← Back to all docs
optum

Optum MCP Server

The Optum MCP server lets AI agents run authorization, eligibility, EVV, claims, and remittance workflows through Optum. Connect Optum to Claude, ChatGPT, and Cursor. Built and maintained by Supergood, since Optum doesn't ship an MCP server.

By Alex Klarfeld•May 12, 2026
Optum MCP Server

What is the Optum MCP server?

The Optum MCP server is a connector that lets AI agents (Claude, ChatGPT, Cursor, and other MCP clients) run authorization, eligibility, EVV, claims, and remittance workflows through Optum using a standard protocol.

In short: Optum, a UnitedHealth Group company, provides payer and health-system technology: prior authorization management, eligibility verification, provider directory and enrollment, claims and remittance, analytics, and EVV connectivity for home and community-based services in many state Medicaid programs.

Optum doesn't ship an official MCP server, and Optum's authorization and EVV handling lives in web portals and batch exports, not unified public APIs, and access is program- and payer-specific. Supergood builds and maintains the connector by reverse-engineering Optum's authenticated web portal and EDI flows and exposing them as MCP tools an agent can call directly, plus a normalized REST API underneath.

What you can do with Optum via MCP

Once connected, an agent can:

  • Check member eligibility and payer-program enrollment (270/271).
  • Submit and track prior authorizations: service codes, units, validity dates.
  • Pull and submit EVV visits: check-in/out, service codes, tasks, verification metadata.
  • Submit Medicaid/MCO claims (837P/I) referencing verified visits.
  • Retrieve remittances (835 ERA) for reconciliation.
  • Look up providers, NPIs, and payer/program records.
  • Surface EVV exceptions: late or missing events, GPS mismatch, overlapping visits.

How to connect Optum to Claude, ChatGPT & Cursor

Connecting works like any other MCP server. The short version:

  • Claude (Desktop or claude.ai): add the Optum MCP server under Settings → Connectors (or your MCP config), authorize the Optum account Supergood provisions, and the tools show up in any chat, including agent runs.
  • ChatGPT: add it as a connector under Settings → Connectors, authorize, and ChatGPT can call the Optum tools in conversations and in agent mode.
  • Cursor: add the server to your MCP config (mcp.json or Settings → MCP), reload, and the tools are available to the agent.

Supergood owns the auth piece (credentials, MFA, session refresh), so the connection doesn't drop. New to MCP? Our explainer covers what an MCP server is and how clients connect to one.

How Supergood builds the Optum MCP server

Supergood doesn't wait for Optum to ship an API. We reverse-engineer the authenticated web portal and EDI flows behind Optum, normalize the responses, and wrap them as MCP tools, plus the underlying REST API if you'd rather call it from code.

  • Auth and MFA, handled. Supergood provisions a dedicated Optum account (email and phone managed by us) and keeps the session alive through MFA, token expiry, and re-auth.
  • Normalized data. Responses come back in consistent JSON shapes across modules, not the raw shape Optum's front-end happens to return.
  • Monitored and adapted. When Optum changes its web portal and EDI UI or internal API, monitoring catches it and the connector gets patched, usually before it reaches you.
  • Program-aware logic. EVV validation rules, service codes, and modifiers vary by state Medicaid program; Supergood normalizes them so the agent sees one consistent API.

Getting Started

  • Schedule Integration Assessment

Book a 30-minute call to confirm which Optum modules and workflows you need and how authentication should work.

  • Supergood Builds and Validates Your MCP Server

We deliver a hardened Optum connector (MCP tools plus the underlying API) scoped to your workflows and entitlements.

  • Deploy with Monitoring

Go live with continuous monitoring and automatic adjustments as Optum changes.

Use Cases

EVV compliance

- Pull the day's visits and verification metadata - Flag GPS mismatches and overlapping shifts before billing - Submit corrected visit events with compliant reason codes

Authorization desk

- Submit prior auths against the right service codes and units - Track validity windows and remaining units - Re-submit when the payer requests changes

Claims and reconciliation

- Submit Medicaid claims referencing verified visits - Pull remittances and post payments - Reconcile billed units against authorizations

Eligibility checks

- Batch-check member eligibility for the schedule - Confirm payer-program enrollment - Surface coverage gaps before service

Technical Specifications

MCP transport

Remote MCP server over HTTPS; works with hosted MCP clients and with local MCP configs.

Authentication

Supergood provisions a dedicated Optum account (managed email and phone) and handles MFA; you can also bring your own credentials. Session refresh is automatic.

Supported clients

Claude (Desktop, claude.ai, Claude Code), ChatGPT connectors, Cursor, and other MCP-compatible clients.

