Getting Started

Once successfully onboarded (see Onboarding), join our Postman Workspace to start interacting with the API. Follow the instructions below to fork and setup the Postman Collection and Environments to facilitate utilization of the Enhanced Eligibility API.

Postman Collection

Pre-Requisites

• Customer Onboarding (see Onboarding)
• API Credentials (client_id, client_secret) provided via email
• Download Postman

Setup

1. Start by clicking the Run in Postman button above. This link redirects you to a page with various options to access our Postman Collection.
2. You will see the button Fork Collection into your own workspace. Click this button and then select the two environments (Sandbox and Production) to fork as well.
   
3. Set the credentials in the "Sandbox" environment
   1. Open the "Sandbox" environment
      
      2. Copy/Paste the "client_id" from your email and save it in the "CURRENT VALUE" column for the variable named "client_id"
      3. Copy/Paste the "client_secret" from your email and save it in the "CURRENT_VALUE" column for the variable named "client_secret"
4. Save your changes
5. Set the credentials in the "Production" environment
   1. Repeat 3.1-3.4 for the "Production" environment
      

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You are now set up to authenticate and execute requests.

Execute Requests

Please refer to the OpenAPI Spec (download here) for the API contract and more in-depth documentation.

API Authentication

Every request in the collection inherits its Authorization from the collection itself. The collection defines an OAuth2.0 Authorization workflow that utilizes the environment variables "client_id" and "client_secret" in a "client_credentials" grant flow. To generate a new token, simply click on the "Enhanced Eligibility API v1" folder, go to the "Authorization" tab, scroll down and hit "Get New Access Token". Postman will automatically interact with the Token API on your behalf and store the token for you to use. Once it is stored, you can use this token in the "Authorization" tab, under the "Current Token" heading. You should see a dropdown of eligible tokens to select from. Select the token named "RCM Enhanced Eligibility".

Sandbox Environment

Supported Sandbox Requests
Using the above Postman Collection, we recommend getting familiar with the Enhanced Eligibility API in the Sandbox environment by utilizing the sandbox values provided by the Medical Network team (see documentation here).
Simply populate the request values of your Eligibility request with the set of predefined fields and values listed in the above documentation. The Medical Network sandbox will return a canned response based on the received data.

1. In the top right hand corner, select the Sandbox environment.
2. Select the POST /New Eligibility Request.
3. Edit the JSON body by using the provided sandbox values (seeSupported Sandbox Requestsabove).
4. Press the Send button to execute the request.
   5. Note the id in the response body. You may retrieve the individual record using the Transactions/Get Transaction By Id endpoint.
5. Repeat steps 3-4, experimenting with different sandbox values
   6. To retrieve all transactions, utilize the Transactions/Get All Transactions. You may use the provided query params to filter the data.
6. If enrolled in standalone Coverage-Discovery, start with the CoverageDiscovery/Post New Discovery Request using the dryRun feature. See more about DryRun in the OpenAPI Spec

Production Environment

After getting familiar with the Product using the Sandbox environment, sending Production traffic is the next step.

1. In the top right hand corner, select the Production environment
2. Select the POST /New Eligibility Request.
3. Edit the JSON body with your request.
4. Press the Send button to execute the request.
   5. Note the id in the response body. You may retrieve the individual record using the Transactions/Get Transaction By Id endpoint.
5. Repeat steps 3-4 to send multiple transactions.
   6. To retrieve all transactions, utilize the Transactions/Get All Transactions. You may use the provided query parameters to filter the data.
6. If enrolled in standalone Coverage-Discovery, start with the CoverageDiscovery/Post New Discovery Request using the dryRun feature. See more about DryRun in the OpenAPI Spec (download here).

Helpful Links

Please refer to our API documentation for details on supported functionality.

• API Authentication: <https://developer.optum.com/eligibilityandclaims/docs/security-and-authorization>
• Forking collection and environments in Postman: [https://learning.postman.com/docs/collaborating-in-postman/using-version-control/forking-elements/]
• Importing in Postman: https://learning.postman.com/docs/getting-started/importing-and-exporting-data/

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Need help? See Troubleshooting and Support

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Looking for the homepage? Return to Enhanced Eligibility Overview here.