Coming Soon!!
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.
Designed for healthcare interoperability, dental attachments submitted using the Real Dental Attachments API supports Solicited and Unsolicited attachments workflows, ensuring payers receive the right documentation at the right time to support faster and more accurate claim adjudication.
- Solicited attachments are submitted in response to a payer‑initiated request after the dental claim has been received where, the payer reviews the claim and identifies the need for additional clinical or supporting documentation to complete adjudication, validate medical necessity, or perform claim investigation. The payer then formally requests documentation from the provider.
- Unsolicited attachments are submitted proactively by the provider at the time of claim submission without an explicit request from the payer.
The API translates the standard-based solution to a more readable JSON format, so it is more accessible to developers for easier integration into users’ applications.
An attachment, in the context of healthcare electronic data interchange (EDI), is an electronic rendition of medical documentation, such as an X-ray, lab report, or questionnaire to support a healthcare administrative transaction.
File formats supported
Our Attachments solution supports the following formats for 275 attachments: JPG, TIF, TIFF, PDF, JPEG, and PNG. Payers provide varying support for these formats. Consult your Optum representative to determine which formats your payers can work with.
Our Attachments solution includes workers’ compensation attachments and medical attachments. Any receiver who does not support electronic attachments will receive the documentation through fax or mail.
Payers can use the Real Dental Attachments service to view claim-related attachments, which are used to justify a given procedure. Payers use attachments to adjudicate the claim and must have the ability to find attachments in the portal to approve (or deny) a claim.
NOTE
In the current release, payers can search and view attachments and track usage. In later releases, payers can act upon attachments, run reports, view rules, and more.
Key features
The Real Dental Attachments API provides these features:
- Upload and Ingest Attachments
- Submit dental attachments securely via API
- Support images, documents, and clinical narratives
- Automatically associate attachments with claims using CDT codes and metadata
- Support Multiple Submission Models
- Unsolicited attachments submitted with the initial claim (e.g., Dental Claims)
- Solicited attachments submitted in response to payer documentation requests
- Retrieve and View Attachments
- Enable payers and authorized users to search and view claim‑related attachments
- Provide visibility needed to approve or deny claims efficiently