Optum Medical Network Eligibility and Claims API

openapi: 3.0.3
info:
  title: Dental Attachment API
  description: The Dental Attachment API offers functionality related toDental Attachment.
  version: 2.2.0
security:
- Bearer: []
servers:
- url: https://sandbox-apigw.optum.com
paths:
  /dentalnetwork/attachments/v1/CreateAttachment:
    post:
      summary: Create attachment container
      tags:
      - Attachment
      requestBody:
        description: Creates an attachment container that can contain a claim with its attachments. Whenever
          a claim is submitted with attachment(s), the container creates an Optum Attachment ID.
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/Attachment'
      responses:
        '201':
          description: 201 Created
        '400':
          description: Bad Request
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: Forbidden
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: The resource could not be found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '422':
          description: Unprocessable Entity.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: Internal Server Error.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/AddAttachment:
    post:
      summary: Add attachment files
      tags:
      - Attachment
      requestBody:
        description: Uploads an attachment file to an existing attachment container with its Optum Attachment
          ID.
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/AttachmentFile'
      responses:
        '201':
          description: Created
        '400':
          description: Bad Request.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: Forbidden.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: The resource could not be found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: An unexpected error occurred.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/{attachmentId}/UpdateAttachmentFile/{attachmentFileId}:
    put:
      summary: Update attachment to container.
      tags:
      - Attachment
      requestBody:
        description: Modifies/updates the attachment file information, such as ImageDate, DocumentTypeCode,
          Narrative, or OrientationType.
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/AttachmentFile'
      parameters:
      - name: attachmentId
        in: path
        schema:
          type: integer
        required: true
        description: The id of the attachment record
        example: 12345433
      - name: attachmentFileId
        in: path
        schema:
          type: integer
        required: true
        description: 'The id of the attachment file '
        example: 1233456        -
      responses:
        '200':
          description: OK
        '400':
          description: Bad Request
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: Forbidden.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: The resource could not be found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: An unexpected error occurred.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/CommitAttachment/{attachmentId}:
    patch:
      summary: Commits the attachment container and files
      description: Commits the attachment container and files. Once the attachment is committed, you can
        add files but cannot update/modify the attachment container and files.
      tags:
      - Attachment
      parameters:
      - name: attachmentId
        in: path
        schema:
          type: integer
        required: true
        description: The id of the unsubmitted claim to submit
        example: 12345
      responses:
        '200':
          description: Ok
        '400':
          description: The request has missing, invalid, or malformed data.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: Forbidden.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: The given unsubmitted claim does not exist.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '409':
          description: The given claim has already been submitted.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '412':
          description: The given claim is not in a suitable state to be submitted.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: Internal Server Error.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/GetAttachmentbyId/{attachmentId}:
    get:
      summary: Gets an attachment container.
      description: Gets the attachment contatiner created by the /attachments/v1/CreateAttachment endpoint
      tags:
      - Attachment
      parameters:
      - name: attachmentId
        in: path
        schema:
          type: integer
        required: true
        description: The id of the attachmentid claim
        example: 123456
      responses:
        '200':
          description: Success
        '400':
          description: The request has missing, invalid, or malformed data.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '401':
          description: The request is not authorized.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: The requestor is forbidden to access this resource.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: The given unsubmitted claim does not exist.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: An unexpected error occurred.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/GetAttachmentList/{AttachmentId}:
    get:
      summary: Get attachment files from container
      description: Gets all the attachment files from the container
      tags:
      - Attachment
      parameters:
      - name: AttachmentId
        in: path
        schema:
          type: integer
        required: true
        description: The AttachmentId of the Container
        example: 898238
      responses:
        '200':
          description: OK
        '400':
          description: The request has missing, invalid, or malformed data.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: The requestor is forbidden to access this resource.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: Not Found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: Internal Server Error.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/{attachmentId}/DeleteAttachmentFile/{attachmentFileId}:
    delete:
      summary: Delete attachment file
      description: Submitter can delete files from the attachment container.
