Optum

Optum Payments API

The Payments API from Optum — 2 operation(s) for payments.

Documentation GitHub OpenAPI

Operations 3

GET /payments/pes-payer-enrollments/v1 GET PES Payer Enrollments #

PATCH /payments/pes-payer-enrollments/v1 PATCH PES Payer Enrollment #

GET /payments/pes-payer-enrollments/v1/enrollment-status GET PES Payer Enrollments Status #

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OpenAPI Specification

openapi: 3.2.0
info:
  title: PES Payer Enrollments V1 Payments API
  version: '1.0'
  contact:
    name: Michael Perusko
  description: API for PES enrollments
servers:
- url: https://sandbox-apigw.optum.com/
tags:
- name: Payments
paths:
  /payments/pes-payer-enrollments/v1:
    get:
      summary: GET PES Payer Enrollments
      tags:
      - Payments
      responses:
        '200':
          description: OK
          content:
            application/json:
              schema:
                type: array
                items:
                  type: object
                  properties:
                    tin:
                      type: string
                      minLength: 7
                      maxLength: 9
                    tinType:
                      type: string
                      enum:
                      - EIN
                      - SSN
                    name:
                      type: string
                      minLength: 2
                      maxLength: 80
                      example: Test Provider Name
                    dba:
                      type: string
                      maxLength: 80
                    submitterEmail:
                      type: string
                      description: Email address that executed the last activity
                      maxLength: 128
                      minLength: 5
                      example: test@example.com
                    submittedTimestamp:
                      type: string
                      description: Last activity timestamp in ISO 8601 format
                      example: '2021-04-15T00:00:00Z'
                    verificationTimestamp:
                      type: string
                      description: Last activity timestamp in ISO 8601 format
                      example: '2021-04-15T00:00:00Z'
                    address:
                      type: object
                      properties:
                        addressLine1:
                          type: string
                          minLength: 1
                          maxLength: 50
                        addressLine2:
                          type: string
                          maxLength: 50
                        city:
                          type: string
                          minLength: 1
                          maxLength: 60
                        state:
                          type: string
                          minLength: 2
                          maxLength: 2
                        zip:
                          type: string
                          minLength: 5
                          maxLength: 10
                    contact:
                      type: object
                      properties:
                        firstName:
                          type: string
                          minLength: 1
                          maxLength: 64
                        lastName:
                          type: string
                          minLength: 1
                          maxLength: 64
                        phone:
                          type: string
                          maxLength: 15
                        ext:
                          type: string
                          minLength: 1
                          maxLength: 15
                        email:
                          type: string
                          minLength: 5
                          maxLength: 128
                    agent:
                      type: object
                      properties:
                        companyName:
                          type: string
                          minLength: 2
                          maxLength: 80
                        firstName:
                          type: string
                          minLength: 1
                          maxLength: 64
                        lastName:
                          type: string
                          minLength: 1
                          maxLength: 64
                        phone:
                          type: string
                          maxLength: 15
                        ext:
                          type: string
                          minLength: 1
                          maxLength: 15
                        email:
                          type: string
                          minLength: 5
                          maxLength: 128
                    signee:
                      type: object
                      properties:
                        firstName:
                          type: string
                          minLength: 1
                          maxLength: 64
                        lastName:
                          type: string
                          minLength: 1
                          maxLength: 64
                        signatureTimestamp:
                          type: string
                          example: '2021-04-15T00:00:00Z'
                    eftEnrollments:
                      type: array
                      items:
                        type: object
                        properties:
                          enrollmentId:
                            type: number
                          changesetId:
                            type: number
                          payerName:
                            type: string
                            maxLength: 100
                          activityType:
                            type: string
                            enum:
                            - NEW
                            - CHANGE
                            - CANCELLATION
                          groupingPreference:
                            type: string
                            enum:
                            - TIN
                            - NPI
                          status:
                            type: string
                            enum:
                            - APPROVED
                            - REJECTED
                            - TERMINATED
                            - CANCELLED
                          submitterEmail:
                            type: string
