MCP For Claude Marketplace
Optum Claims & Billing

Optum Claims & Billing MCP Connector for Claude

A+

Securely submit medical bills, track 837 EDI claims, and process UHG bank remittance advices.

5 tools Official Updated Jun 28, 2026 Official Vinkius Partner
More Details Connect to Claude

What you can do

Take complete proxy control over your hospital Back-Office, accelerating financial throughput securely with Optum Healthcare APIs:

  • Submit Medical Claims: Safely construct X12 837P (Professional) or 837I (Institutional) payloads dispatching bills directly to UnitedHealthcare for payment.
  • Check Claim Sent Status: Automatically intercept Pended, Denied, or Approved medical bills utilizing the EDI 276/277 framework natively.
  • Extract ERA Remittances: Reconcile your banking accounts effortlessly by downloading Electronic Remittance Advices (ERA 835) securely.

How it works

  1. High Security & Compliance: Engineered entirely to handle Back-Office finances (Claims and Billing). This architecture deliberately excludes Patient Front-Desk actions protecting clinical workflows.
  2. Engage OAuth Protocol: Insert substituting your financial CLIENT_ID securely within the runtime module to authorize payloads.
  3. Deploy: Offload overwhelming billing disputes using AI.

Who is this for?

Specifically built for Hospital Billing Departments, FinTech Operators, and Medical Accounting Agencies.

medical-billingediclaims-processingremittancehealthcare-compliance

5 tools expose this connector's capabilities to your AI agent.

opt_check_claim_status

Check if a submitted bill has been paid, denied, or is pending medical review

opt_get_remittance_advice

Downloads the Electronic Remittance Advice (835 ERA) detailing payment breakouts

opt_handle_denial_revision

Resubmits a corrected claim fixing coding errors to overturn a payer denial

opt_submit_institutional_claim

Submits an institutional medical bill (837I) for hospital stays and major facilities

opt_submit_professional_claim

Submits a professional medical bill (837P) for doctors and outpatient clinics

See how to talk to your AI agent using Optum Claims & Billing.

Check the status of the institutional claim ID 88829281X.

Query completed. The medical claim 88829281X is currently Approved and expects a check date on May 15.

List the latest ERA remittances available for clearing.

Pulled 3 recent ERA 835s from UnitedHealth Group clearinghouse totaling $12,450.00 ready for auto-posting.

Draft an 837 payload for an office visit code 99213.

The ANSI 837 Professional Claim string has been successfully prepared for code 99213 passing all pre-adjudication compliance checks.

No. In adherence to US Healthcare segregation architecture (Least Privilege), Claims processing is totally decoupled from Eligibility. For front-desk validations, install the `optum-eligibility-mcp` array safely.

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