Optum

Optum Prepaydme API

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

GitHub OpenAPI

Operations 1

POST /abm/prepaydme/v1 PrePay DME API Endpoint

Documentation

📖
APIReference
https://developer.optum.com/eligibilityandclaims/reference/api-overview
📖
GettingStarted
https://developer.optum.com/eligibilityandclaims/docs/get-started-with-optum-api
📖
Authentication
https://developer.optum.com/eligibilityandclaims/docs/optum-security-and-authorization
📖
APIReference
https://developer.optum.com/optumreal-dental/reference/overview-real-dental
📖
GettingStarted
https://developer.optum.com/optumreal-dental/reference/get-started
📖
APIReference
https://developer.optum.com/pharmacysolutions/reference
📖
APIReference
https://developer.optum.com/paymentandreimbursement/reference
📖
APIReference
https://developer.optum.com/platformandinteroperability/reference
📖
APIReference
https://developer.optum.com/analyticsandinsights/reference
📖
APIReference
https://developer.optum.com/apitools/reference/security-and-authorization-v2-overview
📖
Documentation
https://developer.optum.com/apitools/docs/getting-started

Specifications

⚙
OpenAPI
https://raw.githubusercontent.com/api-evangelist/optum/refs/heads/main/openapi/optum-prepaydme-api-openapi.yml

Other Resources

🔗
ChangeLog
https://developer.optum.com/eligibilityandclaims/docs/eligibility-release-notes

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OpenAPI Specification

optum-prepaydme-api-openapi.yml Raw ↑ 
openapi: 3.2.0
info:
  title: ABM Prepay DME Claim API-1.0.0 Prepaydme API
  version: 1.0.0
  description: 'This is a wrapper API which internally calls ABM CES API to get the claim edits and DME Pricing API to get the rate and then update the claim amount.

    CES calls ABM PriorAuth API to get the matching PriorAuth record with remaining claimed unit. DME Claim API calculates Claim amount based on remaining unit and rate. This API needs auth bearer token which can be retrieved using https://sandbox-apigw.optum.com/apip/auth/sntl/v1/token. Please check documentation under Security section to get more details on auth token.'
servers:
- url: https://sandbox-apigw.optum.com
tags:
- name: prepaydme
paths:
  /abm/prepaydme/v1:
    post:
      summary: PrePay DME API Endpoint
      tags:
      - prepaydme
      requestBody:
        required: true
        content:
          application/xml:
            schema:
              type: object
              xml:
                name: request
              properties:
                environment:
                  type: string
                  xml:
                    name: environment
                enterprise-id:
                  type: string
                  xml:
                    name: enterprise-id
                claim:
                  type: object
                  xml:
                    name: claim
                  properties:
                    id:
                      type: string
                      xml:
                        name: id
                    subscriber-id:
                      type: string
                      xml:
                        name: subscriber-id
                    line:
                      type: object
                      xml:
                        name: line
                      properties:
                        id:
                          type: string
                          xml:
                            name: id
                        procedure-code:
                          type: string
                          xml:
                            name: procedure-code
              example: "<request>\n    <environment>live</environment>\n    <enterprise-id>ENTERPRISEID</enterprise-id>\n    <claim>\n        <id>ClaimId</id>\n        <subscriber-id>54654</subscriber-id>\n        <line>\n            <id>1</id>\n            <procedure-code>EXXXX</procedure-code>\n        </line>\n    </claim>\n</request>"
      responses:
        '200':
          description: Response for PREPAY DME API
          content:
            application/xml:
              schema:
                type: object
                xml:
                  name: request
                properties:
                  environment:
                    type: string
                    xml:
                      name: environment
                  enterprise-id:
                    type: string
                    xml:
                      name: enterprise-id
                  claim:
                    type: object
                    xml:
                      name: claim
                    properties:
                      id:
                        type: string
                        xml:
                          name: id
                      subscriber-id:
                        type: string
                        xml:
                          name: subscriber-id
                      line:
                        type: object
                        xml:
                          name: line
                        properties:
                          id:
                            type: string
                            xml:
                              name: id
                          procedure-code:
                            type: string
                            xml:
                              name: procedure-code
                example: "<request>\n    <environment>live</environment>\n    <enterprise-id>ENTERPRISEID</enterprise-id>\n    <claim>\n        <id>ClaimId</id>\n        <subscriber-id>54654</subscriber-id>\n        <line>\n            <id>1</id>\n            <procedure-code>EXXXX</procedure-code>\n        </line>\n    </claim>\n</request>"
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