Optum Real APIs

Our Optum Real APIs provide a smarter, faster way to connect with payers. With real-time, automated exchange of eligibility, claims and payment data, you get the information you need when you need it – from pre-service to payment.

Optum Real APIs for Medical Providers

Our APIs take standard transactions so they are accessible to developers and easily integrate into users' applications.

• The Real Pre-Service Eligibility API gives providers real-time insight into a patient’s benefits, network status and coordination of benefits data before their scheduled visit.
• With Real Claim Pre-Check API providers can complete a series of validation steps to improve the efficiency of claim processing and reduce the risk of invalid claims before a claim is submitted.
• With Real Claim Inquiry API providers can receive real-time updates on submitted claims such as summaries, details and status updates.
• With Real Patient Benefit Check API providers can validate patient benefits as well as prior authorization and referral requirements before care is delivered.

Coming soon:

• With Real Claim Action API providers can submit more accurate claims, reconsideration requests, appeals and supporting documentation.