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Payer Finder V1 Getting Started

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Payer Finder v1 API

Our new Payer Finder v1 API enables you to search and filter through your entire clearinghouse. Developers can use Payer Finder v1 API to programmatically search for the right payer in each transaction. It is a read-only API service that you can use without any financial obligations to query for information in your payer database for key pieces of information. Please review our clearinghouse endpoint, v1/payers/fields/clearinghouses and evaluate your enrollment with Optum, and understand which payer list you need to filter by, to avoid mix and matching of our payer list data and to avoid errors when using the payer data in other application to submit eligibility, claims, and claim status and so on.

Payer Finder v1 API is a complete re-write of Trading Partner v7 API with a new database supporting a better data model resulting in increased accuracy. Furthermore, a server-less infrastructure that delivers better performance.

Please see the API Examples section for examples.

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Legacy Relay Health (LRH)/Exchange Payers can be accessed by using our Payer Finder API.

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Works with Optum (also internally known as Legacy Change, Emdeon, or Ark) payer list and Revenue Performance Advisor (known internally as RPA or Capario) that are now in the Payer Profile Database.

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Explore the Payer Finder API in the Payer Finder UI. For more information, contact your Optum representative.

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DO NOT perform load testing or production data testing in the sandbox environment. Please use the sandbox ONLY to view sample API responses to HTTP requests using our predefined values and to familiarize yourself with our APIs.

For load testing and production data resting, we recommend using our APIs in production environment.

Payer Finder v1 endpoint

https://apigw.optum.com/medicalnetwork/payerfinder/v1/payers

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Payer Finder API uses OAuth2 security to access the APIs.

Payer Finder API

  • Allows you to pinpoint the specific payers you want to work with instead of downloading the entire payer list at one time.
  • Enables you to learn the details about payer services so you can refine your claims and other submitted information.
  • API Healthcheck /payerfinder/v1/healthcheck endpoint verifies that the operating status of our APIs is optimal and the APIs are running and accessible.
  • Search Payers /payerfinder/v1/payers/ endpoint lets you search by payerName, serviceId, planType, serviceName, businessName, and a few other parameters documented in the page.
  • Export Payers /payerfinder/v1/payers/export endpoint exports the payers list to a CSV file.
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Payers export to CSV file

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  • If you only plan to use a few daily transactions, you can use our Payer Finder V1 API user interface (UI) 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 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.

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Updated 4 months ago