Dental Claim Status

post

https://sandbox-apigw.optum.com/oihub/dental/claim/inquiry/v1

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This API submits a real-time dental claim status inquiry to the Intelligent Medical Network (IMN)/MedNet Claim Status API V2 (X12 276) and returns the authoritative payer claim status (277) response. The request fields are mapped to 276 search criteria and routed to the appropriate payer through the IMN platform. The API supports the external PMS/EHR/RCM integrations and Optum Real portal consumers.

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Supported Payer IDs

UnitedHealthcare: 52133

Wellmark: 88848

Multiple payers supported

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IMPORTANT
Please note that the request requires you to provide all the required field values. Please note that these required values are GREYED out, which are pre-populated example values and can be selected to view the canned response. To view the required fields, expand the + symbol (indicated by the variables field below.

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Please do not submit PHI or PII data on the developer portal's Try It! interface.

See required fields and possible values

Body Params

GraphQL query payload for dental claim status inquiry.

operationName

string

enum

Name of the GraphQL operation to execute. Supported value: SearchClaim

Allowed:

query

string

required

GraphQL query string for the SearchClaim operation.

variables

object

required

Variables for the SearchClaim GraphQL query.

Headers

providerTaxId

string

required

Provider Tax Identification Number (TIN). Used as fallback billing TIN when billingTin is not provided in the request body. Maps to providers[].tin in Claim Status API V2.

x-optum-consumer-correlation-id

string

Unique UUID used to track the transaction end-to-end. Serves as the tracking/control number for the claim identification process. Maps to encounter.trackingNumber in Claim Status API V2.

environment

string

Target environment (e.g., sandbox, production).

nextPageToken

string

Pagination identifier to retrieve the next set of claim records.

Responses

Dental Claim Status

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Supported Payer IDs

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📘Supported Payer IDs

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200Successful claim status inquiry. Returns payer-authoritative claim and service-line status as returned by IMN Claim Status API V2.

400Bad request. Validation failed — missing required fields, invalid search combination, or unsupported operation name.

401Unauthorized

404Not found. The requested claim or payer could not be found.

500Internal server error

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Supported Payer IDs

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IMPORTANT

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