Sandbox API Values and Test Responses
We provide a list of service ID values for testing a variety of responses.
NOTE
DO NOT perform load testing or production data testing in the sandbox environment. Please use the sandbox ONLY to view sample API responses to HTTP requests using our predefined values and to familiarize yourself with our APIs.
For load testing and production data resting, we recommend using our APIs in production environment.
Contact an Optum representative at any time for more information.
NOTE
Your representative will provide you a set of secure credentials that you use for interacting with the sandbox environment. If you contract with Optum for API usage, you will use a separate pair of credential for your production API environment.
For testing the APIs in the sandbox environment, you can edit the request body and send it to the API engine to see what kinds of responses you will get.
The sandbox provides a set of predefined fields and values that you can apply to see how the API works. It uses simulated Medical Service ID and Personal Medical Information (PMI).
IMPORTANT
For sandbox usage, all fields must have the correct predefined values to obtain a successful response. Inventing new PMI values or using real-world PMI values will result in errors. Please provide all of the values, such as
tradingPartnerServiceId,controlNumber,subscriber, and so on marked as required (R) (see) in your API requests.
For successful use of APIs in the sandbox, you must use these "pseudo patient" and “pseudo provider” values for your testing.
NOTE
Avoid using real-world values in our sandbox API endpoints! Doing so will generate errors.
NOTE
All fields must use predefined values to have successful responses in the sandbox.
Eligibility Sandbox Test Responses
For Eligibility API testing in the sandbox, you can edit the request body and send it to the API engine to view what kinds of responses you will get. You can use the following values as the tradingPartnerServiceId (is the Payer ID; this will vary based on the payer you want to connect to) to change the responses you will receive from your test request body:
IMPORTANT
The sandbox returns a canned response based on the received data. There is no validation check or confirmation of specifically required information. These checks occur only in the production environment. You should manually review the companion guides offered by the specific payers to confirm what is required.
| Test using THIS tradingPartnerServiceId | Description |
|---|---|
| 00001 | This is a canned response that returns a single coverage plan. This will work for any payers. |
| 000002 | This is a canned response that returns a badly formatted 271. This will work for any payers. |
| 00003 | This is a canned response that returns a good 271 that contains maxed MSG01 field (AN..264) and EB03 repeating data element (99 repeats). This will work for any payers. |
| 00004 | This is a canned response that returns AAA Not Eligible For Inquiries. This will work for any payers. |
| 00005 | This is a canned response that contains non-printable characters which we need to make sure we can parse. This will work for any payers. |
| 00006 | A system error from the Payer. AAA segment in the 2000A Information Source Loop with AAA01 = Y, AAA03 = 42 and AAA04 = R. |
| 00007 | This is a canned response that returns a single coverage plan with unused fields. This will work for any payers. |
| 000008 | This is a canned response that returns a 271 that contains data in deprecated fields. It is used to test our parser's handling of data in these fields. This will work for any payers. |
| 00009 | This returns a canned 271 response where the patient is a dependent. |
| 000010 | Hospital Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, Date of Service and service type as input parameters. |
| 000011 | Rehabilitation Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, Last Name Date of Service and service type as input parameters. |
| 000012 | Medical Care Inquiry: A 270 request with provider ID, subscriber ID, Date of Service and service type as input parameters. |
| 000013 | Rehabilitation Inquiry: A 270 request with provider ID, Subscriber last name, first name, Date of Service and service type as input parameters. Sample response from Health Maintenance Organization (HMO) Blue. |
| 000014 | Vision (Optometry) Inquiry: A 270 request with provider ID, subscriber ID, SSN, DOB, Date of Service and service type as input parameters. |
| 000015 | Home Health Care Inquiry: A 270 request with provider ID, subscriber ID, DOB, Date of Service and service type as input parameters. |
| 000016 | Pharmacy Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, Last Name, Date of Service and service type as input parameters. |
| 000017 | Medical Care Inquiry: A 270 request with provider ID, subscriber ID, Date of Service and service type as input parameters. |
| 000018 | Emergency Services Inquiry: A 270 request with Information Receiver, Subscriber ID, Subscriber Last Name, Date of Service, and serviceType parameters as follows is given as input. |
| 000019 | Rehabilitation Inquiry: A 270 request with provider ID, subscriber SSN, DOB, Date of Service and service type as input parameters. |
| 000020 | Rehabilitation Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, Date of Service and service type as input parameters. |
