Apex EDI API V3 Documentation

powered by Apex EDI Claims Delivery

Common API V3

Host Names
Return Values and Errors
GetPayers
GetTestPayers

Claims API V3

Introduction
Claim API Reference

Host Names
Return Values and Errors
GetPayers
GetTestPayers
SubmitClaims
GetClaimStatusByDate
GetClaimStatusWithHistoryByDate
GetClaimStatusWithHistoryByClaims
GetPayerResponseDocuments

Claim Field Reference
Apex EOB to JSON Field Mapping
Enumerations
External Code Sources
Authentication and Privacy
Proxy Login API Reference
C# Sample Code
Testing

Eligibility API V3

Eligibility API Reference

Host Names
Return Values and Errors
GetPayers
GetTestPayers
GetEligibilityPayers
SubmitEligibilityRequests
GetEligibilityResponses

Eligibility Field Reference
Eligibility Enumerations
Eligibility External Code Sources

Authentication and Privacy
Sample JSON Eligibility Requests
C# Sample Code for Eligibility

Enrollment API V3

Enrollment API Reference

Host Names
Return Values and Errors
Host Names
Processing of Providers by Apex
Return Values and Errors
When to Submit a Request
SubmitEnrollments

API V3 General

Vendor Portal
Contact Apex

External Code Sources

The following web pages are sources for various codes used in claim submissions and responses.

Claim Status Codes • X12 External Code Source 508
Claim Adjustment Reason Codes (CARC) • X12 External Code Source 139
Remittance Advice Remark Codes (RARC) • X12 External Code Source 411
HCPS Procedure Codes
Place of Service Code Set for Professional Claims
Health Insurance Prospective Payment System (HIPPS) Rate Code for Skilled Nursing Facilities
Code (Standard ISO) for country in whose currency the charges are specified. CODE SOURCE 5: Countries, Currencies and Funds

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