Sandbox API Values and Test Responses

We provide a list of service ID values for testing a variety of responses.

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NOTE

DO NOT perform load testing or production data testing in the sandbox environment. Please use the sandbox ONLY to view sample API responses to HTTP requests using our predefined values and to familiarize yourself with our APIs.

For load testing and production data resting, we recommend using our APIs in production environment.

Contact an Optum representative at any time for more information.

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NOTE

Your representative will provide you a set of secure credentials that you use for interacting with the sandbox environment. If you contract with Optum for API usage, you will use a separate pair of credential for your production API environment.

For testing the APIs in the sandbox environment, you can edit the request body and send it to the API engine to see what kinds of responses you will get.

The sandbox provides a set of predefined fields and values that you can apply to see how the API works. It uses simulated Medical Service ID and Personal Medical Information (PMI).

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IMPORTANT

For sandbox usage, all fields must have the correct predefined values to obtain a successful response. Inventing new PMI values or using real-world PMI values will result in errors. Please provide all of the values, such as tradingPartnerServiceId, controlNumber,subscriber, and so on marked as required (R) (see) in your API requests.

For successful use of APIs in the sandbox, you must use these "pseudo patient" and “pseudo provider” values for your testing.

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NOTE

Avoid using real-world values in our sandbox API endpoints! Doing so will generate errors.

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NOTE

All fields must use predefined values to have successful responses in the sandbox.

Eligibility Sandbox Test Responses

For Eligibility API testing in the sandbox, you can edit the request body and send it to the API engine to view what kinds of responses you will get. You can use the following values as the tradingPartnerServiceId (is the Payer ID; this will vary based on the payer you want to connect to) to change the responses you will receive from your test request body:

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IMPORTANT

The sandbox returns a canned response based on the received data. There is no validation check or confirmation of specifically required information. These checks occur only in the production environment. You should manually review the companion guides offered by the specific payers to confirm what is required.