| 000021 | Rehabilitation Inquiry: A 270 request with provider ID, DOB, First Name, Last Name Date of Service and service type as input parameters. |
| 000022 | Medical Care Inquiry: A 270 request with provider ID, subscriber ID, Date of Service and service type as input parameters. |
| 000023 | Health Benefit Plan Coverage Inquiry: A 270 request with provider ID, subscriber ID, Last Name, First Name, Date of Service and service type as input parameters. Sample response from Medicare Part A/Medicare Part B. |
| 000024 | Health Benefit Plan Coverage Inquiry: A 270 request with provider ID, subscriber ID, First Name, Date of Service and service type as input parameters. |
| 000025 | Rehabilitation Inquiry: A 270 request with provider ID, subscriber ID, Last Name, Date of Service and service type as input parameters. |
| 000026 | Hospital Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, service type and diagnosis code as input parameters. |
| 000027 | Hospital Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, service type and provider code as input parameters. |
| 000028 | Hospital Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, service type and provider information as input parameters. |
| 000029 | Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Provider ID. |
| 000030 | Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Patient Information. |
| 000031 | Health Benefit Plan Coverage Inquiry: A 270 request with Inactive Coverage date as service date. |
| 000032 | Health Benefit Plan Coverage Inquiry: A 270 request with Duplicate. Subscriber ID. |
| 000033 | Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Provider ID. |
| 000034 | Rehabilitation Inquiry: A 270 request with Subscriber ID, Dependent first Name and service type code as input parameters. |
| 000035 | Pharmacy Inquiry: A 270 request with Subscriber ID, Dependent first Name and service type as input parameters. |
| 00036 | Florida Medicaid: Sample response. |
| 000036 | Home Health Care Inquiry: A 270 request with Subscriber ID, Dependent DOB and service type as input parameters. |
| 000037 | Psychiatric Inquiry: A 270 request with Subscriber ID, Dependent First Name and service type as input parameters. |
| 000038 | Rehabilitation Inquiry: A 270 request with Subscriber ID, Dependent DOB, Dependent Last Name and service type as input parameters. |
| 000039 | Different Deductible at 30 and other STC. |
| 000040 | EB 1 with no benefits (Active Coverage) and EB I (Non Covered). |
| 000041 | Test EB 6 (Inactive) and EB W (Other Source of Data). |
| 000042 | EB R — other additional payer. Sample use case for standard Medicaid benefit. |
| 000043 | EB W response (other source of Data). |
| 000044 | High Out-of-Pocket Remaining but no deductible in response. |
| 000045 | Low Deductible High Premium — many different copayments. |
| 000046 | Low Deductible High Premium with no coinsurance. |
| 000047 | Low Deductible High Premium. |
| 000048 | Low Deductible with no copayment. |
| 000049 | Multiple Services. |
| 000050 | No Deductible, High Out-of-Pocket Remaining, only co-pay and co-insurance. |
| 000051 | No Deductible, only copay for 33,98, UC. |
| 000052 | No Deductible, No copayment. |
| 000053 | Plan with active coverage but no patient responsibility. |
| 000054 | Response with AD time period 25. |
| 000055 | Too many deductibles at service levels. |
| 000056 | Uniquely formatted EB segment. |
| 000067 | Sample use case from PAA. |
| 000068 | Sample use case 2 from PAA. |
| 000069 | Sample Use case for EB V (Cannot Process). |
| 000070 | Sample Use case for EB U (contact Following Entity for Eligibility or Benefit Information). |
| 000074 | Sample Use case for Connecticut Medicaid. |
| 000081 | Sample response for WellCare. |
| 000082 | Sample response for Blue Cross Blue Shield Georgia. |
| 000083 | Sample response for Humana. |
| ABHFL | Sample use case for Aetna Better Health of Florida. |
| ABHKY | Sample use case for Aetna Better Health of Kentucky. |
| ABHLA | Sample use case for Aetna Better Health of Louisiana. |
| ABHMO | Sample use case for Aetna Better Health of Missouri. |
| AETNX | Sample response for AETNA. |
| BCCTC | Sample use case for Blue Cross Blue Shield Connecticut. |
| BCNJC | Sample response for BCBS of New Jersey (Horizon). |
| CABC | A 270 request with memberId, firstName, lastName,gender,entityIdentifier,entityType,dateOfBirth,groupNumber,relationToSubscriber,insuredIndicator,maintenanceTypeCode, andmaintenanceReasonCode.Sample response for Platinum Full PPO 250 15 OFFEX. |
| CIGNA | A sample response for CIGNA for dependent. |
| CMSMED | A 270 request with additional fields. Sample response for Medicare Part A/Medicare Part B. |
| CNTCR | Sample use case for Connecticare Inc. |
| COVON | Sample response for Coventry. |
| CT | Sample use case for Connecticut Medicaid. |
| DENTAL | Sample response for benefits from Dental Payer. |
| HUM | Sample response for Humana. |
| ILMSA | Sample use case for Aetna Better Health of Illinois. |
| ISCAM | Sample response for Medi-CAL Portal connection. |
| MA/MB | Sample response for Medicare Part A/Medicare Part B. |
| MEDX | Sample response for MEDEX. |
| MMSI | Sample use case for Mayo. |
| TRICE | Sample response for Tricare. |
| TX | Sample response for Texas Medicaid. |
| TXBCBS | Sample response for Blue Advantage HMO. |
| UHC | Sample response for United Healthcare. |
Updated 8 months ago