Overview

The Optum Real Dental APIs enable seamless integration of dental data into your existing workflows, helping reduce development and support costs. By leveraging our APIs, you can enhance application and product development to ensure efficient and accurate dental service operations. Our APIs are compatible with practice management systems, dental information systems, electronic dental records (EDRs), and third-party billing platforms—providing detailed, up-to-date dental information.

Our APIs are secure, and are standard-based solutions that enable providers and vendors to submit, ingest, and retrieve dental claim attachments, such as images, narratives, and clinical documents using a modern, developer‑friendly JSON interface. Our APIs help developers build or extend healthcare applications and services. To learn more about us, visit Optum.

The following Real Dental products are supported. Each API product provides the key features and downloadable OpenAPI specs.

Current release

• The Real Pre-Care Estimate API enables dental providers to receive real-time cost estimates from dental payers prior to treatment to help reduce denials and improve patient cost transparency.
• The Real Pre-Care Eligibility API provides dental providers real-time insight into a patient’s eligibility, coverage, and benefits details before the patient’s visit.
• The Real Dental Claim Submission API provides a secure, streamlined solution for transmitting the X12 EDI 837D-compliant dental claims to payers through Med-Net Clearinghouse for processing.
• The Real Dental Attachments API is a secure, standard-based solution that enables providers and vendors to submit, ingest, and retrieve dental claim attachments, such as images, narratives, and clinical documents using a modern, developer‑friendly JSON interface.

Coming soon!

• The Real Claim Status Inquiry API enables providers to receive real-time updates on submitted claims either from Optum Real or directly from connected payers, based on the payer’s integration model to make informed decisions regarding reconciliation requests and appeals to help reduce administrative burden.
• The Real Pre-Care Eligibility Intelligence (Enhanced Eligibility) API provides a real‑time eligibility platform that provides a single integration point for submitting eligibility transactions across a broad payer ecosystem.
• The Real Electronic Remittance Advice API enables real‑time, standards‑compliant retrieval and delivery of payer remittance information.
• The Real Dental Attachments API with Image Intelligence is an AI‑driven capability that evaluates dental attachment images for correctness, quality, type, and clinical relevance.