Overview

Optum Real Pre-Service Eligibility API

With Real Pre-Service Eligibility API, providers gain real-time insight into a patient’s benefits, network status and coordination of benefits data before their scheduled visit.

Through a single, centralized API, 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

Supported Payer IDs