Change Log

v1 above refers to the public API path and lifecycle. The version value inside the downloadable OpenAPI file is the specification document version and may advance independently as examples, schemas, and documentation metadata are updated.

Release Notes

v1.14 (07/14/2026)

• Updates:
  • NPI Validation Added
    Enhanced Eligibility now validates the submitted provider NPI. If an invalid NPI is sent, the transaction returns processing_error with this message: No valid NPI identified for this request. Please reach out to the Enhanced Eligibility team if assistance is needed.
  • Sandbox Mock Header Scenarios Expanded
    Sandbox mock header scenarios now support the JSON Real-Time Eligibility endpoint in addition to the X12 endpoint. Both JSON and X12 Real-Time Eligibility mock header scenarios can now produce linked Coverage Discovery mock responses when Coverage Discovery is enabled in Sandbox.

v1.13 (06/15/2026)

• Deprecations:
  • Search Options Cascading
    Removed Search Options Cascading from Coverage Discovery Value-Added Features.

v1.12 (05/05/2026)

• Updates:
  • Sandbox X12 Mock Header Scenarios
    Added Sandbox mock header scenarios for testing Real-Time Eligibility X12 requests against the POST /rcm/eligibility/v1/real-time/x12 endpoint.

v1.11 (04/08/2026)

• Updates:
  • Coverage Discovery Documentation
    Updated the guides and callback references to improve clarity around Coverage Discovery request patterns and result handling.

v1.10 (04/07/2026)

• Updates:
  • Added Real-Time X12 Endpoint
    Added the POST rcm/eligibility/v1/real-time/x12 endpoint for real-time X12 transactions.
  • Added Subtenant Header
    Added support for the optional subtenantId (x-optum-subtenant-id) header on POST requests for sub-level configurations needed for API consumers' customers.

v1.9 (01/15/2026)

• Updates:
  • Exponential Backoff for Callback Retries
    Callback retries to customer postback endpoints now use an exponential backoff strategy to accommodate customer network interruptions, maintenance windows, and other transient failures.
    See more details in the public documentation:
    Customer Callback Example API – Retries
  • RTCOB Processing Improvement
  • RTCOB path performance improved significantly, reducing typical turnaround for this path from the older long-running model.

v1.8 (12/15/2025)

• Updates:

  • Expanded Queryability for Transaction Search
    The GET rcm/eligibility/v1/transactions endpoint now supports additional query parameters to make patient‑centric searches more precise and efficient.

    New Query Parameters:

    • patientFirstName
    • patientLastName
    • patientAccountNumber
    • medicalRecordNumber
    • memberId
    • patientDateOfBirth
    • npi — provider NPI submitted on the request
    • payerId

v1.7 (10/03/2025)

• Updates:
  • Coverage Discovery Commercial Path : Added support for facility-specific commercial payer targeting. See more about this value-add here.

v1.6 (08/20/2025)

• Updates:
  • New POST x12 API Endpoint for Coverage Discovery : POST rcm/eligibility/v1/coverage-discovery/x12

v1.5 (06/25/2025)

• Updates
  • Coverage Discovery added support for the optional RTCOB add-on for additional coverage research.
  • Coverage Discovery response model updated to contain the optional realTime object for real-time Enhanced Eligibility customers enrolled in integrated Coverage Discovery.
  • Get All Coverage Discovery Endpoint supports querying by task status:
    • success
    • failure
    • pending
  • Get All Transactions supports querying by patient information:
    • patientFirstName
    • patientLastName
    • patientAccountNumber
    • medicalRecordNumber
    • memberId

v1.4 (12/17/2024)

• Updates
  • Search Options Cascading, a new Coverage Discovery Path.
• Deprecations
  • Change Healthcare request and response headers (x-chng-) are no longer supported.

v1.3 (10/23/2024)

• Updates
  • [Non-Breaking] Optum rebranding of request and response headers in OpenAPI Specification, Customer Callback API example, and all documentation guides.
    • Change Healthcare request and response headers are still supported to maintain backwards compatibility.
  • Support of the x-optum-trace-id response header for traceability into customer transactions.

v1.2 (08/14/2024)

• Updates
  • New API basepath rcm/eligibility/v1
  • Added supporting documentation
    • FAQs, Getting Started, Troubleshooting and Support, etc.
  • Updated API Specifications
    • Coverage Discovery
• Deprecations
  • Payer Alias API
  • NPI Management API
  • rcmcomplete/eligibility/v1 (legacy basepath)

v1.1 (05/03/2023)

• Initial Release