Payer Finder V1 API Parameters

Try Payer Finder APIs.

Payer Finder user interface (UI) and API parameters

Parameter	Description
`parStatus`	A valid `parCode` is required to get `parStatus`.
`parCode`	An access code required to view the `parStatus` in the Payer Finder user interface (UI) and API 📝 Contact Optum support for an access code.
`businessName`	Labeled Payer Name.
`Alias`	Labeled alternative Payer Name.
`serviceId`	Labeled Payer ID.
`planType`	One or more from Auto, Blue Cross Blue Shield, Commercial, Delta Dental, Dental, HMO, Medicaid, Medicaid MCO, Medicare, Medicare Advantage, Medicare Supplement, Transportation, Optical, Tricare/Champus, Work Comp.
`states`	📝 States match on both, a single entry and a comma-separated list. A wildcard match on either a single two-letter abbreviation or a comma-separated list of more than abbreviation. For example, states=FL would match records with a states value of FL and FL,GA,AL; states=AZ would match on an entry of “AZ” as well as “AZ,CA,PA”.
`serviceName`(`TransactionTypes`)	One or more from Claim Status, Claims, Real-Time Claims, Claims Attachments, Electronic Funds Transfer, Eligibility, Health Services Review Inquiry, Health Services Review Request, Medical Attachments, Notice of Admission, Remittance (ERA), Remittance Images.
`lineOfBusiness`	One or more from Dental, Hospital, Medical.
`clearingHouse` (`Suite/ClearingHouse`)	Acceptable values are: `npd`(for Legacy Emdeon) `rpa` (for RPA/Capario) `dbq` (for Exchange/Legacy Relay Health) 📝 Only one value can be submitted in a query. Not including it will result in `npd` being used. Using more than one will generate an error.
`wildcard=true/false`	wildcard=false: An exact match search is performed for `businessName` or `alias`. wildcard=true: A wildcard search is performed. 📝 The default value is true. But the API users may want to set it to false.
`serviceModifiedGte`	Filters a search/export for only those payers whose `serviceModified` date is greater than or equal to the value provided. If the date is in any format other than YYYY-MM-DD, example: serviceModifiedGte=2022-12-02, an “invalid date format” error is returned.
`start`	The record number to begin at. '0' is the first number. This is only meaningful if the `size` is supplied.
`size`	The number of records to return. This is important. For example, searching on “21st century insurance” (wildcard=false) yields over 1,000 records that all have the same `serviceId` so, a user would only be interested in the first one. Setting `size=1` would only return one record instead of more than 1,000 records.
`sort`	The column name to sort on, and ascending (asc) or descending (desc) order. `sort=alias,asc` or `sort=serviceModified,desc`.
`total`	How many hits the query matched.

Available Fields in the Columns drop-down

Field	Description
`serviceDate`	Date of the service.
`acceptsSecondary`	Letter "Y" or "N" denoting if the payer accepts secondary.
`reportLevel`	—
`serviceModified`	Labeled date last modified.
`enrollmentStatus`	Labeled enrollment.
`serviceNotes`/`serviceNotes1`	—
`parStatus`	📝 A valid `parCode` is required to get `parStatus`.
`passThroughFee`	Letter "Y" or "N" denoting whether the payer has a pass through fee or not.
`payerSearchOptionsURL`	📝 Shows when clearinghouse is CAP/RPA and `Service` is `Eligibility` or `Claim Status`.
`enrollmentAuthorizationURL`	📝 Shows when clearinghouse is CAP/RPA and `Service` is `Eligibility` or `Claim Status`.

Updated 4 months ago