Overview


Ancillary Benefits Management Claims Pre-Pay DME API

DME Navigator is a specialized solution within Optum's Ancillary Benefits Management (ABM) portfolio that helps health plans manage the home-medical equipment services. The product connects providers, suppliers, and health plans through an integrated workflow that improves access, ensures clinical appropriateness, and creates a more efficient member experience.

The Pre-Pay DME API provides health plans with the ability to integrate DME Navigator determinations, policy logic, and supplier validation into claims workflows including:

  • Validates whether required authorization was obtained
  • Links claims to clinical determinations
  • Supplier validation
  • Enables policy enforcement during claims adjudication
  • DME claim pricing

How to try an API?

Refer to the Getting started section on how to use an API.
Release notesFAQs
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