All PlansAdministrativeMedium impact
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UnitedHealthcare·Digital platform updates
Effective date
Sep 1, 2025
We identified it
Jan 12, 2026
Summary
UnitedHealthcare has launched new Optum Real APIs that provide real-time eligibility verification, claims pre-checking, and automated data exchange directly within practice management systems. These APIs aim to reduce administrative denials, automate routine tasks like eligibility checks, and provide instant access to patient coverage information.
Action Required
By mid-November 2025: Billing team should evaluate connecting to new Optum Real APIs including Pre-Service Eligibility, Claim Pre-Check, Claim Inquiry, and Patient Benefit Check through the Optum AI Marketplace. Contact UnitedHealthcare to assess integration with existing practice management system for automated eligibility verification and claims processing.