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PayerList V1 FAQs

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What is PayerList v1 API?

Please PayerList API Getting Started .

Which payer lists does PayerList API support?

Currently, the API can query the Payer Profile Database for payers associated with the RPA/Capario PayerList (RPA) PayerList (NPD), and ConnectCenter.

What does a typical PayerList v1 API request look like?

PayerList APIs allow you to retrieve individual Payer information, including any or all services offered by that Payer. The API paths are the requests you send to the API engine to perform lookup tasks to the database.

  • Use GET /payerlist/v1/payers?system=imn request to query our Payer Performance Database to obtain more specific information.
  • Use the GET request to build a query and filter for subsets of PayerList information from the payer list.

Example

https://apigw.optum.com/medicalnetwork/payerlist/v1/payers?businessName=blue&serviceName=Claims

What does a typical PayerList v1 API response look like?

In a sandbox environment, if you want to query for payers that start with business name blue and service name Claims, send a GET request to the following endpoint with your authorization header.

Example

Which data fields/JSON attributes can I use in the PayerList API for searching?

You can search using any of the available search parameters .

  • Control how many records and which to start from, using the size and start parameters
/payers?businessName=aetna&size=25&start=50

This query returns 25 records having businesName with aetna starting with record number 50.

The API also returns:

  • start: tells where the offset starts
  • size: number of payers displayed in the response, which will default to '50' and can be changed through query parameter (size)

What are the PayerList API error types and their format?

If you are searching to see if a particular service is supported by a payer, and if you do not specify the serviceName argument in the correct case, you will get a Nothing Found error:

```json
   [ ]
```

Querying for a value using the serviceId or with any other supported attribute that does not match anything in the database, will yield the same result.

Can I get the .csv of the PayerList?

  1. Yes, use the v1/payers/export endpoint to export the PayerList as a .csv file.
  2. Enter the payer name in the text box and click Enter.
  3. Click Export.
    The CSV file for the selected payer name downloads.

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Updated 5 days ago