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Guides API Reference

OPTUM API DEVELOPER PORTAL

Quick Start
Readme
Get Started with Optum APIs
API Onboarding
Security and Authorization V2
Generate an API Token
API Environments
Access the APIs
Try Our APIs
API URLs and Endpoints
Using our Postman Collection
Using the Try It Interface
Sandbox Predefined Fields and Values
Sandbox API Values and Test Responses
Using Test Payers in the Sandbox
API Health Check
Troubleshoot APIs with Metadata
Metadata Search Feature
Glossary
Quick Reference

API RELEASE NOTES

API Release Notes

API WORKFLOW

Attachment Workflow and Best Practice
Claims API Best Practices and Workflow
Claims Submission Workflow
Claims Rejected or Denied Workflow
Claim Processing and Reporting Workflow
Eligibility API Best Practices and Workflow

OPTUM API IMPLEMENTATION

Generate a Client SDK

ERROR MESSAGES

Overview

API Examples

Overview

FREQUENTLY ASKED QUESTIONS

FAQs

MEDICAL NETWORK ELIGIBILITY V3

Eligibility V3 Getting Started
Eligibility JSON-to-EDI API Contents
Eligibility FAQs

MEDICAL NETWORK PROFESSIONAL CLAIMS V3

Professional Claims V3 Getting Started
Professional Claims FAQs

MEDICAL NETWORK INSTITUTIONAL CLAIMS V1

Institutional Claims V1 Getting Started
- Institutional Claims API JSON-to-EDI Contents
Institutional Claims FAQs

MEDICAL NETWORK INTEGRATED RULES PROFESSIONAL V1

Integrated Rules Professional V1 Getting Started
- Integrated Rules Professional JSON-to-EDI Contents
Integrated Rules Professional FAQs

MEDICAL NETWORK INTEGRATED RULES INSTITUTIONAL V1

Integrated Rules Institutional V1 Getting Started
- Integrated Rules Institutional Claims JSON-to-EDI Contents
Integrated Rules Institutional FAQs

MEDICAL NETWORK CLAIM STATUS V2

Claim Status V2 API Getting Started
Claim Status FAQs

MEDICAL NETWORK ATTACHMENTS RETRIEVAL V1

Attachments Retrieval V1 Getting Started
- Attachments Retrieval JSON-to-EDI API Contents
Attachments Retrieval FAQs

MEDICAL NETWORK ATTACHMENTS SUBMISSION V1 API

Attachments Submission V1 Getting Started
Attachments Submission FAQs

MEDICAL NETWORK ATTACHMENTS STATUS V1

Attachment Status V1 Getting Started
Attachments Status FAQs

MEDICAL NETWORK CLAIM RESPONSES AND REPORTS (ERA) API

Claim Responses and Reports V2 Getting Started
Claim Responses and Reports FAQs

DENTAL BENEFITS ADVISOR API

Change Log/Release Notes

MEDICAL NETWORK PAYERLIST V1

PayerList V1 Getting Started

Enhanced eligibility api v1

Onboarding
Getting Started
Change Log/Release Notes
Frequently Asked Questions
Troubleshooting and Support
Value-Added Features
Customer Callback Example API

Prior Authorization INQUIRY v1

Change Log/Release Notes
Frequently Asked Questions
Sandbox Test Responses
Authorization Inquiry JSON-to-EDI API Contents

MEDICAL NETWORK DENTAL ATTACHMENT API

Dental Attachment Getting Started
- Request Body Content
- Response Body Content
Dental FAQs

MEDICAL NETWORK PAYER ENROLLMENT FORMS

PayerEnrollment Forms Getting Started
PayerEnrollment Forms API Parameters

Eligibility API Best Practices and Workflow

Here is the detailed Eligibility API Best Practices and Workflow guide.

Updated about 1 month ago

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