Prior Authorization API FAQs

Which payers can I submit prior authorization requests to?

The payer list can be found here: payerList.

Prior authorization requests can be submitted to any payer that has a value in the Authorization Verification Inquiry Connection column.

Do you have a sandbox that I can test before signing a contract?

Yes, please see Onboarding with Prior Authorization API. You can use our sandbox environment even before signing a contract. It requires a separate set of secure credentials which you can obtain from your Optum representative. After receiving your client_id and client_secret for our sandbox environment, you can test the API in our interactive documentation. The interactive documentation can be found by following the "Return to the API" button above.

Are there any test responses available in the Sandbox?

Yes, there are test responses available in the sandbox environment. See this page for more details Inquiry Sandbox Test Responses and Submission Sandbox Test Responses.

I am attempting to integrate the Prior Authorization API and am confused on what the x-optum-tenant-id header value is supposed to be. Is this a separate authorization key we need to obtain?

Please ignore the x-optum-tenant-id and leave it blank. That header is only required for clients that act on behalf of multiple customers and is used to identify which customer each individual request belongs to.

In the JSON-EDI API mapping section, should we fill in all of the NM109 Element fields marked as required?

No, all of the fields marked as R are not required to be filled in; only one of the fields marked as (R) is required. That is, if you have provided the payerId, the remaining fields are not mandatory. For more information, please see Inquiry JSON-to-EDI API Contents and Submission JSON-to-EDI API Contents.