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Guides API Reference

API & Services Connection™Request Sandbox Access Marketplace Community Quick Reference

API Reference

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Guides API Reference

API Overview

Overview
Get Started
Telehealth Medical Eligibility and Claims Management Bundle V1

Medical Network Eligibility v3

Overview
Health Check
- Health Checkget
Eligibility
- Check Eligibilitypost
- Check Eligibility x12post

Medical Network Professional Claims V3

Overview
Health Check
- Health Checkget
Professional Claims

Medical Network Institutional Claims V1

Overview
Health Check
- Health Checkget
Institutional Claims

Medical Network Claims Responses And Reports v2

Overview
Reports
- List Reportsget
Health Check
- Health Checkget
Report

Medical Network Integrated Rules Institutional v1

Overview
Health Check
- Health Checkget
Integrated Rules Institutional
- Claim Validationpost
- Claim Validation x12post

Medical Network Integrated Rules Professional V1

Overview
Health Check
- Health Checkget
Integrated Rules Professional
- Claim Validationpost
- Claim Validation x12post

Medical Network Claim Status V2

Overview
Claim Status API

Medical Network Attachments Submission v1

Overview
Attachments Submission
- Attachments Submissionpost
Health Check
- Health Checkget

Medical Network Attachment Status v1

Overview
Attachment Status
- Endpoint to retrieve the attachment status based on traceIdget
- Endpoint to retrieve the attachment status based on metadatapost

Medical Network Attachment Retrieval v1

Overview
Attachment Document
- Searchpost
- Download a document for the given documentIdget

Dental Network Enhanced Eligibility v1

Overview
Enhanced Eligibility
- Check Enhanced Eligibility and Coveragepost
Enhanced Eligibility Enrollment
- Enroll Provider for Enhanced Eligibility and Coveragepost
Health Check
- Health Check of APIget

Medical Network Dental Attachment API

Overview
Attachment

Enhanced Eligibility API

Overview
Eligibility Requests
- Submit a new eligibility requestpost
Eligibility Transactions
- Find all eligibility transactionsget
- Find eligibility transaction by IDget
Coverage Discovery
Healthcheck
- Validate the status of the systemget

Medical Network Payer List v1

Overview
Payer List
Health Check
- Health Checkget

Prior Authorization v1

Overview
Authentication
- Get Tokenpost
Determination
Inquiry
Authorization (Orchestration)
- 278x215 Prior Authorization Orchestrationpost
- JSON Prior Authorization Orchestrationpost
Health Check
- Service heartbeatget

API Overview

Overview
Get Started
Telehealth Medical Eligibility and Claims Management Bundle V1

Medical Network Eligibility v3

Overview
Health Check
- Health Checkget
Eligibility
- Check Eligibilitypost
- Check Eligibility x12post

Medical Network Professional Claims V3

Overview
Health Check
- Health Checkget
Professional Claims

Medical Network Institutional Claims V1

Overview
Health Check
- Health Checkget
Institutional Claims

Medical Network Claims Responses And Reports v2

Overview
Reports
- List Reportsget
Health Check
- Health Checkget
Report

Medical Network Integrated Rules Institutional v1

Overview
Health Check
- Health Checkget
Integrated Rules Institutional
- Claim Validationpost
- Claim Validation x12post

Medical Network Integrated Rules Professional V1

Overview
Health Check
- Health Checkget
Integrated Rules Professional
- Claim Validationpost
- Claim Validation x12post

Medical Network Claim Status V2

Overview
Claim Status API

Medical Network Attachments Submission v1

Overview
Attachments Submission
- Attachments Submissionpost
Health Check
- Health Checkget

Medical Network Attachment Status v1

Overview
Attachment Status
- Endpoint to retrieve the attachment status based on traceIdget
- Endpoint to retrieve the attachment status based on metadatapost

Medical Network Attachment Retrieval v1

Overview
Attachment Document
- Searchpost
- Download a document for the given documentIdget

Dental Network Enhanced Eligibility v1

Overview
Enhanced Eligibility
- Check Enhanced Eligibility and Coveragepost
Enhanced Eligibility Enrollment
- Enroll Provider for Enhanced Eligibility and Coveragepost
Health Check
- Health Check of APIget

Medical Network Dental Attachment API

Overview
Attachment

Enhanced Eligibility API

Overview
Eligibility Requests
- Submit a new eligibility requestpost
Eligibility Transactions
- Find all eligibility transactionsget
- Find eligibility transaction by IDget
Coverage Discovery
Healthcheck
- Validate the status of the systemget

Medical Network Payer List v1

Overview
Payer List
Health Check
- Health Checkget

Prior Authorization v1

Overview
Authentication
- Get Tokenpost
Determination
Inquiry
Authorization (Orchestration)
- 278x215 Prior Authorization Orchestrationpost
- JSON Prior Authorization Orchestrationpost
Health Check
- Service heartbeatget

Service heartbeat

get https://sandbox-apigw.optum.com/healthcheck

Returns the health of the API

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