      tags:
      - Attachment
      parameters:
      - name: attachmentId
        in: path
        schema:
          type: integer
        description: The AttachmentId is Id for the Attachment Container.
        example: 123456
        required: true
      - name: attachmentFileId
        in: path
        schema:
          type: integer
        description: The id of the Attachment File to delete it from attachment container.
        example: 123456
        required: true
      responses:
        '200':
          description: OK
        '400':
          description: The request has missing, invalid, or malformed data.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: Cannot delete a committed attachment file.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: If a “Delete” is attempted on a file that has previously been deleted a 404 will
            be returned.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '412':
          description: The given customer route does not exist.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: An unexpected error occurred.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/GetAllParticipatingPayers:
    get:
      summary: Get participating payers
      description: Optum maintains a list of payers that participate in the attachments solutions. This
        endpoint gets all of the participating payers.
      tags:
      - Attachment
      responses:
        '200':
          description: Success
        '400':
          description: The request has missing, invalid, or malformed data.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: Forbidded.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: The resource could not be found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: Internal Server Error.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/IsParticipatingPayer:
    get:
      summary: Check participating payer by payer ID
      description: Optum maintains a list of payers that participate in the attachments solutions. This
        endpoint gets participating payer by Payer.
      tags:
      - Attachment
      parameters:
      - name: payerid
        in: query
        schema:
          type: string
        description: The id of the account that owns this Legal Entity.
        required: true
      responses:
        '200':
          description: Success
        '400':
          description: Bad Request.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: The requestor is forbidden to access this resource.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: The resource could not be found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '412':
          description: The account resource does not exist.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: Internal Server Error.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /dentalnetwork/attachments/v1/GetPayerBusinessRules/me:
    get:
      summary: Get payer business rule
      description: Optum stores each payer’s rules for the procedure codes that require an attachment.
        If an attachment rule exists, it will be returned along with any details related to the attachment
        requirement.
      tags:
      - Attachment
      parameters:
      - name: payerid
        in: query
        schema:
          type: string
        description: Identifies the payer to Optum.
        required: true
      - name: procedurecodes
        in: query
        schema:
          type: array
          items:
            type: string
      responses:
        '200':
          description: Success
        '400':
          description: Bad Request.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '401':
          description: The request is not authorized.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: Forbidded.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: Not Found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: Internal Server Error.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
  /apip/auth/v2/token:
    post:
      summary: To generate token.
      tags:
      - Attachment
      requestBody:
        description: Generate token to verify access.
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/AttachmentFile'
      responses:
        '200':
          description: Success
        '400':
          description: The request has missing, invalid, or malformed data.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '403':
          description: Forbidded.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '404':
          description: The resource could not be found.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '429':
          description: The requestor has sent more requests within a given timeframe than allowed.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '500':
          description: Internal Server Error.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '502':
          description: An unexpected error occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '503':
          description: The endpoint is not available, or an unknown endpoint has been requested.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
        '504':
          description: A timeout has occurred within a gateway.
