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1755 Telstar Drive Ste 400 Colorado Springs CO 80920 www. optum.com KYMCR Thank you for choosing Electronic Network Systems Clearinghouse a division of Optum to submit your ERAs. Cgsmedicare. com/pdf/edienrollpacket. pdf Attached under the paperclip on the left side of the payer s website are five forms. This form is for Optum use only and will not be forwarded on to the payer with your Optum user ID Contact Name Group Name Group Billing TIN Group Legacy ID Please list all providers for this...

How to fill out fax 877-630-2064

How to fill out fax 877-630-2064

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