O
Payer Directory
How to check Optum Pinnacle Medical Group eligibility
A portal or phone check takes a front-desk staffer 10–15 minutes per patient. Optum Pinnacle Medical Group has no eligibility API — so instead of your staff doing that, our screen agent runs the portal check for you, on your schedule.
Payer ID
95271Screen agent · setup requiredThree ways to verify Optum Pinnacle Medical Group coverage
- Payer portal — free, but one patient at a time and 10–15 minutes each with logins.
- Phone (IVR) — hold times vary; no written record for the chart.
- Automated 270/271 check — full benefit detail in seconds, batched for the whole schedule, from $0.50 per check.
Optum Pinnacle Medical Group at a glance
What billers need before running a check.
Payer ID
95271Also known as 1106, 3945
Real-time eligibility
Via screen agent
Optum Pinnacle Medical Group has no eligibility API, so our screen agent runs the portal check for you on your schedule. Setup required.
Coverage
medical
Operating area
California
Payer website
pmg.optum.comSupported transactions
What can be exchanged electronically with Optum Pinnacle Medical Group today.
| Transaction | Status |
|---|---|
Eligibility (270/271) Real-time benefit and coverage checks | NOT AVAILABLE |
Claim status (276/277) Where a submitted claim stands | NOT AVAILABLE |
Professional claims (837P) Physician and outpatient claims | SUPPORTED |
Institutional claims (837I) Facility claims | SUPPORTED |
Dental claims (837D) Dental claims | NOT AVAILABLE |
Remittance (835 ERA) Electronic remittance advice | ENROLLMENT REQUIRED |
Coordination of benefits Secondary-payer routing | NOT AVAILABLE |
Claim attachments (275) Supporting documentation | NOT AVAILABLE |
Portal vs. phone vs. automated
The same verification, three ways.
| Payer portal | Phone / IVR | Automated check | |
|---|---|---|---|
| Time per patient | 10–15 min | 15–30 min | Seconds |
| Cost per check | ~$7.97 staff time* | ~$7.97+ staff time* | from $0.50 |
| Record for the chart | Screenshot | None | Full audit trail |
| Whole-day schedule | One at a time | One at a time | Batched overnight |
*CAQH Index benchmark for a manual eligibility verification.
Frequently asked questions
What is the payer ID for Optum Pinnacle Medical Group?+–
Optum Pinnacle Medical Group uses payer ID 95271. It also appears as 1106, 3945 in some systems.
Does Optum Pinnacle Medical Group support real-time eligibility verification?+–
Optum Pinnacle Medical Group has no eligibility API, so there is no 270/271 transaction to send. Checks still run automatically: our screen agent performs the portal check for you on your schedule, rather than a staff member doing it per patient. Setup is required. Claims can be submitted electronically.
How long does a Optum Pinnacle Medical Group eligibility check take?+–
A portal check takes 10–15 minutes of staff time per patient. A screen agent runs the same check without occupying anyone — scheduled ahead of the day's appointments, so results are waiting rather than being fetched one patient at a time.
Run your first Optum Pinnacle Medical Group eligibility check
From $0.50 per check, pay-as-you-go. No contract, no implementation project.
Billing more than Optum Pinnacle Medical Group? — upload it and see which of your payers run automatically.
65%
fewer denials at Valley Diabetes & Obesity
90%
of eligibility checks fully automated
$107–149K
annual savings, small specialty practice
24 mo
in production