                            description: Email address that executed the last activity
                            minLength: 5
                            maxLength: 128
                          submittedTimestamp:
                            type: string
                            description: Last activity timestamp in ISO 8601 format
                            example: '2021-04-15T00:00:00Z'
                          verificationTimestamp:
                            type: string
                            description: Last activity timestamp in ISO 8601 format
                            example: '2021-04-15T00:00:00Z'
                          npis:
                            type: array
                            items:
                              type: string
                              minLength: 10
                              maxLength: 10
                          bank:
                            type: object
                            properties:
                              bankName:
                                type: string
                                minLength: 2
                                maxLength: 128
                              ownerType:
                                type: string
                                enum:
                                - BUSINESS
                                - INDIVIDUAL
                              ownerBusinessName:
                                type: string
                                minLength: 2
                                maxLength: 80
                              ownerFirstName:
                                type: string
                                minLength: 1
                                maxLength: 64
                              ownerLastName:
                                type: string
                                minLength: 1
                                maxLength: 64
                              routingNumber:
                                type: string
                                minLength: 1
                                maxLength: 50
                              accountNumber:
                                type: string
                                minLength: 4
                                maxLength: 50
                              accountType:
                                type: string
                                enum:
                                - CHECKING
                                - SAVINGS
                    eraEnrollments:
                      type: array
                      items:
                        type: object
                        properties:
                          enrollmentId:
                            type: number
                          changesetId:
                            type: number
                          payerName:
                            type: string
                            maxLength: 100
                          activityType:
                            type: string
                            enum:
                            - NEW
                            - CHANGE
                            - CANCELLATION
                          groupingPreference:
                            type: string
                            enum:
                            - TIN
                            - NPI
                          status:
                            type: string
                            enum:
                            - APPROVED
                            - REJECTED
                            - TERMINATED
                            - CANCELLED
                          submitterEmail:
                            type: string
                            description: Email address that executed the last activity
                            minLength: 5
                            maxLength: 128
                          submittedTimestamp:
                            type: string
                            description: Last activity timestamp in ISO 8601 format
                            example: '2021-04-15T00:00:00Z'
                          verificationTimestamp:
                            type: string
                            description: Last activity timestamp in ISO 8601 format
                            example: '2021-04-15T00:00:00Z'
                          npis:
                            type: array
                            items:
                              type: string
                              maxLength: 10
                              minLength: 10
                          eraRetrievalMethod:
                            type: string
                            maxLength: 100
                          eraRetrievalValue:
                            type: string
                            maxLength: 100
              examples:
                Success Example:
                  value:
                  - tin: '123456789'
                    tinType: EIN
                    name: Test Provider
                    dba: Test DBA
                    submitterEmail: user@example.com
                    submittedTimestamp: '2021-04-20T00:00:00Z'
                    verificationTimestamp: '2021-04-20T00:00:00Z'
                    address:
                      addressLine1: 123 Main St.
                      addressLine2: ''
                      city: New York
                      state: NY
                      zip: '01234'
                    contact:
                      firstName: John
                      lastName: Doe
                      phone: 555-555-5555
                      ext: '12345'
                      email: user@example.com
                    agent:
                      companyName: Test Agent Company
                      firstName: Jane
                      lastName: Smith
                      phone: 555-555-5555
                      ext: '12345'
                      email: user@example.com
                    signee:
                      firstName: John
                      lastName: Doe
                      signatureTimestamp: '2021-04-16T00:00:00Z'
                    eftEnrollments:
                    - enrollmentId: 5000001
                      changesetId: 123
                      payerName: Test Provider
                      activityType: NEW
                      service: EFT
                      groupingPreference: NPI
                      status: APPROVED
                      submitterEmail: user@example.com
                      submittedTimestamp: '2021-04-20T00:00:00Z'
                      verificationTimestamp: '2021-04-20T00:00:00Z'
