Optum

Optum Next Question API

The NextQuestion API from Optum — 1 operation(s) for nextquestion.

Documentation GitHub OpenAPI

Business capability

Eligibility & Benefits Verification BC-2800.30

Operations 1

POST /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Questionnaire/$next-question #

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OpenAPI Specification

openapi: 3.2.0
info:
  title: Real Prior Authorization Next Question API
  description: FHIR Prior Authorization APIs (CDS, DTR, PAS)
  version: 1.0.0
servers:
- url: https://sandbox-apigw.optum.com
tags:
- name: NextQuestion
paths:
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Questionnaire/$next-question:
    post:
      operationId: getNextQuestion
      tags:
      - NextQuestion
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: bh
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          description: Unique transaction identifier
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          description: Environment name
          example: sandbox
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/NextQuestionRequest'
            example:
              resourceType: QuestionnaireResponse
              id: 62b12331-3b16-4345-a1a6-6e60b236e6a5
              meta:
                profile:
                - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt
              contained:
              - resourceType: Questionnaire
                id: '12345'
                meta:
                  profile:
                  - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-adapt
                extension:
                - url: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive
                  valueBoolean: true
                name: Questionnaire name
                title: Questionnaire title
                status: active
                date: '2025-07-03T00:00:00-05:00'
                description: Questionnaire description
              extension:
              - url: http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context
                valueReference:
                  reference: Coverage/CoverageExample
              questionnaire: '#12345'
              status: in-progress
              subject:
                reference: Patient/anonymous
              authored: '2025-11-04T12:12:59.7131+00:00'
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/NextQuestionResponse'
              example:
                resourceType: QuestionnaireResponse
                meta:
                  profile:
                  - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt
                contained:
                - resourceType: Questionnaire
                  id: '12345'
                  meta:
                    profile:
                    - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-adapt
                  extension:
                  - url: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive
                    valueBoolean: true
                  name: Questionnaire name
                  title: Questionnaire title
                  status: active
                  date: '2025-07-03T05:00:00+00:00'
                  description: Questionnaire description
                  item:
                  - id: '1264854090'
                    extension:
                    - url: http://hl7.org/fhir/StructureDefinition/questionnaire-supportLink
                      valueUri: https://apimarketplace.uhcprovider.com/DTR_DOC_REF_API
                    linkId: '1'
                    text: 'Choose one:'
                    type: choice
                    required: true
                    repeats: false
                    answerOption:
                    - valueCoding:
                        code: '1'
                        display: Age ≥ 50
                    - valueCoding:
                        code: '2'
                        display: Age < 50
                extension:
                - url: http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context
                  valueReference:
                    reference: Coverage/CoverageExample
                questionnaire: '#12345'
                status: in-progress
                subject:
                  reference: Patient/anonymous
                authored: '2025-11-04T12:12:59.7131+00:00'
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
components:
  schemas:
    Item:
      type: object
      description: Questionnaire item (question)
      properties:
        id:
          type: string
          example: '1264854090'
        linkId:
          type: string
          example: '1'
        text:
          type: string
          example: 'Choose one:'
        type:
          type: string
          example: choice
        required:
          type: boolean
          example: true
        repeats:
          type: boolean
          example: false
        extension:
          type: array
          items:
            $ref: '#/components/schemas/ExtensionGeneric'
        answerOption:
          type: array
          items:
            $ref: '#/components/schemas/AnswerOption'
        item:
          type: array
          description: Nested child questions
          items:
            $ref: '#/components/schemas/Item'
    ExtensionGeneric:
      type: object
      description: Generic extension supporting multiple value types
      properties:
        url:
