Endpoints Supported

• Sandbox URL

https://sandbox-apigw.optum.com/

• Production URL

https://apigw.optum.com/

• Get authentication/bearer token API

This API generates an authentication token using your client_id and client_secret. For information, see generate a Bearer token.

https://sandbox-apigw.optum.com/apip/auth/sntl/v1/token

• Healthcheck API

The /healthcheck endpoint verifies that the connection to the API server is established and the API is operational. Use your Bearer token to perform API health check. It is a ping for the API entry points to ensure the entry points are accessible and it is the first thing you can do if the API request is not working.

PAS API

The POST and GET APIs creates a new resource bundle to enable providers to check authorization statuses directly from payers in real-time by connecting EDI, web portal payers, and UM vendors for efficient authorization inquiries and retrieve authorization statuses directly from payers in real-time by connecting EDI, web portal payers, and UM vendors for efficient authorization inquiries.

• A standard X12 EDI 278 /inquire transaction request

With a valid X12 for 275 request, the prior authorization support /inquire request will be submitted to the payer or clearinghouse to return a 278 response with a single x12 property that has a 215 EDI string.

https://sandbox-apigw.optum.com/medicalnetwork/priorauth/v2/inquire

https://sandbox-apigw.optum.com/medicalnetwork/priorauth/v2/inquire/bundle/{id}

• A 278 transaction for a /raw-x12 request

Using the EDI X12 275 requests, submits a raw X12 prior authorization payload. This operation enables Pre Authorization Claim request submission for adjudication as a Bundle containing the PASClaimRequest and other referenced resources for processing. This operation enables the ability to submit solicited and unsolicited attachments or additional information for claims or prior authorization.

https://sandbox-apigw.optum.com/medicalnetwork/priorauth/v2/fhir/2.1/pas/raw-x12

CDex API

This API accepts structured attachment data (e.g., PDF, image, or document) and associates it to the correct authorization case, validating required identifiers and linkage details.

https://sandbox-apigw.optum.com/medicalnetwork/priorauth/v2/cdex/submit-attachment

CRD CDS Hook

This API retrieves the list of available CDS services from the discovery endpoint following the CDS Hooks specification.

https://sandbox-apigw.optum.com/medicalnetwork/priorauth/v2/crd/{hook_id} (cds-services/{service.id})

DTR API

The POST and GET DTR Questionnaire APIs create a new questionnaire and retrieve payer documentation requirements and/or rules.

https://sandbox-apigw.optum.com/medicalnetwork/priorauth/v2/dtr/Questionnaire`/{qr_id}`