The Real Dental Claim Submission API provides a secure, streamlined solution for transmitting the X12 EDI 837D-compliant dental claims to payers through the Clearing House. The Clearing House generates and sends the 277 CA acknowledgment files, forwards the 837D files to the payers, and returns the payer-generated 277 response files.
Designed for seamless integration, this API ensures accurate and efficient claim submission while maintaining compliance with HIPAA standards.
Key features
Through a single, centralized interface, providers and practice management systems can:
- Submit X12 837D Dental Claims — Includes provider details, patient demographics, member/subscriber information, procedure codes (CDT), and payer identifiers.
- Receive Real-Time Acknowledgments — Gets a unique transaction identifier for tracking and confirmation of successful submission.
- Enable Secure, Scalable Connectivity — Supports real-time and batch claim delivery to multiple payers through the Dental Clearing House.
This API improves interoperability between provider systems and the Optum Real platform by minimizing manual errors, accelerating onboarding, and enhancing overall claims processing efficiency.