Tools exposed

8 tools covering the workflows listed above; the set is scoped to the modules you license.

Data freshness

Near real-time for portal flows; EDI/SFTP batches follow program-defined windows, which Supergood orchestrates with retry.

Rate limits

Tuned to Optum's tolerances; Supergood paces requests to avoid tripping security throttles.

Latency

Sub-second for most reads under normal load; writes reflect the underlying platform timing.

Session management

Automatic re-auth plus cookie/token rotation, with health checks.

Security

Encrypted transport, scoped access, and audit logging; respects Optum role-based permissions.

Webhooks

Optional asynchronous delivery for long-running operations; polling otherwise.

Reliability

Retry logic, backoff, and idempotency keys to avoid duplicates.

Adaptation

Continuous monitoring for Optum web portal and EDI surfaces changes, with rapid connector updates.

Frequently asked questions

No. Optum doesn't publish an MCP server. Supergood builds and maintains one by reverse-engineering Optum's authenticated flows and exposing them as MCP tools, plus the underlying REST API.

All of them, plus any MCP-compatible client. The same connector shows up in Claude (Desktop, claude.ai, Claude Code), ChatGPT connectors, and Cursor.

Supergood provisions a dedicated Optum account with managed MFA, or uses credentials you supply. We keep the session alive through MFA prompts, token expiry, and re-auth, so the connection stays live.

Yes. Reads and writes hit Optum's live system, not a nightly export. Optum's authorization and EVV handling lives in web portals and batch exports, not unified public APIs, and access is program- and payer-specific.

Both. The MCP tools are a layer on top of a normalized REST API for Optum; you can call either, from an agent or from your own code.

Related APIs in Healthcare RCM / Billing

Healthcare RCM / Billing

AccuReg API

Programmatically access patient access, insurance eligibility, prior authorization, registration quality assurance, and patient cost estimates in AccuReg with a stable REST API. Supergood builds and operates production-grade, unofficial AccuReg integrations so your team can automate front-end revenue cycle workflows without heavy custom engineering. AccuReg is software used by hospitals and health systems to prevent denials at the front end by verifying insurance, securing prior authorizations, scoring registration accuracy, generating price estimates for patients, and enabling point-of-service collections. With an unofficial API, you could verify eligibility from your EHR, submit and track prior authorization requests, surface registration defects to staff, generate patient-friendly estimates, and reconcile payments—end to end. In plain English: AccuReg helps hospital registration teams get the right coverage, authorization, and patient payment lined up before care happens. An unofficial API lets you automate those steps—checking eligibility, creating authorizations, pulling registration worklists, and producing estimates—directly from your own software.

Healthcare RCM / Billing

Availity API

Programmatically access eligibility and benefits, prior authorizations, claims submission, claim status, and ERA remittance workflows in Availity with a stable REST API. Supergood builds and operates production-grade, unofficial Availity integrations so your team can automate critical billing and practice management pipelines without heavy custom engineering. Availity is a healthcare information network and provider portal that connects payers and providers to verify coverage, submit and track claims, exchange authorizations and attachments, and reconcile payments. With an unofficial API, you could verify member eligibility in real time, submit prior authorization requests, assemble and send 837P/I claims, retrieve 835 ERA remittances, and coordinate payer-specific workflows end to end.

Healthcare RCM / Billing

Availity MCP Server

The Availity MCP server lets AI agents run eligibility, claims, status, and remittance workflows through Availity. Connect Availity to Claude, ChatGPT, and Cursor. Built and maintained by Supergood, since Availity doesn't ship an MCP server.

Healthcare RCM / Billing

Billed Right API

Billed Right is a healthcare revenue cycle management (RCM) and medical billing company that helps clinics and provider groups get paid correctly and on time. An unofficial API would let your startup pull live claim statuses, ERAs (835s), denials, patient balances, and payer information—and push encounters, charges, and claim submissions—so you can automate billing, AR workflows, and reporting.

Healthcare RCM / Billing

Cedar API

Cedar is software that powers the patient financial experience for healthcare providers. It centralizes digital statements, payment plans, price estimates, insurance capture, and payment acceptance so patients can understand and resolve their bills. With an unofficial API, you could read real-time balances and statement details, initiate payments, create payment plans, update contact/insurance info, and pull pre-visit estimates to drive smarter scheduling and financial clearance.

Healthcare RCM / Billing

Change Healthcare API

Change Healthcare is a healthcare clearinghouse and revenue cycle network that connects providers, payers, and pharmacies. With an unofficial API, you can validate insurance eligibility in real time, submit and track claims, retrieve remittances for auto-posting, and streamline prior authorization checks—end to end.

Ready to get a real API?