Ambetter Health has contracted Optum to review and audit claim reimbursements for potential overpayments

Date: 06/09/25

New process starts August 1, 2025

We want to inform you about a new process Ambetter Health will implement starting August 1, 2025. Ambetter Health has contracted Optum to review and audit claim reimbursements for potential overpayments. Optum will perform audits on claim payments to ensure overpayments are not a result of a billing error or a member having coverage with another payor.

What does this mean for you:

• As a provider, you may receive written notification from Optum if a claim has been identified for review.
• You will have thirty days from the date of the notice to provide reimbursement to Ambetter Health.
• Reimbursements should be mailed to:

Ambetter Health
3153 Momentum Place
Chicago, IL 60689-5331

If you disagree with the request or have questions, you may contact Optum via phone at 1-866-750-2306.