Overview

Introduction

The Enhanced Eligibility API extends the functionality of Optum's 270/271 json-based Eligibility API by offering value-add functionality that aims to improve response accuracy and quality. The value-add functionality is made available through a customer specific Rules Engine that takes data about the submitter and enhances transactions in real-time. This functionality alleviates the need for RCM specialists to track Eligibility specific intelligence offline, handle payer-specific response deviations, and will save your operation time and money.

Release NotesFAQ
View the API Release Notes for information about the API.Check out our FAQ for help with specific questions about this API.

📘

For next steps, visit the Onboarding Guide.

The Onboarding Guide is a comprehensive resource to ensure you have a smooth start and are well-prepared to utilize the API effectively. If you’ve already been through the onboarding process, you can jump straight into the Getting Started instructions to begin utilizing the API.