Transparency
Unlock real-time transparency into a patient’s benefit data to help avoid claim errors and give patients a clear picture of how much they’ll owe.
Efficiency
Access dental payer data through a single integration, relieving administrative burden and improving dental claim processing workflows.
Administrative cost savings
Submit more accurate dental claims, reducing administrative costs and accelerating reimbursement.
Included modules
Real Pre-Care Estimate API
Dental providers can receive real-time estimates from payers before care is delivered. Through a centralized API, you can access dental claim processing information – like eligibility and prior authorization requirements – in real time to help reduce errors and give patients a clear picture of what they’ll owe before they receive care.
Real Pre-Care Eligibility API
Dental providers can submit real-time eligibility inquiries to payers before the patient visit. Through a centralized API, you can access real-time patient eligibility information from multiple payers within your existing practice management system. Spend less time chasing information and more time helping to improve the patient experience.
Real Claim Submission API
Dental providers can submit claims directly to payers in real time. This centralized API helps streamline and enhance the efficiency of the submission process, so you can spend less time on administrative tasks and more time with patients.
Real Dental Attachment API
Dental providers can submit claim attachments directly to payers in real time. This centralized API makes it easier for dental providers to submit supporting documentation – such as imaging, narratives or other records – so you can spend less time on administrative tasks and more time with patients.
For UnitedHealthcare, this will be processed as a trial claim. For all other payers, it will be a pre-care estimate.
Transforming dental claim processing
With real-time exchange of patient visit, claim and payment data between dental payers and providers, Optum Real for Dental helps provide insight into how a payer will likely process a claim, notifies them of likely denials and gives patients a clear picture of how much they’ll owe — before care is delivered.
By streamlining claim processing, Optum Real for Dental helps improve claim denial and appeal rates, reduce administrative costs and minimize back-and-forth between payers and providers.
Transforming dental claim processing
With real-time exchange of patient visit, claim and payment data between dental payers and providers, Optum Real for Dental helps provide insight into how a payer will likely process a claim, notifies them of likely denials and gives patients a clear picture of how much they’ll owe — before care is delivered.
By streamlining claim processing, Optum Real for Dental helps improve claim denial and appeal rates, reduce administrative costs and minimize back-and-forth between payers and providers.
Developer Resources
Try before subscribe – Request access to sandbox credentials for all Optum Real Dental APIs
Q: How can I test the Real APIs before subscribing?
A: You can request access to the AI Marketplace sandbox environment to test sample API responses by scrolling up to Developer Resources and clicking “Request sandbox.” After you submit the form, you'll receive credentials that allow you to integrate your software with the sandbox environment. You can use these credentials to test the APIs in our interactive environment on the Try It page or use an application like Postman. Please note: The pre-subscription sandbox will only return responses based on preloaded data until your Real API subscription status is “subscribed.”
Q: Can I subscribe to multiple Real APIs for Dental Providers?
A: Yes, you can subscribe to one or more Real APIs for Dental Providers. The subscriptions will align to the same set of API credentials whether they are ordered at the same time or not.
Q: What payers do the Real APIs cover?
A: For a listing of payer ID coverage for each API, please refer to the Optum Real Supported Payer IDs by API Capability page in the developer portal.
Q: Can software vendors subscribe to the Real APIs on behalf of their provider clients?
A: Yes. Once the API subscription is implemented, the software vendor's account administrator will be contacted for their provider clients' billing TINs so they can be associated with the active account subscription.
Q: What organization name do I use when creating my AI Marketplace account?
A: Please use your employer's organization name listed on the active W-9 form filed with the IRS.
Q: What billing information should I use for the subscription?
A: Please use the name of the organization that will use the API. The organization name from your user account is auto-populated into the billing information section when subscribing. If there is a discrepancy with the auto-populated name, please call 866-678-8646 (choose option 2) or visit our customer support portal.
Q: How can I make changes to my AI Marketplace account?
A: Once a One Healthcare ID is assigned to your AI Marketplace account, you must contact AI Marketplace support at 866-678-8646 (choose option 2) or visit our customer support portal to make changes.
Q: How can I test the Real APIs in a lower environment after subscribing but prior to live implementation within my organization?
A: Currently, the sandbox only returns sample API responses. It does not support live data testing at this time As a temporary option to test live data, Optum Real customers may consider configuring their production environment to point to a non-production environment of the host system. Please note: If you requested access to the sandbox prior to purchase, you would use the same set of credentials.
Q: Is there support available if I experience issues with my implementation?
A: Yes. Please call 866-678-8646 (and choose option 2) or visit our customer support portal.
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