reminder from TSO and OptumHealth

OHV can now access the CAQH universal provider database for credentialing. Please set up your CAQH profile and be sure OHV is a chosen entity.  Once you have your CAQH ID and password send to Roxana at rgsalinas@tso.com as soon as possible. 
You must be credentialed by OHV through CAQH so please get your CAQH numbers and forward to Roxana ASAP.