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Revised 01. 13. 2015 For Internal Optum use only Fax to Health Net of Arizona Fax number 800-677-4147 Est. 885. 3713 This COV must be attached to a ERA Provider Set-Up Form PSF http //www. emdeon.com/enrollment/index. The letter is required when the provider changes from their existing Emdeon certified software vendor submitter id to a different Emdeon certified software vendor submitter id. 1755 Telstar Drive Ste 400 Colorado Springs CO 80920 www. optum.com 06108 Thank you for choosing...

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