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Optum Inquiry API

The Inquiry API from Optum — 3 operation(s) for inquiry.

Optum Inquiry API is one of 166 APIs that Optum publishes on the APIs.io network, described by a machine-readable OpenAPI specification.

Tagged areas include Inquiry. The published artifact set on APIs.io includes an OpenAPI specification, an API reference, a getting-started guide, authentication docs, a changelog, and API documentation.

This API exposes 3 operations across 3 paths, and defines 37 schemas. It is described by OpenAPI 3.2.0, at version 1.0.

Requests are made against 3 base URLs: https://sandbox-apigw.optum.com/rcm/prior-authorization/v1/, /processor, https://sandbox-apigw.optum.com.

3 operations 3 paths 37 schemas 3 POST

Metadata

The identity and technical contract details declared by the specification.

Specification
OpenAPI 3.2.0
API Version
1.0
Base URL
https://apigw.optum.com/medicalnetwork/
Authentication
HTTP Bearer, OAuth 2.0
Resource Areas
1

Authentication & Security 2

Optum Inquiry API declares 2 security schemes for authenticating requests. It accepts HTTP bearer tokens (JWT) (bearerAuth). It supports OAuth 2.0 (oAuth) using the clientCredentials flow, exposing 5 scopes.

  • oAuth — This API uses OAuth 2 with the clientcredentials grant flow.

Paths & Operations 3

Across 3 paths, the API surfaces 3 operations — 3 POST. Each is listed below with its method, path, parameters, and response codes.

Inquiry 3
POST
/inquiry/x12
278x215 Prior Authorization Inquiry
2 params body → 200400401403500
POST
/inquiry
JSON Prior Authorization Inquiry
2 params body → 200400401403500
POST
/oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Claim/$inquire
inquireClaim 4 params body → 200400401406500

Schemas 37

The contract defines 37 schemas that model the data the API accepts and returns. The most detailed are AuthorizationJSONResponsePatientEventDetail (61 properties), AuthorizationJSONResponseServiceLevel (32 properties), AuthorizationJSONResponseServiceProviderName (26 properties), AuthorizationJSONResponsePatientEventProviderName (26 properties). Each schema is shown below with its type and property counts.

AuthorizationJSONResponse
object
16 properties
AuthorizationJSONResponsePatientEventDetail
object
61 properties
AuthorizationJSONResponsePatientEventTransportInformation
object
7 properties
InquiryX12Request
object
1 property
InquiryResponse
object
2 properties
AuthorizationJSONResponseRequestValidation
object
3 properties
AuthorizationJSONResponseIonalService
object
14 properties
AuthorizationJSONResponsePatientEventProviderName
object
26 properties
AuthorizationJSONResponseDependent
object
14 properties
InquiryJSONRequest
object
9 properties
AuthorizationJSONResponseDependentSupplementalIdentification
object
3 properties
AuthorizationJSONResponseServiceLevel
object
32 properties
AuthorizationJSONResponseRequesterIdentification
object
8 properties
AuthorizationJSONResponseRequester
object
14 properties
AuthorizationJSONResponseProviderSupplementalInformation
object
10 properties
AuthorizationJSONResponseDentalService
object
15 properties
Errors
array
AuthorizationJSONResponseSubscriberSupplementalIdentification
object
11 properties
AuthorizationJSONResponseToothInformation
object
6 properties
AuthorizationJSONResponseServiceProviderName
object
26 properties
AuthorizationJSONResponseSubscriber
object
15 properties
Entry
object
1 property
CareTeam
object
2 properties
ResponseEntry
object
2 properties
ClaimResponse
object
FHIR ClaimResponse
14 properties
CodeableConcept
object
FHIR CodeableConcept
1 property
ResponseItem
object
3 properties
Meta
object
FHIR metadata
1 property
Extension
object
FHIR extension with Reference
2 properties
Adjudication
object
3 properties
Identifier
object
2 properties
Period
object
2 properties
Claim
object
FHIR Claim Inquiry Request
11 properties
Coding
object
Coding structure for answers
2 properties
Reference
object
FHIR Reference
1 property
InquireRequest
object
FHIR Bundle for claim inquiry
4 properties
InquireResponse
object
FHIR Bundle with ClaimResponse
2 properties

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

optum-inquiry-api-openapi.yml Raw ↑

Other APIs Optum publishes across the network.

Optum Real (Medical) API
Optum Interoperability APIs (CMS Patient Access)
Optum Ambulance Fee Schedule APIs API
Optum Anesthesia Fee APIs API
Optum APC Calculator APIs API
Optum APC Cross Codes APIs API
Optum Apip API
Optum Application.wadl API
Optum Attachment API
Optum Attachment Document API
Optum Attachment Status API
Optum Attachment Submission API
Where this information came from

This is an independent, third-party profile of Optum Inquiry API, published by API Evangelist. We do not operate, host, resell, or support these APIs, and we are not affiliated with or endorsed by the company unless stated above. Everything here is built from publicly available information — the company's own site, developer portal, documentation, public repositories, and the specifications it publishes for public use. Nothing is obtained by breaching a system, defeating an access control, or using credentials.

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