                      npis:
                      - 0123456789
                      - '9876543210'
                      bank:
                        bankName: Test National Bank
                        ownerFirstName: John
                        ownerLastName: Doe
                        routingNumber: '123456789'
                        accountNumber: '9876543210'
                        accountType: CHECKING
                    eraEnrollments:
                    - enrollmentId: 5000002
                      changesetId: 124
                      payerName: Test Provider
                      activityType: NEW
                      service: ERA
                      groupingPreference: NPI
                      status: APPROVED
                      submitterEmail: user@example.com
                      submittedTimestamp: '2021-04-20T00:00:00Z'
                      verificationTimestamp: '2021-04-20T00:00:00Z'
                      npis:
                      - 0123456789
                      - '9876543210'
                      eraRetrievalMethod: Clearinghouse
                      eraRetrievalValue: Change Healthcare
                      tradingPartnerId: TPID123456
        '401':
          description: Status 401
          content:
            application/json:
              schema:
                description: ''
                type: object
                properties:
                  error:
                    type: string
                    minLength: 1
                  error_description:
                    type: string
                    minLength: 1
                required:
                - error
                - error_description
              examples:
                Unauthorized Example:
                  value:
                    error: invalid_request
                    error_description: The access token is missing
        '422':
          description: Status 422
          content:
            application/json:
              schema:
                type: object
                required:
                - code
                - message
                properties:
                  code:
                    type: string
                    description: 'The error code. The format of the error code is MPS-####, where #### is a four digit code representing the type of error. 1024 is the code for a JSON schema validation error, and the schemaValidationErrors property will be populated.'
                  message:
                    type: string
                    description: The error message
                  schemaValidationErrors:
                    type: array
                    description: Optional array of objects that contain the fields that have JSON schema validation errors and what the failure is.
                    items:
                      type: object
                      required:
                      - field
                      - message
                      properties:
                        field:
                          type: string
                          description: The field with the JSON schema error
                        message:
                          type: string
                          description: The JSON schema error
                    minItems: 1
              examples:
                Validation Example:
                  value:
                    code: PES-1234
                    message: A JSON schema validation error occurred
                    schemaValidationErrors:
                    - field: data.startTimestamp
                      message: is required
        '500':
          description: Status 500
          content:
            application/json:
              schema:
                type: object
                properties:
                  code:
                    type: string
                  message:
                    type: string
              examples:
                Error example:
                  value:
                    code: PES-1000
                    message: An unexpected error occurred
      operationId: get-pes-enrollments
      parameters:
      - schema:
          type: string
        in: header
        name: Authorization
        description: Bearer token
        required: true
      - schema:
          type: string
          example: '2021-04-01T00:00:00Z'
        in: query
        name: startTimestamp
        description: Start timestamp in ISO 8601 format
        required: true
      - schema:
          type: string
          example: '2021-04-15T00:00:00Z'
        in: query
        name: endTimestamp
        description: End timestamp in ISO 8601 format
        required: true
      - schema:
          type: string
        in: header
        name: X-CHC-CorrelationId
        description: Unique ID for the request
      - schema:
          type: string
          enum:
          - ERA
          - EFT
          - ALL
        in: query
        name: service
        description: If not passed, will return enrollments for all services
      - schema:
          type: string
          enum:
          - APPROVED
          - REJECTED
          - TERMINATED
          - CANCELLED
          - ALL
        in: query
        name: status
        description: If not passed, will return enrollments for all statuses
      - schema:
          type: string
          enum:
          - NEW
          - CHANGE
          - CANCELLATION
          - ALL
        in: query
        name: activityType
        description: If not passed, will return enrollments for all activity types
      description: Retrieve PES enrollments
    patch:
      summary: PATCH PES Payer Enrollment
      tags:
      - Payments
      operationId: patch-pes-payer-enrollments-v1
      responses:
        '200':
          description: OK
          content:
            application/json:
              schema:
                type: object
                properties:
                  enrollmentId:
                    type: number
                  changesetId:
                    type: number
                  status:
                    type: string
                    enum:
                    - PAYER APPROVED
                    - PAYER REJECTED
                  rejectedReasonCode:
                    type: string
                    enum:
                    - '0001'
                    - '0002'
              examples:
                Successful Example:
                  value:
                    enrollmentId: 5000001
                    changesetId: 123
                    status: PAYER APPROVED
                Rejected Example:
                  value:
