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Optum

Optum Real (Medical) API

Optum Real point-of-care APIs on the oihub gateway: pre-service eligibility, claim pre-check, claim actions, claim inquiry, patient benefit check, document search, auth referral submission, plus HL7 FHIR R4 Da Vinci implementations — Prior Authorization Support (PAS $submit/$inquire/$submit-attachment), Documentation Templates and Rules (DTR questionnaire package and adaptive $next-question), Coverage Requirements Discovery over CDS Hooks, and Provider Access with $bulk-member-match and $davinci-data-export.

Documentation Provider Profile APIs.io OpenAPI GitHub

This API exposes 1 operation across 1 path, and defines 7 schemas. It is described by OpenAPI 3.0.0, at version 1.0.0.

Requests are made against a single base URL, https://sandbox-apigw.optum.com.

1 operations 1 paths 7 schemas 1 POST

Metadata

The identity and technical contract details declared by the specification.

Specification
OpenAPI 3.0.0
API Version
1.0.0
Base URL
https://apigw.optum.com/oihub/
Authentication
OAuth 2.0
Resource Areas
1

Authentication & Security 1

Optum Real (Medical) API declares 1 security scheme for authenticating requests. 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 1

Across 1 path, the API surfaces 1 operation — 1 POST. Each is listed below with its method, path, parameters, and response codes.

Claim Actions 1
POST
/oihub/claim/actions/v1
Call Claim Actions API
claimActions 3 params body → 200400401500

Schemas 7

The contract defines 7 schemas that model the data the API accepts and returns. The most detailed are ClaimTicketInput (15 properties), AttachmentInput (9 properties), OperatorInput (8 properties), ClaimSubmissionResponse (6 properties). Each schema is shown below with its type and property counts.

AttachmentInput
object
Represents the input for submitting a claim attachment.
9 properties 1 required
ClaimSubmissionInput
object
Input data for the Claim Actions operation
2 properties 2 required
ClaimSubmissionResponse
object
Response model for Claim Submission operations
6 properties
ClaimTicketInput
object
Input for submitting a claim ticket (Pend, Recon, Appeal)
15 properties 1 required
ClaimTicketResponse
object
Claim Ticket Response
4 properties
LineDetailInput
object
Details for a single claim line
2 properties
OperatorInput
object
Operator details for claim ticket
8 properties

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

optum-attachment-openapi.yml Raw ↑
#FHIR#Da Vinci#Prior Authorization#CDS Hooks#Provider Access#Eligibility#Claims#Benefit Check
← Back to O APIs
API Details
ID
optum:optum-real-medical-api
Base URL
https://apigw.optum.com/oihub/
Docs
https://developer.optum.com/optumreal-medical
Provider
Optum
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This is an independent, third-party profile of Optum Real (Medical) 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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