Test using THIS tradingPartnerServiceIdDescription
00001This is a canned response that returns a single coverage plan. This will work for any payers.
000002This is a canned response that returns a badly formatted 271. This will work for any payers.
00003This is a canned response that returns a good 271 that contains maxed MSG01 field (AN..264) and EB03 repeating data element (99 repeats). This will work for any payers.
00004This is a canned response that returns AAA Not Eligible For Inquiries. This will work for any payers.
00005This is a canned response that contains non-printable characters which we need to make sure we can parse. This will work for any payers.
00006A system error from the Payer.  AAA segment in the 2000A Information Source Loop with AAA01 = Y, AAA03 = 42 and AAA04 = R.
00007This is a canned response that returns a single coverage plan with unused fields. This will work for any payers.
000008This is a canned response that returns a 271 that contains data in deprecated fields. It is used to test our parser's handling of data in these fields. This will work for any payers.
00009This returns a canned 271 response where the patient is a dependent.
000010Hospital Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, Date of Service and service type as input parameters.
000011Rehabilitation Inquiry:  A 270 request with provider ID, subscriber ID, DOB, First Name, Last Name Date of Service and service type as input parameters.
000012Medical Care Inquiry: A 270 request with provider ID, subscriber ID, Date of Service and service type as input parameters.
000013Rehabilitation Inquiry: A 270 request with provider ID, Subscriber last name, first name, Date of Service and service type as input parameters.
Sample response from Health Maintenance Organization (HMO) Blue.
000014Vision (Optometry) Inquiry: A 270 request with provider ID, subscriber ID, SSN, DOB, Date of Service and service type as input parameters.
000015Home Health Care Inquiry:  A 270 request with provider ID, subscriber ID, DOB, Date of Service and service type as input parameters.
000016Pharmacy Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, Last Name, Date of Service and service type as input parameters.
000017Medical Care Inquiry: A 270 request with provider ID, subscriber ID, Date of Service and service type as input parameters.
000018Emergency Services Inquiry: A 270 request with Information Receiver, Subscriber ID, Subscriber Last Name, Date of Service, and serviceType parameters as follows is given as input.
000019Rehabilitation Inquiry: A 270 request with provider ID, subscriber SSN, DOB, Date of Service and service type as input parameters.
000020Rehabilitation Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, Date of Service and service type as input parameters.
000021Rehabilitation Inquiry: A 270 request with provider ID, DOB, First Name, Last Name Date of Service and service type as input parameters.
000022Medical Care Inquiry: A 270 request with provider ID, subscriber ID, Date of Service and service type as input parameters.
000023Health Benefit Plan Coverage Inquiry: A 270 request with provider ID, subscriber ID, Last Name, First Name, Date of Service and service type as input parameters.
Sample response from Medicare Part A/Medicare Part B.
000024Health Benefit Plan Coverage Inquiry: A 270 request with provider ID, subscriber ID, First Name, Date of Service and service type as input parameters.
000025Rehabilitation Inquiry: A 270 request with provider ID, subscriber ID, Last Name, Date of Service and service type as input parameters.
000026Hospital Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, service type and diagnosis code as input parameters.
000027Hospital Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, service type and provider code as input parameters.
000028Hospital Inquiry: A 270 request with provider ID, subscriber ID, DOB, First Name, service type and provider information as input parameters.
000029Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Provider ID.
000030Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Patient Information.
000031Health Benefit Plan Coverage Inquiry: A 270 request with Inactive Coverage date as service date.
000032Health Benefit Plan Coverage Inquiry: A 270 request with Duplicate. Subscriber ID.
000033Health Benefit Plan Coverage Inquiry: A 270 request with Invalid Provider ID.
000034Rehabilitation Inquiry: A 270 request with Subscriber ID, Dependent first Name and service type code as input parameters.
000035Pharmacy Inquiry: A 270 request with Subscriber ID, Dependent first Name and service type as input parameters.
00036Florida Medicaid: Sample response.
000036Home Health Care Inquiry: A 270 request with Subscriber ID, Dependent DOB and service type as input parameters.
000037Psychiatric Inquiry: A 270 request with Subscriber ID, Dependent First Name and service type as input parameters.
000038Rehabilitation Inquiry: A 270 request with Subscriber ID, Dependent DOB, Dependent Last Name and service type as input parameters.
000039Different Deductible at 30 and other STC.
000040EB 1 with no benefits (Active Coverage) and EB I (Non Covered).
000041Test EB 6 (Inactive) and EB W (Other Source of Data).
000042EB R — other additional payer.
Sample use case for standard Medicaid benefit.
000043EB W response (other source of Data).
000044High Out-of-Pocket Remaining but no deductible in response.
000045Low Deductible High Premium — many different copayments.
000046Low Deductible High Premium with no coinsurance.
000047Low Deductible High Premium.
000048Low Deductible with no copayment.
000049Multiple Services.
000050No Deductible, High Out-of-Pocket Remaining, only co-pay and co-insurance.
000051No Deductible, only copay for 33,98, UC.
000052No Deductible, No copayment.
000053Plan with active coverage but no patient responsibility.
000054Response with AD time period 25.
000055Too many deductibles at service levels.
000056Uniquely formatted EB segment.
000067Sample use case from PAA.
000068Sample use case 2 from PAA.
000069Sample Use case for EB V (Cannot Process).
000070Sample Use case for EB U (contact Following Entity for Eligibility or Benefit Information).
000074Sample Use case for Connecticut Medicaid.
000081Sample response for WellCare.
000082Sample response for Blue Cross Blue Shield Georgia.
000083Sample response for Humana.
ABHFLSample use case for Aetna Better Health of Florida.
ABHKYSample use case for Aetna Better Health of Kentucky.
ABHLASample use case for Aetna Better Health of Louisiana.
ABHMOSample use case for Aetna Better Health of Missouri.
AETNXSample response for AETNA.
BCCTCSample use case for Blue Cross Blue Shield Connecticut.
BCNJCSample response for BCBS of New Jersey (Horizon).
CABCA 270 request with memberId, firstName, lastName,gender,entityIdentifier,entityType,dateOfBirth,groupNumber,relationToSubscriber,
insuredIndicator,maintenanceTypeCode, and
maintenanceReasonCode.
Sample response for Platinum Full PPO 250 15 OFFEX.
CIGNAA sample response for CIGNA for dependent.
CMSMEDA 270 request with additional fields.
Sample response for Medicare Part A/Medicare Part B.
CNTCRSample use case for Connecticare Inc.
COVONSample response for Coventry.
CTSample use case for Connecticut Medicaid.
DENTALSample response for benefits from Dental Payer.
HUMSample response for Humana.
ILMSASample use case for Aetna Better Health of Illinois.
ISCAMSample response for Medi-CAL Portal connection.
MA/MBSample response for Medicare Part A/Medicare Part B.
MEDXSample response for MEDEX.
MMSISample use case for Mayo.
TRICESample response for Tricare.
TXSample response for Texas Medicaid.
TXBCBSSample response for Blue Advantage HMO.
UHCSample response for United Healthcare.