API Onboarding

Optum API onboarding process ensures that our API customers automate their API consumption process and helps API users solve problems and successfully complete the medical network tasks. Experience the best user experience with our API that enables you to develop and automate several tasks without examining how the APIs work.

Our APIs enable you to:

  • Use your own development workflow for our APIs
  • Test the APIs with our interactive OpenAPI Spec in the overview section of our API categories

📘

NOTE

  1. HTTPS: Optum APIs are only accessible through HTTPS
  2. JSON: Request and response contents are in JSON format
  3. OAuth: All Optum API requests are protected by OAuth2 Bearer authorization token to obtain access

Security and Authorization Protocols and Implementation

A data entry console to make claims requests

All providers' offices need an effective and straightforward console for creating and filing new claims, with the common knowledge shared across the team reflected across the user interface (UI).

Automate API bearer token usage, using OAuth2 token retrieval

Apply the same token across all transactions during the full token lifespan and automatically refresh the token just before it expires.

Token automation

  1. Get a unique authorization token for each transaction;
  2. Apply the same token across all transactions during the token lifespan and automatically refresh the token just before it expires.

📘

BEARER TOKEN LIFESPAN

The lifespan of a Bearer token is one hour (3600 seconds) for both sandbox and production environments.

We recommend automating transactions to use the tokens generated over the token lifespan. Obtaining tokens for each transaction is less efficient and does not improve the security criteria for any transactions.

Optum API URLs

📘

NOTE

The JSON attributes in our APIs use snake-case, with the first letter of the attribute in lower case as in tradingPartnerServiceId (this is the Payer ID). Here is a list of test Trading Partner Service IDs. Our APIs are case-sensitive and your JSON request body must observe this convention.

Use our REST APIs with these HTTP URLs.

  • Sandbox URL
https://sandbox-apigw.optum.com/medicalnetwork/
https://apigw-optum.com/medicalnetwork/

For more details, see Access the Optum APIs.

API endpoint usage example

A request contains an HTTPS/URL and endpoint. See the API Endpoint Usage example.

Abstract the complex data needed for a successful request

API users can easily make requests and efficiently get responses.
For example, the controlNumber field exists in all of our APIs as a required value that the provider or institution generates to identify each transaction. When the provider's office sends a request, they need not worry about defining and entering these values as they are programmatically handled.

Audit and track all transactions

This includes tracking of all the controlNumber, payer ID, and patient information for effective cross-referencing.

Use our REST APIs

Use your access credentials provided by Optum.
The credential set consists of a random alphanumeric client_id and client_secret pair. Contact your Optum representative if you do not have this information.

📘

NOTE

Optum strongly recommends you carefully guard your API access credentials. Avoid sharing them with others.

Optum API Healthcheck

Optum provides a /healthcheck endpoint in all of the APIs (for example, Eligibility, Professional Claims v3, Claim Responses and Reports (ERA), and so on) to verify that the operating status of the API is optimal and is accessible. It is the first thing you can do if something goes wrong. For more information, see Checking the operating status of API.

Metadata for troubleshooting

Optum Medical Network APIs support a significant troubleshooting feature called metadata.

📘

NOTE

API users need not enable this capability; it is automatic and has no effect on information in any medical transaction. If you encounter any issues with a transaction and need to work with Optum technical support, provide the values provided in the meta object to the Optum representative for troubleshooting.

Prerequisites to use our APIs

Our APIs are private and require credentials to gain access Sign in and request for API credentials.

API components

API ComponentsValue
Content-Type HeaderAlways defaults to application/json
Authorization HeaderPass the Bearer authorization token to authorization header
grant_type FieldAlways client_credentials

API credentials

  1. Your API credentials include the following information in an API request.
FieldValue
client_idYour client ID provided by Optum
client_secretYour client secret provided by Optum
grant_typeAlways client_credentials

📘

NOTE

You should have two sets of credentials:

  • One for the sandbox — to help you test our APIs before signing a contract
  • One for production — provided after signing a contract or after processing a subscription

These credentials are specific and unique to an API environment and your company.

Bearer token

  1. A Bearer token.
    The /apip/auth/v2/token/ endpoint allows you to obtain a short-lived access token that must be transmitted with subsequent API requests.

📘

BEARER TOKEN LIFESPAN

The lifespan of a Bearer token is one hour (3600 seconds) for both sandbox and production environments.

Sandbox credentials

For sandbox credentials, see.

Try our APIs

If you do not own a development platform to sample the APIs, you can Try our APIs using one of two methods.

📘

NOTE

Use sandbox predefined fields and values to try our APIs.

Using Postman

To test our APIs, we recommend using Postman – a free tool for testing APIs. You just need to create an account and set up a workspace. See using our Postman collection.

Importing Optum OpenAPI specification and testing our APIs

Use the Postman (preferred method to test run our APIs) tool or any other API tool/platform of your choice, quickly submit API requests to our gateways by importing our OpenAPI Spec collection in the required Optum API. For information about how to use our Postman collection, see use our Postman collection

  1. For example, to copy the URL for the Eligibility V3 API, right-click the Download OpenAPI Spec in the Eligibility V3 API getting started page and select Copy Link Address.
https://developers.changehealthcare.com/eligibilityandclaims/openapi/60352a6f7e12f500829d5bbe
  • To download locally and view the specification (optional), click Download OpenAPI Spec.
2990

Eligibility V3 API Getting Started Page

  1. Open Postman >> "your" workspace, and click Import next to My Workspace.
  2. Paste the copied URL link in the Enter a URL box.
  3. Click Continue, and then click Import.
  4. In your imported APIs, click the API you want to test, for example, Get Health Check.
1662

Health Check Response

📘

NOTE

Postman is a third-party API tool/platform and not associated with Optum. The tool enables you to test our RESTful APIs.

📘

NOTE

See API URLs and endpoints for a list of Optum API endpoints.

Using interactive Try It interface

Use the API reference's Try It feature within our interactive documentation as shown below by using our predefined values to familiarize yourself with our APIs. For example, generate a bearer token. For information about testing our APIs in the interactive Try It interface, see testing our APIs in Try It interface.

📘

NOTE

See API URLs for a list of Optum API endpoints.

Optum client checklist

Make sure to get the following information from your Optum representative:

  • SFTP Login/Password;
  • SSH Secret Pair;
  • Required SFTP configuration security settings;
  • The Optum Submitter ID. You use this for all your batch 275 submissions, goes in element ISA06 of every batch submission's ISA envelope;
  • Required tradingPartnerServiceID.

Related Topics