Real Interoperability APIs
Optum Real Interoperability APIs
Optum Real also offers interoperability APIs that give providers access to prior authorization requirements, documentation workflows and patient clinical data across multiple payers in real time. Built on Fast Healthcare Interoperability Resources (FHIR®) and aligned with CMS-0057 (Advancing Interoperability and Improving Prior Authorization Processes) and applicable state regulations. These APIs reduce administrative burden, support continuity of care as members change plans, and improve coordination across the healthcare ecosystem.
Optum Real Interoperability APIs for Medical Providers
Our APIs take standard transactions so they are accessible to developers and easily integrate into users' applications.
- With Real Prior Authorization API users can determine prior authorization requirements, gather required documentation and submit authorization requests in real time. Through a centralized, FHIR API, providers can identify when prior authorization is needed, capture necessary clinical information, and submit and track requests with status updates, supporting CMS‑0057‑F compliance.
- With Real Provider Access API users can securely request and retrieve a patient’s clinical data from payers in real time. This centralized, FHIR based API gives providers access to key information such as clinical data, claims, encounters, and prior authorization details, supporting CMS interoperability requirements.