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/ErrorResponse'
components:
  securitySchemes:
    Bearer:
      type: oauth2
      flows:
        clientCredentials:
          scopes: {}
          tokenUrl: '{{baseUrl}}/apip/auth/v2/token'
  schemas:
    Attachment:
      type: object
      properties:
        vendorId:
          type: integer
          format: int32
        vendorTransactionId:
          type: integer
          format: int32
        vendorClaimId:
          type: string
          nullable: true
        attachmentId:
          type: integer
          format: int32
        clearinghouseTraceNumber:
          type: string
          nullable: true
        payerId:
          type: string
          nullable: true
        payerName:
          type: string
          nullable: true
        payerReferenceNumber:
          type: string
          nullable: true
        payerContactName:
          type: string
          nullable: true
        payerCommNumberQualifier1:
          type: string
          nullable: true
        payerCommNumber1:
          type: string
          nullable: true
        payerCommNumberQualifier2:
          type: string
          nullable: true
        payerCommNumber2:
          type: string
          nullable: true
        payerCommNumberQualifier3:
          type: string
          nullable: true
        payerCommNumber3:
          type: string
          nullable: true
        providerEntityType:
          type: integer
          format: int32
        billingProviderTaxId:
          type: string
          nullable: true
        billingProviderNpi:
          type: string
          nullable: true
        billingProviderLastName:
          type: string
          nullable: true
        billingProviderFirstName:
          type: string
          nullable: true
        billingProviderTaxonomyCode:
          type: string
          nullable: true
        billingProviderStreetAddress:
          type: string
          nullable: true
        billingProviderCity:
          type: string
          nullable: true
        billingProviderState:
          type: string
          nullable: true
        billingProviderZipCode:
          type: string
          nullable: true
        renderingProviderNpi:
          type: string
          nullable: true
        renderingProviderLastName:
          type: string
          nullable: true
        renderingProviderFirstName:
          type: string
          nullable: true
        patientControlNumber:
          type: string
          nullable: true
        patientLastName:
          type: string
          nullable: true
        patientFirstName:
          type: string
          nullable: true
        patientDob:
          type: string
          format: date-time
        insuredId:
          type: string
          nullable: true
        insuredLastName:
          type: string
          nullable: true
        insuredFirstName:
          type: string
          nullable: true
        insuredDob:
          type: string
          format: date-time
        serviceDateLow:
          type: string
          format: date-time
        serviceDateHigh:
          type: string
          format: date-time
        totalChargeAmt:
          type: number
          format: double
        statusCode:
          type: integer
          format: int32
        statusDate:
          type: string
          format: date-time
        isServiceLineRequest:
          type: boolean
        serviceLineReferenceNumber:
          type: string
          nullable: true
        serviceLineChargeAmt:
          type: number
          format: double
        procedureCode:
          type: string
          nullable: true
        loincCode:
          type: string
          nullable: true
        requestDate:
          type: string
          format: date-time
        isCommitted:
          type: boolean
        isSolicited:
          type: boolean
        attachmentFile:
          type: array
          items:
            $ref: '#/components/schemas/AttachmentFile'
          nullable: true
        links:
          type: array
          items:
            $ref: '#/components/schemas/Link'
          nullable: true
      additionalProperties: false
    AttachmentFile:
      type: object
      properties:
        attachmentFileId:
          type: integer
          format: int32
        attachmentId:
          type: integer
          format: int32
        vendorId:
          type: integer
          format: int32
        dateProcessed:
          type: string
          format: date-time
        documentTypeCode:
          type: integer
          format: int32
        imageDate:
          type: string
          format: date-time
        orientationCode:
          type: integer
          format: int32
        narrative:
          type: string
          nullable: true
        pageCount:
          type: integer
          format: int32
        fileChecksum:
          type: string
          nullable: true
        fileSize:
          type: integer
          format: int32
        fileExtension:
          type: string
          nullable: true
        fileName:
          type: string
          nullable: true
        attachmentFileData:
          type: string
          format: byte
          nullable: true
        attachmentFileContent:
          type: string
          nullable: true
        links:
          type: array
          items:
            $ref: '#/components/schemas/Link'
          nullable: true
      additionalProperties: false
    HttpVersionPolicy:
      enum:
      - 0
      - 1
      - 2
      type: integer
      format: int32
    Link:
      type: object
      properties:
        rel:
          type: string
          nullable: true
        href:
          type: string
          nullable: true
        action:
          type: string
          nullable: true
        types:
          type: string
          nullable: true
      additionalProperties: false
    StringStringIEnumerableKeyValuePair:
      type: object
      properties:
        key:
          type: string
          nullable: true
        value:
          type: array
          items:
            type: string
          nullable: true
      additionalProp

# --- truncated at 32 KB (34 KB total) ---
# Full source: https://raw.githubusercontent.com/api-evangelist/optum/refs/heads/main/openapi/optum-dental-attachment-api-openapi.yml