Optum Real Claim Actions API
With Real Claim Actions API providers can submit more accurate claims, reconciliation requests, appeals, and supporting documentation at the point of billing.
Through a single, centralized API, providers can access claim information in real time, including:
- X12 claim validation (HIPAA)
- Membership coverage eligibility for the date of service
- Coordination of benefits including primacy and coverage details
- Prior authorization requirements and status
- Claim submission
- Reconciliation request and appeal submission
- Supporting documentation submission
Supported Payer IDs are available here
| Release Notes | Resources (need to be updated) |
|---|---|
| View Release Notes for more information about the history of programmatic updates for Optum Real APIs. | Check out API Setup, Real Claim Actions API User Guide and Technical Reference Guide for more information on API integration. |