View all our available APIs along with the specific details about each in the following dropdowns.
Learn more about Application Programming Interface (API).
Claims API is an easy way to send and retrieve up-to-date claims information using automation capabilities. Reduce your organization’s development and support costs by integrating our claims services directly into your current workflows. API data can be distributed from and to practice management systems, hospital information systems, electronical medical records (EMRs), electronic health records (EHRs) and other applications your organization may use.
This is a Representational State Transfer (REST) API that includes:
The API uses JavaScript Object Notation (JSON) for requests and responses. All API traffic is encrypted over HTTPS and authentication is handled with OAuth 2.0.
Registration and approval is required in the API Marketplace to obtain credentials to access API services.
Claim Services APIs are secured using OAuth 2.0. All calls to APIs are encrypted over HTTPS. APIs support connections using TLS version 1.2 or higher. All modern languages and frameworks support TLS 1.2 (although specific older ones do not).
The Eligibility Basic Services API returns eligibility, benefit and copay information in real time. It also retrieves additional plan and member information including, but not limited to:
This is a Representational State Transfer (REST) API that returns:
The API uses JavaScript Object Notation (JSON) for requests and responses. All API traffic is encrypted over HTTPS and authentication is handled with OAuth 2.0.
Registration and approval is required in the API Marketplace to obtain credentials to access API services.
Claim Services APIs are secured using OAuth 2.0. All calls to APIs are encrypted over HTTPS. APIs support connections using TLS version 1.2 or higher. All modern languages and frameworks support TLS 1.2 (although specific older ones do not).
The Eligibility Lightweight Services API provides basic eligibility and member information by member demographics.
This is a Representational State Transfer (REST) API that returns:
The API uses JavaScript Object Notation (JSON) for requests and responses. All API traffic is encrypted over HTTPS and authentication is handled with OAuth 2.0.
Registration and approval is required in the API Marketplace to obtain credentials to access API services.
APIs are secured using OAuth 2.0. All calls to APIs are encrypted over HTTPS. APIs support connections using TLS version 1.2 or higher. All modern languages and frameworks support TLS 1.2 (although specific older ones do not).
The Prior Authorization API consists of 2 main components:
Data Elements:
1. Summary by care provider and member:
2. Case detail by care provider:
3. Care provider case lookup:
Registration and approval is required in the API Marketplace to obtain credentials to access API services.
APIs are secured using OAuth 2.0. All calls to APIs are encrypted over HTTPS. APIs support connections using TLS version 1.2 or higher. All modern languages and frameworks support TLS 1.2 (although specific older ones do not).
Updating your information with insurance companies can be challenging. We've simplified it with our Provider Demographic API and Provider Roster API. Now, you can directly submit updates from your practice management systems to UnitedHealthcare, eliminating the need for emails, faxes, calls or portals. Our standardized and integrated approach helps ensure smooth communication between providers and UnitedHealthcare, making updates hassle-free.
The Provider Demographic API lets you manage provider details using National Provider Identifier (NPI) number, tax ID number (TIN) and Group information.
Operations include adding, updating or terminating provider data.
To request access, submit a JSON with details like:
Registration and approval is required in the API Marketplace to obtain credentials to access API services.
APIs are secured using OAuth 2.0. All calls to APIs are encrypted over HTTPS. APIs support connections using TLS version 1.2 or higher. All modern languages and frameworks support TLS 1.2 (although specific older ones do not).
The Referrals API offers referral information.
This is a Referrals API that provides detailed information about previous referrals and referral submissions. The API uses JavaScript Object Notation (JSON) for requests and responses. All API traffic is encrypted over HTTPS and authentication is handled with OAuth 2.0.
Registration and approval is required in the API Marketplace to obtain credentials to access API services.
APIs are secured using OAuth 2.0. All calls to APIs are encrypted over HTTPS. APIs support connections using TLS version 1.2 or higher. All modern languages and frameworks support TLS 1.2 (although specific older ones do not).
The TrackIt API helps streamline tracking and management of actions and notifications. It provides updates on commercial pended claims that need additional information and outlines the necessary steps for reconsiderations and attachments. TrackIt also helps understand the volume and distribution of notifications across different categories, such as admissions, discharge, emergency and referrals.
Note: This API is for informational purposes only. To take further action based on the information received, you will need access to the Reconsiderations and Appeals with Attachments API and/or the Pended Claims Attachments API.
This is a REST API that provides:
Registration and approval is required in the API Marketplace to obtain credentials to access API services.
APIs are secured using OAuth 2.0. All calls to APIs are encrypted over HTTPS. APIs support connections using TLS version 1.2 or higher. All modern languages and frameworks support TLS 1.2 (although specific older ones do not).