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Application Programming Interface (API)

Application Programming Interface (API) is a free digital solution that allows health care professionals to automate administrative transactions. This option is best for organizations that have the technical resources to implement and maintain APIs.

 

Want to learn more about API? Check out our guides: API Overview, Self-Paced User Guide and Digital Solutions Comparison Guide.

Find all things API

Explore and discover our API Marketplace for all things API, including a technical sandbox.

Benefits of using API

  • Allows you to automate transactions on your timetable
  • Permits data transfers to your application of choice (interoperability)
  • Distributes data faster
  • Reduces phone calls and paper
  • Maintains workflow
  • Supports standard formats but compatible with new technology
  • Maximizes efficiency and productivity through workflow integration

API transaction types

  • Eligibility and benefits
  • Referrals
  • Prior authorizations (status check)
  • Claim submissions
  • Claim status and payment
  • Claim reconsiderations (with attachments)
  • Claim appeals (with attachments)
  • Provider demographics (add, term, change)
  • Documents (replacing paper correspondence)

Why add API to your practice?

API is designed to help your organization improve efficiency, reduce costs and increase cash flow. Phone calls and paper handling decrease, while contributing to a smoother workflow with fewer interruptions. Automatic data feeds are created to pull information on a timetable you set, and transfer the data to and from your practice management system, proprietary software, portal, spreadsheets or any application you prefer.

Flexibility

  • Appropriate for practices, facilities, health care systems, vendors, clearinghouses and revenue cycle management companies
  • Various levels of data are accessible for each API type; choose those that that fit your needs
  • Available for many UnitedHealthcare payers and plans

Automation

  • Transactions are automated on a timetable you set
  • Real-time data is returned faster
  • Incorporates seamlessly into existing workflow

Security

  • Enforces password reset every 2 years
  • Protects data from unauthorized view through encryption
  • Offers a secure, standardized method of communication between software programs

Testimonials

UnitedHealthcare has done an amazing job of providing documentation, resources and qualified people in their API department. As some companies do not even have a test environment or support, UnitedHealthcare has exceeded any expectations.

Love the API claim status service. Claim status programs that used to take us 5 hours over 2 days to run, now takes about 20 minutes to run the same transaction and get the same data. We will be seeking additional API services with UnitedHealthcare.

API setup and post-production support

API requires technical programming to exchange data in an automated fashion. The implementation will require coordination with either your IT department, software vendor or clearinghouse to set up the API service. We have a business and technical team ready to support you through each step of the implementation process, including post-production. Our team will schedule onboarding meetings to support you through testing to production.
 
Schedule a consultation with an API consultant to learn more.