Our APIs translate standard ANSI X12 medical transactions to JSON so they are more accessible to developers, enabling efficient integration into users’ applications.
We also provide extensive medical network API documentation (through FAQs, Getting Started Guides, JSON-to-EDI mappings, and OpenAPI 3.0 annotated docs).
Optum offers a comprehensive API bundle to help manage all aspects of telehealth operation. Providers should verify coverage of telehealth medical services before engaging.
Change Healthcare offers a comprehensive API bundle to help manage all aspects of telehealth operation. Our Telehealth bundle includes the following:
The Eligibility API (X12 EDI 270/271) provides patient profile and benefits insights to help support accurate care delivery. Its primary function is to verify insurance benefit status for a patient. This information helps ensure timely and accurate reimbursement.
The Professional Claims API (837P) and the Institutional Claims API (837I) allow healthcare providers to submit healthcare claims for a service or encounter.
Claim submitters use the Claims Status API (276/277) to check on the status of previously submitted claims.
Providers should verify insurance companies' coverage of telehealth medical services before engaging in telehealth encounters and transactions.