Talk to Us
← All payersOptimum Healthcare logo

Optimum Healthcare

Primary payer ID
20133Compare transaction IDs ↓
Last successful claim statusWithin the past 3 monthsObserved across Substrate's claim-status network.
Currently not answeringEDI 270/271

Is your practice experiencing high volumes of no response claims or denials from Optimum Healthcare? Try Substrate Denial Intelligence here -->.

Coverage profile

How Substrate can help you with Optimum Healthcare

Substrate can help practices and billers with the following claims tasks for Optimum Healthcare.

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Optimum Healthcare.

Available

Payer intelligence

Observed adjudication timing

How long completed claims in Substrate’s aggregate network took from payer receipt to the 835 payment date.

Median time to payment

23 days
10% of adjudications by
21 days
90% of adjudications by
27 days
Applicable state coverage
FL
Current As Of
June 2026

Five-month median trend

Days to 835 payment

A trend needs at least two qualified service months.

View chart data as a table
Optimum Healthcare observed adjudication timing by service month
Service monthMedian10% of adjudications by90% of adjudications byCompleted claimsCoverage
AprNo qualified data
MayNo qualified data
Jun23 days21 days27 days101FL
JulNo qualified data
AugNo qualified data

Frequently asked questions

Optimum Healthcare payer FAQs

What is the payer ID for Optimum Healthcare?

The primary payer ID for Optimum Healthcare is 20133. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.

What are the 837 payer IDs for Optimum Healthcare?

The 837P and 837I payer ID for Optimum Healthcare is 20133 via Stedi.

What is the 835 payer ID for Optimum Healthcare?

The 835 payer ID for Optimum Healthcare is 20133 via Stedi.

What is the 270 payer ID for Optimum Healthcare?

The 270 payer IDs for Optimum Healthcare are 20133 via Stedi and AGPMEDICAID and OPT01 via Availity.

What is the 276 payer ID for Optimum Healthcare?

The 276 payer ID for Optimum Healthcare is AGPMEDICAID via Availity.

What state does Optimum Healthcare operate in?

Optimum Healthcare operates in FL.

Resource library

Routing reference

Optimum Healthcare payer IDs and operating states

Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.

Optimum Healthcare payer name, operating states, and transaction-specific payer IDs
Payer nameOptimum HealthcareSource: Substrate payer directory · last refreshed
Operating statesFLSource: Substrate payer directory · last refreshed
837P professional claims payer IDStedi20133Source: Stedi payer catalog · catalog dated · matched by payer ID
837I institutional claims payer IDStedi20133Source: Stedi payer catalog · catalog dated · matched by payer ID
835 ERA payer IDStedi20133Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDStedi20133Source: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDAvailityAGPMEDICAIDOPT01Source: Availity payer catalog · catalog dated · matched by payer name
276 claim status payer IDAvailityAGPMEDICAIDSource: Availity payer catalog · catalog dated · matched by payer name

Routing sources and verification

  • Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .Open payer website ↗
  • Stedi payer catalogMatched by payer ID; matched record: Optimum Healthcare. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
  • Availity payer catalogMatched by payer name; matched records: OPTIMUM HEALTHCARE INCORPORATED, WELLPOINT. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
  • United Clearinghouse payer catalogMatched by payer name; matched record: Wellpoint. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗

Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.

Other aliases

Also known as

  • 14460
  • 20133
  • 20133MA
  • 4227
  • Optimum Healthcare Incorporated
  • Optimum Healthcare, Incorporated
  • Wellpoint
  • OPTIMUM HEALTHCARE INC.