Coming Soon-User Guide

The Optum® Real Claim Actions API helps streamline everyday tasks by making it easier to submit claims, appeals, reconciliation requests and supporting documents. It’s designed to reduce manual work, improve turnaround times and keep your office workflows running smoothly.

When to use it:

• Pre-check claims before submission to ensure all required information is included
• Submit claims correctly the first time to avoid delays and reduce rework
• Minimize follow-up tasks for unresolved claims and speed up payment

How it helps:

• Submit claims in real time using a pre-check process that validates formatting before submission
• Attach documents to a claim or ticket after submission for easier follow-up
• Initiate a reconsideration, appeal or pend request directly through the system
• Send both solicited and unsolicited claim attachments as needed

What you’ll see:

• A confirmation message showing whether the submission was successful
• A detailed response outlining any issues that need to be corrected
• Status updates that help you track the progress of your submission

How it’s different:

• Validates claims before submission to reduce errors and rework
• Allows documents to be added during or after submission for easier follow-up
• Enables direct submission of appeals, reconsiderations and pend requests
• Accepts both requested and unrequested attachments to support claims
• Provides instant feedback so issues can be fixed quickly
• Offers status updates to track progress and reduce uncertainty