                    enrollmentId: 5000002
                    status: PAYER REJECTED
        '401':
          description: Status 401
          content:
            application/json:
              schema:
                description: ''
                type: object
                properties:
                  error:
                    type: string
                    minLength: 1
                  error_description:
                    type: string
                    minLength: 1
                required:
                - error
                - error_description
              examples:
                Unauthorized Example:
                  value:
                    error: invalid_request
                    error_description: The access token is missing
        '422':
          description: Status 422
          content:
            application/json:
              schema:
                type: object
                required:
                - code
                - message
                properties:
                  code:
                    type: string
                    description: 'The error code. The format of the error code is MPS-####, where #### is a four digit code representing the type of error. 1024 is the code for a JSON schema validation error, and the schemaValidationErrors property will be populated.'
                  message:
                    type: string
                    description: The error message
                  schemaValidationErrors:
                    type: array
                    description: Optional array of objects that contain the fields that have JSON schema validation errors and what the failure is.
                    items:
                      type: object
                      required:
                      - field
                      - message
                      properties:
                        field:
                          type: string
                          description: The field with the JSON schema error
                        message:
                          type: string
                          description: The JSON schema error
                    minItems: 1
              examples:
                Schema Validation Error Example:
                  value:
                    code: PES-1234
                    message: A JSON schema validation error occurred
                    schemaValidationErrors:
                    - field: data.enrollmentId
                      message: is required
        '500':
          description: Status 500
          content:
            application/json:
              schema:
                type: object
                properties:
                  code:
                    type: string
                  message:
                    type: string
              examples:
                Error example:
                  value:
                    code: PES-1000
                    message: An unexpected error occurred
      requestBody:
        content:
          application/json:
            schema:
              type: object
              properties:
                enrollmentId:
                  type: string
                changesetId:
                  type: string
                status:
                  type: string
                  enum:
                  - PAYER APPROVED
                  - PAYER REJECTED
                rejectedReasonCode:
                  type: string
                  enum:
                  - '0001'
                  - '0002'
                  - '0003'
                  - '0004'
                  - '0005'
                  - '0006'
                  - '0007'
              required:
              - enrollmentId
              - status
      description: Update PES payer enrollment status
      parameters:
      - schema:
          type: string
        in: header
        name: Authorization
        description: Bearer token
        required: true
      - schema:
          type: string
        in: header
        name: X-CHC-CorrelationId
        description: Unique ID for the request
  /payments/pes-payer-enrollments/v1/enrollment-status:
    get:
      summary: GET PES Payer Enrollments Status
      tags:
      - Payments
      responses:
        '200':
          description: OK
          content:
            application/json:
              schema:
                type: array
                items:
                  type: object
                  properties:
                    tin:
                      type: string
                      minLength: 7
                      maxLength: 9
                      example: 123456789
                    name:
                      type: string
                      minLength: 2
                      maxLength: 80
                      example: Test Provider Name
                    billingNpi:
                      type: string
                      minLength: 10
                      maxLength: 10
                      example: 1234567890
                    exemptFromNpi:
                      type: boolean
                      example: false
                    eftEnrollments:
                      type: array
                      items:
                        type: object
                        properties:
                          enrollmentId:
                            type: number
                          payerName:
                            type: string
                          service:
                            type: string
                            enum:
                            - EFT
                          groupingPreference:
                            type: string
                            enum:
                            - TIN
                            - NPI
                          status:
                            type: string
                            enum:
                            - Approved
                            - Rejected
                            - Terminated
                            - Cancelled
                            - In Progress
                            - In Progress Aged
                            - Submitted
                            - Manual Review
                            - Risk Review
                            - Returned to Customer
                            - Pending Attachments
                            - Duplicate
                            - Withdrawn
                            - Payer Approved
                            - Payer Rejected
                          npis:
                            type: array
                            items:
