API uses a Representational State Transfer (REST) connection and returns in a JavaScript Object Notation (JSON) format. UnitedHealthcare offers two API options:
All API transaction types are available.
Connect to us directly through a secure connection.
An API Trading Partner Agreement may be required.
View the reference guides for specific data returned for each transaction type and current options available.
Reference Guides:
Claim Status, Eligibility and Benefits are currently available.
API data is returned as an extension to your existing compliant EDI transaction responses.
The extended data provides information that is not included in the standard EDI response, which eliminates billing staff having to call us or going to the UnitedHealthcare Provider Portal to research.
To establish connectivity for API Extended X12, contact us directly for assistance or contact your clearinghouse to inquire about the UnitedHealthcare data they have available through their API services.
View the reference guides for extended data elements returned with EDI response transactions.
Reference Guides:
If you need help or to request a consultation, email physician_esolutions@uhc.com.
For more on API Extended X12, email supportedi@uhc.com or call 800-842-1109.