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Claim Entry through Provider Express


Optum's clinician website, Provider Express, supports entry of outpatient behavioral health claims by a registered user. This time-saving and secure transaction feature is designed to streamline the claim submission process with Provider Express.

Here are some advantages we think you will find:

  • Faster claim payment and disposition
  • Reduced mailing time and expense
  • Faster claim form completion
  • More accurate claim information
  • Higher level of auto-adjudication

Claims Supported by Provider Express Claim Entry

  • Claims for traditional behavioral health services
  • Claims for EAP services 
  • Claims from a participating clinician
  • Claims from a non-participating clinician

Claims Not Supported by Provider Express Claim Entry

  • Claims for any facility-based behavioral health service (such as residential, inpatient, partial hospitalization, or intensive outpatient treatment)
  • Claims for members who's coverage has been expired more than 90 days 

Frequently Asked Questions About Claim Entry through Provider Express

Can I submit my Optum claims electronically?

Yes. Claims for outpatient behavioral health services can be entered through the Claim Entry feature on Provider Express.

Facility claims can be submitted electronically using EDI. Click here for EDI/Electronic claims information.

I submitted my claim through Provider Express and received a confirmation number in Claim Entry – Step 4 of 4. How long does it take to see my claims that I submitted on Provider Express?

If you have received a confirmation number through Provider Express, you can be assured that Optum has received your claim successfully. Claims entered through Provider Express must be passed electronically to one of Provider Express' host claim systems for adjudication. In most cases, you should be able to get status through the Claim Inquiry feature of Provider Express within 2 to 3 business days after entry. However, it sometimes takes longer. To see claims you have submitted through Provider Express, use the  My Submitted Claims feature under the claims menu. This feature will show the claims you submitted directly to Optum via Provider Express. 

I want to keep a hard copy of the claims I submit through Provider Express. How can I get a copy?

We recommend you print the confirmation page in Claim Entry – Step 4 of 4 for your records. If you want more detail than that, we recommend you use your browser's print function to make a screen print of the completed form in Claim Entry – Step 2 of 4 (note: you may need to change settings on your browser to print on a single page).

Can I submit claims on any form other than a CMS-1500 (such as a UB-04) on Provider Express?

No, only claims submitted on a CMS-1500 can be submited on Provider Express  See the Facility Claims section for details of how to submit a facility claim.

Please refer to the Claim Tips page through Provider Express for instructions on submitting a claim manually.

How long will it take to get my payment?

Generally, clean claims that contain all of the required information will be paid within 30 days after receipt of the claims. This may exclude claims which require an exception process, such as coordination of benefits (COB) and student status verification, which can delay this process. The procedure for processing claims will be modified as necessary to satisfy any applicable state laws.

How do I check the status of my claim?

Registered users of Provider Express can use the Claim Inquiry transaction or you can call the number on the back of the member’s ID card.