Coming Soon!!
The Real Claim Status API enables providers perform status inquiry without a user interface (UI). It enables providers to get claim status updates programmatically, without relying on a portal or UI, and ensures a consistent, scalable, and centralized approach to claim status retrieval across payers. Through a single, centralized API, providers can retrieve claim information in near real‑time or batch‑based modes.
The Claim Status API enables providers to retrieve claim status updates either from Optum Real or directly from connected payers, based on the payer’s integration model.
- Real‑time (RT)–enabled payers may return payer‑generated claim IDs and adjudication feedback immediately through 277CA responses
- Batch‑connected payers, processed via IEDI, may return claim status responses asynchronously and may or may not include a payer‑generated claim ID
- Providers can query the system for payer 277 Claim Acknowledgement (277CA) using the Optum Real claim IDs, generated when dental claim submission API was invoked (see the response example in the Dental Claim Actions API
Through the centralized API, providers can:
- Retrieve claim details, status, and summary using GraphQL API
- Retrieve real-time claim‑level and service‑level status and updates