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Application Programming Interface (API)

Application Programming Interface (API) is a free digital solution that enables a real-time exchange of eligibility, claims and payment data into your existing systems. From pre-service to payment, health care professionals can more easily get the information they need, when they need it. Optum Real APIs provide even more real-time connectivity and clarity at every step of the care journey. APIs work best for organizations that have the technical resources to implement and maintain them.

Why add Optum Real APIs to your practice?

  • Make decisions with confidence. Get real-time data to help catch issues before claims are submitted.
  • Cut costs and save time. Streamline routine tasks like eligibility checks, authorization requirements and claim edits. 
  • Focus more on patient care. Automate documentation and coding, so you have more time to care for patients.
  • Enhance the member experience. Confirm coverage and costs before a patient receives care.
Connect with a consultant Why add Optum Real APIs to your practice?

API transaction types

  • Real Pre-Service Eligibility
  • Real Patient Benefit Check
  • Real Prior Auth/Referral Actions
  • Real Claim Pre-Check
  • Real Claim Actions
    • Claim submission with pre-check
    • Post attachment (reconsiderations/appeals, pended claims)
    • Submit claim ticket (reconsiderations/appeals)
  • Real Claim Inquiry
  • Real Document Search
  • Provider Demographics
  • TrackIt 

API setup and post-production support

API implementation requires technical programming. We have a team ready to work with your IT department, software vendor or clearinghouse with each step of the process, including post-production. We will also schedule onboarding meetings to help ensure your office has the support you need.

 

Connect with an API Consultant to learn more.

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.