Integrated Rules Institutional V1 Getting Started
Nail the details of your Institutional Claims with Integrated Rules API!
Overview
The Integrated Rules Institutional API enables you to perform intelligent claim scrubbing, and fix any possible errors, before sending the institutional claim to the payer. This becomes vital, considering that institutional claims can carry up to 999 line items upon submission.
Using our Integrated Rules Knowledge Packs, our representatives can tailor your institutional Claims' error checks and validations to the needs of your medical team. If you need a powerful General Billing capability, or you specialize in Medicare, Ambulance Place of Service, Dialysis, Prior Authorization, and many other options, you can order a Knowledge Pack from Optum that matches your medical company's specific Claims requirements.
NOTE
The Integrated Rules Institutional v1 API is designed to work in complementary fashion with the standard Institutional Claims API.
The Integrated Rules Institutional API is designed to be complementary to the Institutional Claims v1 API /institutionalclaims/v1/validation endpoint, where you build and submit professional claims. The Integrated Rules API does not submit claims; it is a separate analysis tool. You must use your standard Institutional Claims API for submission.
Integrated Rules Institutional Claims API URL
https://sandbox-apigw.optum.com/medicalnetwork/institutionalclaims/advanced/v1/validation/
Standard Institutional Claims APIs HTTP
https://sandbox-apigw.optum.com/medicalnetwork/institutionalclaims/v1/
NOTE
- If you only plan to use a few daily transactions, you can use our ConnectCenter for your Medical Network transaction needs.
It provides most of the features supported by an API console but only allows manual entry for all data needed for a transaction. It contains Optum’s Payer Lists, the Payer List Enrollments wizard, and other API customer resources.- For providers sending hundreds of daily requests, we recommend using our APIs to be able to automate the submission processes and have a better fit for your business needs.
Related Topics
Updated about 1 month ago