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1755 Telstar Drive Ste 400 Colorado Springs CO 80920 www. optum.com 87815 Thank you for choosing Electronic Network Systems Clearinghouse a division of Optum to submit your ERAs. Following Payers MUST have Legacy ID s listed to complete Payer Enrollment SB580-SB690-SKAR0-SKMD0 Individual ID Enter E-mail address Section 1 Provider Organization section must be fully completed with Facility/Provider information failure to complete all fields may result in form rejections. 885. 3713 This COV must...
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