Prerequisites

1. Optum Developer Account — Register at developer.optum.com
2. Claims submission enrollment — Contact your Optum implementation manager for EDI enrollment
3. Application credentials — client_id and client_secret from the developer portal

Step 1: Understand the Data Requirements

A minimal professional claim requires:

Field	Description
submitterNpi	Your NPI or submitter organization NPI
memberId	Patient's Optum member ID
dateOfService	ISO 8601 date (YYYY-MM-DD)
diagnosisCodes	ICD-10 diagnosis codes array
procedureCodes	CPT/HCPCS codes with units

Step 2: Get an Access Token

curl -X POST https://api.optum.com/oauth/token \
  -H "Content-Type: application/x-www-form-urlencoded" \
  -d "grant_type=client_credentials" \
  -d "client_id=$CLIENT_ID" \
  -d "client_secret=$CLIENT_SECRET" \
  -d "scope=claims:submit"

Step 3: Submit a Claim

curl -X POST https://sandbox-apigw.optum.com/claims/professional/v2/claims \
  -H "Authorization: Bearer $ACCESS_TOKEN" \
  -H "Content-Type: application/json" \
  -d '{
    "claimType": "professional",
    "submitterNpi": "1234567890",
    "memberId": "U12345678",
    "dateOfService": "2026-01-15",
    "diagnosisCodes": ["Z00.00"],
    "procedureCodes": [{"code": "99213", "units": 1}]
  }'

Step 4: Handle the Acknowledgment

A 202 Accepted response means the claim passed validation and entered the processing queue:

{
  "claimNumber": "CLM-20260115-001",
  "status": "accepted",
  "transactionId": "TXN-20260115-001"
}

Use the claimNumber with the Claim Status API to track processing.

Next Steps

• Check claim status with the Claim Status API
• Review claim rejection codes and resolution steps
• Read the 837P compliance guide