The Optum Real APIs for Medical Providers Technical Reference Guide will contain all of the essential information the user will need to integrate with an API and serve as a ready reference source should you encounter a problem.

Note: This guide is intended to be referenced by information technology personnel.****

The Real Claim Pre-Check API takes the standard X12 EDI 837 transaction. All API traffic is encrypted over HTTPS and authentication is handled with OAuth2.

Test API in sandbox or in production:

Use token generated using client ID and secret key for sandbox or production.
Download API specs from overview page - every API overview section provides links to download the file in a JSON format, which generates our documentation for developers to use.
Hit API endpoint through the following options:

Use Try It page to request complete API response or customize response.
OR

Use Postman to request complete API response or customize response.

Notes:
DO NOT perform load testing or production data testing in the sandbox environment. Please use the sandbox ONLY to view sample API responses to HTTP requests using our predefined values and to familiarize yourself with our APIs.

To perform load testing and production data testing, we recommend using our APIs in the production environment.

API endpoint:

Instance	API Endpoint	Description
Optum Real Claim Pre-Check sandbox	https://sandbox-apigw.optum.com/oihub/pre-service/v1/claim/precheck	Use previously generated bearer token test API through this URL
Optum Real Claim Pre-Check production	https://apigw.optum.com/oihub/pre-service/v1/claim/precheck	Use previously generated production bearer token test API through this URL

HTTP response codes:

Code	Description
200	Success response
401	Unauthorized - authentication failed
500	Internal server error - problem occurred on the server
400	Bad request - includes schema level validation errors
504	Gateway timeout - the server, while acting as a gateway or proxy, did not receive a timely response from an upstream server

Request Elements:

Request element	Required/conditional/ optional	Notes
x12RequestData	Required	Contains 837X12 request data for institutional/professional claims. Refer to Overview for support Payer IDs.

Response elements:

Response element	Notes
transactionId	Returns the transaction ID when the claim is either successfully validated or encounters an error for tracking
responseType	Returns the 837999/ERR837 responses for success/internal failures
x12ResponseData	Returns X12 response as 999/837 request based on a success/failure scenario
x12Response277CA	Returns 277CA response which contains success/failure details
message	Returns appropriate message which explains the status of submitted request
statusCode	Returns the code associated with each submitted request, which will be used for internal error tracking

Screenshot of the sample request response looks to show success call:

API health check:

The health check endpoint checks the operating status of our API. It is a ping for the API entry point to ensure the entry points are accessible. This is the first thing you can do if something goes wrong.

Performing the Optum Real APIs health check (for first-time users):

To run the health check of an Optum Real API - the Real Claim Pre Check API, go to
Healthcheck

Response If the API engine is working correctly and if the entry points are accessible, the API operating status response shows "OK."

NOTE

If you receive a response other than 200 OK, the health check failed.

Please submit a service tickett with Optum.