          type: string
          example: http://hl7.org/fhir/StructureDefinition/questionnaire-supportLink
        valueBoolean:
          type: boolean
          example: true
        valueUri:
          type: string
          example: https://apimarketplace.uhcprovider.com/DTR_DOC_REF_API
    Questionnaire:
      type: object
      description: FHIR Questionnaire resource
      properties:
        resourceType:
          type: string
          example: Questionnaire
        id:
          type: string
          example: '12345'
        meta:
          $ref: '#/components/schemas/Meta'
        extension:
          type: array
          description: Questionnaire extensions
          items:
            $ref: '#/components/schemas/ExtensionGeneric'
        name:
          type: string
          description: Questionnaire name
          example: Questionnaire name
        title:
          type: string
          description: Questionnaire title
          example: Questionnaire title
        status:
          type: string
          description: Questionnaire status
          example: active
        date:
          type: string
          description: Date of creation
          example: '2025-07-03T00:00:00-05:00'
        description:
          type: string
          description: Questionnaire description
          example: Questionnaire description
        item:
          type: array
          description: List of questions
          items:
            $ref: '#/components/schemas/Item'
    Meta:
      type: object
      description: FHIR metadata
      properties:
        profile:
          type: array
          description: FHIR profile URLs
          items:
            type: string
            example: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt
    Extension:
      type: object
      description: FHIR extension with Reference
      properties:
        url:
          type: string
          example: http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context
        valueReference:
          $ref: '#/components/schemas/Reference'
    Coding:
      type: object
      description: Coding structure for answers
      properties:
        code:
          type: string
          example: '1'
        display:
          type: string
          example: Age ≥ 50
    Reference:
      type: object
      description: FHIR Reference
      properties:
        reference:
          type: string
          example: Patient/anonymous
    NextQuestionRequest:
      type: object
      description: FHIR QuestionnaireResponse request containing current answers and context to fetch next adaptive question
      properties:
        resourceType:
          type: string
          description: FHIR resource type
          example: QuestionnaireResponse
        id:
          type: string
          description: Unique QuestionnaireResponse identifier
          example: 62b12331-3b16-4345-a1a6-6e60b236e6a5
        meta:
          $ref: '#/components/schemas/Meta'
        contained:
          type: array
          description: Contained Questionnaire resource
          items:
            $ref: '#/components/schemas/Questionnaire'
        extension:
          type: array
          description: FHIR extensions providing additional context
          items:
            $ref: '#/components/schemas/Extension'
        questionnaire:
          type: string
          description: Reference to Questionnaire
          example: '#12345'
        status:
          type: string
          description: QuestionnaireResponse status
          example: in-progress
        subject:
          $ref: '#/components/schemas/Reference'
        authored:
          type: string
          description: Date/time when response was authored
          example: '2025-11-04T12:12:59.7131+00:00'
    NextQuestionResponse:
      type: object
      description: FHIR QuestionnaireResponse response containing next adaptive question
      properties:
        resourceType:
          type: string
          example: QuestionnaireResponse
        meta:
          $ref: '#/components/schemas/Meta'
        contained:
          type: array
          description: Contained Questionnaire with next question items
          items:
            $ref: '#/components/schemas/Questionnaire'
        extension:
          type: array
          items:
            $ref: '#/components/schemas/Extension'
        questionnaire:
          type: string
          example: '#12345'
        status:
          type: string
          example: in-progress
        subject:
          $ref: '#/components/schemas/Reference'
        authored:
          type: string
          example: '2025-11-04T12:12:59.7131+00:00'
    AnswerOption:
      type: object
      description: Answer choice option
      properties:
        valueCoding:
          $ref: '#/components/schemas/Coding'
  securitySchemes:
    oAuth:
      type: oauth2
      description: This API uses OAuth 2 with the client_credentials grant flow.
      flows:
        clientCredentials:
          tokenUrl: /apip/auth/v2/token
          scopes:
            read_txn: read transactions
            create_txn: submit a new transaction request
            read_coveragediscovery: read coverage discovery tasks
            create_coveragediscovery: submit a new coverage discovery task
            read_healthcheck: check the status of the system
x-readme:
  explorer-enabled: true
  proxy-enabled: true