                              type: string
                              minLength: 10
                              maxLength: 10
                          updatedAt:
                            type: string
                            description: Last activity timestamp in ISO 8601 format
                            example: '2022-01-01T00:00:00Z'
                    eraEnrollments:
                      type: array
                      items:
                        type: object
                        properties:
                          enrollmentId:
                            type: number
                          payerName:
                            type: string
                          service:
                            type: string
                            enum:
                            - ERA
                          groupingPreference:
                            type: string
                            enum:
                            - TIN
                            - NPI
                          status:
                            type: string
                            enum:
                            - Approved
                            - Rejected
                            - Terminated
                            - Cancelled
                            - In Progress
                            - In Progress Aged
                            - Submitted
                            - Manual Review
                            - Risk Review
                            - Returned to Customer
                            - Pending Attachments
                            - Duplicate
                            - Withdrawn
                            - Payer Approved
                            - Payer Rejected
                          npis:
                            type: array
                            items:
                              type: string
                              minLength: 10
                              maxLength: 10
                          updatedAt:
                            type: string
                            description: Last activity timestamp in ISO 8601 format
                            example: '2022-01-01T00:00:00Z'
              examples:
                Success Example:
                  value:
                  - tin: '123456789'
                    name: Test Provider
                    billingNpi: '1234567890'
                    exemptFromNpi: false
                    eftEnrollments:
                    - enrollmentId: 5000001
                      payerName: BlueCross BlueShield of Tennessee
                      service: EFT
                      groupingPreference: NPI
                      status: APPROVED
                      npis:
                      - 0123456789
                      - '9876543210'
                      updatedAt: '2022-05-01T00:00:00Z'
                    eraEnrollments:
                    - enrollmentId: 5000002
                      payerName: BlueCross BlueShield of Tennessee
                      service: ERA
                      groupingPreference: NPI
                      status: APPROVED
                      npis:
                      - 0123456789
                      - '9876543210'
                      updatedAt: '2022-05-01T00:00:00Z'
                Success Example - no data return:
                  value:
                    message: Provider not found
        '400':
          description: Status 400
          content:
            application/json:
              schema:
                type: object
                properties:
                  message:
                    type: string
                    description: The error message
              examples:
                Validation Example:
                  value:
                    message: Bad Request - querystring should match one of ['startTimestamp' and 'endTimestamp'] or ['tin' and/or 'npi']
        '401':
          description: Status 401
          content:
            application/json:
              schema:
                description: ''
                type: object
                properties:
                  error:
                    type: string
                    minLength: 1
                  error_description:
                    type: string
                    minLength: 1
                  traceId:
                    type: string
                required:
                - error
                - error_description
                - traceId
              examples:
                Unauthorized Example:
                  value:
                    error: invalid_access_token
                    error_description: Invalid access token
                    traceId: c908b858-0e32-af0e-1d02-7582c346da70
        '422':
          description: Status 422
          content:
            application/json:
              schema:
                type: object
                required:
                - message
                properties:
                  message:
                    type: string
                    description: The error message
              examples:
                Validation Example:
                  value:
                    message: Day range limit is 30 days
        '500':
          description: Status 500
          content:
            application/json:
              schema:
                type: object
                properties:
                  message:
                    type: string
              examples:
                Error example:
                  value:
                    message: An unexpected error occurred
      operationId: get-pes-enrollments-enrollment-status
      parameters:
      - schema:
          type: string
        in: header
        name: Authorization
        description: Bearer token
        required: true
      - schema:
          type: string
          example: '2021-04-01T00:00:00Z'
        in: query
        name: startTimestamp
        description: Start timestamp in ISO 8601 format, if passed, must to pass endTimestamp, can not pass tin or npi
      - schema:
          type: string
          example: '2021-04-15T00:00:00Z'
        in: query
        name: endTimestamp
        description: Start timestamp in ISO 8601 format, if passed, must to pass startTimestamp, can not pass tin or npi
      - schema:
          type: string
        in: query
        name: tin
        description: If passed, can not pass startTimestamp and endTimestamp, can combine npi for searching
      - schema:
          type: string
        

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