February 26, 2015


Important Claims Filing Updates for CoOportunity Health


As we move toward the liquidation of CoOportunity Health, here is some important information for you to know.


Claims Payment Update

The first claims payments by guaranty associations will be made as soon as possible after the liquidation order is entered on February 28. This payment will include all claims processed but unpaid as of February 20. After that, claim payments will generally occur every two weeks.


File 2014 Claims Immediately


Please file 2014 claims now. Under the Affordable Care Act, there is a risk adjustment program that provides financial compensation for CoOportunity's high claim expenses. 2014 claims processed by March 15, 2015, will be included in CoOportunity's risk adjustment reports.


Refund Overpayments to Members Promptly   


Under your Midlands Choice contract, you are allowed to collect member liability at the time of service. If you have collected more than the member is responsible for paying out-of-pocket, please promptly refund any overpayment.

Look for Notice of Liquidation in the US Mail  


A notice of liquidation will be mailed via US Mail to all CoOportunity providers. Providers will not need to file any additional proof of claim under the liquidation. This includes all claims already filed. Providers will continue to file new healthcare claims as normal.   


CoOportunity Health Insurance is Valid After March 1  


As part of the liquidation process, individual and group members will receive a notice as to when their CoOportunity Health coverage will be terminated. There is a termination date for members with group coverage and a termination date for members with individual coverage. All individual policies will terminate by August 31, 2015. All group policies will terminate by April 15, 2015, except for groups with an April 1, 2015, renewal date. Groups with an April 1, 2015, renewal date will terminate on March 31, 2015.   


Our enrollment continues to decrease dramatically, and we anticipate it to continue to drop as many members will be moving to other carriers on March 1.


 Continue to Check Eligibility

During this time of transition, it's important to check each CoOportunity Health member's eligibility using one of these options:  


  • Use the CoOportunity Health secure Provider website to find answers all day, every day - no waiting.
    • Log on 24/7 and enter the ID number, or find an ID number using the patient's name and birth date.
  • Contact CoOportunity Health's Member Services for help.
    • Follow prompts when you dial 1.888.324.2064, available 24/7. You'll need to enter the patient's ID number and birth date.
    • Use the Contact Us tool to direct your question to the correct area. The Contact Us tool includes phone numbers, website resources, and an online form that requests information needed to research your question.
    • Call Member Services at 1.888.324.2064 between 7 a.m. and 6 p.m., Monday through Friday. 

Not registered for secure access? Visit coOportunityhealth.com/provider and sign up today.


Go Online for Additional Communications

The Iowa Insurance Division and Nebraska Insurance Department websites have additional information and answers to frequently asked questions.


Providers will be updated regularly through Midlands Choice.


We appreciate your patience and continued service as we work with you to process your claims and serve CoOportunity Health members.