Change Healthcare API
Change Healthcare publishes 70+ REST APIs for eligibility, claims, remittance, attachments, and prior auth through a self-serve developer portal with a sandbox. The JSON is a wrapper over X12 EDI, so EDI semantics leak through, and docs split across Change and Optum portals.
Frequently asked questions
Change Healthcare scores C on Supergood's API Report Card. Change Healthcare publishes 70+ REST APIs for eligibility, claims, remittance, attachments, and prior auth through a self-serve developer portal with a sandbox. The JSON is a wrapper over X12 EDI, so EDI semantics leak through, and docs split across Change and Optum portals.
Change Healthcare has an official API, but teams routinely hit its limits: gated access, partial coverage, or paid tiers. Most end up supplementing it with exports or an unofficial API layer like Supergood. Site terms may apply to any integration approach, and how they apply is a determination each team makes for itself.
Change Healthcare (now part of Optum) operates the largest US medical claims clearinghouse and a broad revenue-cycle-management suite. It validates and routes electronic claims, eligibility, remittance, prior-authorization and attachment transactions between providers and virtually all US payers.
Healthcare RCM / Clearinghouse, Typically for providers, health systems, payers, and health-tech companies needing payer connectivity and claims processing. Providers and their practice-management/EHR systems submit claims, check eligibility (X12 270/271), receive remittances (835), and manage prior auth and attachments through the clearinghouse; health-tech firms integrate via the API platform.
Largest US claims clearinghouse; processes 15B+ transactions annually representing $1.5T+ in claims, connected to nearly all commercial/Medicare/Medicaid payers. Now Optum's medical network.
Intermediary network, Carries critical claims/eligibility/remittance data, but as a clearinghouse it is a transaction network/intermediary between providers and payers, not the provider's own trapped system-of-record.
Formed via 2017 merger (Emdeon + Change Healthcare); acquired by UnitedHealth/Optum in 2022. Modern API platform (JSON-over-X12, FHIR) actively expanded with self-service developer resources.
X12/EDI semantics still leak through the JSON APIs (steep learning curve). Portal/branding split across Change Healthcare and Optum domains. Full sourced list under Sources below.
Common alternatives include Availity, Waystar, Office Ally, Stedi, Experian Health. Graded alternatives appear under "More from the report card" below.
Supergood's grades measure one thing: can a customer's engineering team get their own data out programmatically? Supergood checks six things (whether a real API exists, how access is gated, data coverage, auth quality, docs and developer experience, and stability) and rolls them into a letter grade. Supergood re-verifies grades, and they only move on evidence.
Yes, via a managed API layer. Supergood builds REST APIs and MCP servers for authenticated enterprise web apps, so AI agents and internal tools can read and write data programmatically. Site terms may apply to any integration approach, and how they apply is a determination each team makes for itself.
Not that we could find. As of August 2026 there is no official Change Healthcare MCP server in any public registry, and no maintained community server we're aware of. We re-verify this periodically — report an inaccuracy below if we missed one.
Not natively. Change Healthcare doesn't publish an MCP server, so MCP clients like Claude, Cursor, and Codex have nothing to connect to out of the box. If that changes, this page will reflect it.