Optum Real API Release Notes
This document contains information about new features, enhancements, regulatory updates, and any issues or defects that have been addressed from the previous version of the product.
Release Notes V1
- As part of this release, we are now supporting “Real Pre-Service Eligibility API” where providers can access eligibility data across multiple payers directly within their existing workflow, including:
-Eligibility information including patient demographic information, plan-level cost shares, plan coverage details and insurance details -Coordination of benefits including primacy and coverage details for each payer plan -Image of a patient’s insurance ID card -Provider In and Out of Network status
- As part of this release, we are now supporting “Real Claim Pre-Check API” where providers can validate claim data directly within existing workflow, including:
-X12 claim validation (HIPAA)
-Membership and coverage eligibility for the date of service
-Coordination of Benefits (COB) including primacy and coverage details for patient
-Prior Authorization (PA) requirements and status
-Adherence to payment and medical policies
Updated 3 days ago