Attachments Submission V1 Getting Started
Attachments Submission v1 API
NOTE
See Attachments in electronic data interchange and their use in our APIs.
The Attachments Submission API supports the X12 EDI 275 Patient Information transaction and clinical documentation between healthcare entities. It translates this standard to the more-readable Javascript Object Notation (JSON), so it is more accessible to developers and more easily integrated into usersā applications.
- Accepts supporting claim documentation
- Associates the documentation with a claim or attachment control number
- Sends the attachment through the Med-Net/clearinghouse ecosystem
- Generates an acknowledgment response confirming receipt and processing status
The attachments submission takes two forms: Solicited and Unsolicited.
- For Unsolicited attachment, consider workman's compensation claims. Attachments illustrating the conditions giving rise to the claim are required in all worker's compensation claims, hence they are called unsolicited claims.
Worker's Compensation Requirements
To send attachments to Worker's Compensation agencies, you must enroll beforehand. If you expect to do so when your API services are up and running, contact your Optum representative for more information about enrollment.
- Solicited attachments submission usually are sent by providers to payers that request documentation for a claim.
An attachment, in the context of healthcare electronic data interchange (EDI), is an electronic rendition of medical documentation, such as an X-ray, lab report, or questionnaire, to support a healthcare administrative transaction.
File formats supported
Our Attachments solution supports the following formats for 275 attachments: JPG, TIF, TIFF, PDF, JPEG, and PNG. Payers provide varying support for these formats. Consult your Optum representative to determine which formats your payers can work with.
Our Attachments solution includes workersā compensation attachments and medical attachments.
Attachments process flow
- Claim is submitted (837 transaction or API equivalent).
- Payer requests additional documentation or attachments may be sent proactively.
- Documents are packaged into a 275 attachment transaction.
- The attachment is linked to the claim using identifiers.
- Clearinghouse/payer receives the attachment.
- An acknowledgment is returned. Industry companion guides describe acknowledgments such as 824 responses and other processing acknowledgments for attachment transactions.
NOTE
- If you only plan to use a few daily transactions, you can use our ConnectCenter for your Medical Network transaction needs.
It provides most of the features supported by an API console but only allows manual entry for all data needed for a transaction. It contains Payer Lists, the Payer List Enrollments wizard, and other API customer resources.- For providers sending hundreds of daily requests, we recommend using our APIs to be able to automate the submission processes and have a better fit for your business needs.
NOTE
For examples, see API examples.
Related Topics
Updated 21 days ago