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Patient eligibility requests can be integrated directly into your software or can be done from the Apex EDI claims portal.
Eligibility Request Through the Apex EDI Claims Portal
Eligibility requests from the Apex EDI claims portal are performed directly through the Apex EDI claims portal. Clients will enter patient information and receive payer responses via the Apex EDI claims portal.
Integrated Eligibility Requests
Eligibility calls can be integrated directly into your software.
Apex EDI Eligibility API Methods
The Eligibility API methods should be used in the sequence outlined below.
- GetProvider- This will give you the Apex provider ID for submitting the eligibility request.
- GetEligibilityPayers - This will give you the payer ID for submitting the eligibility request.
- SubmitEligibility - This will submit the eligibility request. You will need the provider ID, payer ID, username, password and patient data.
- GetEligibilityResponse - This will return an eligibility response for a given request. You will need the return value from the SubmitEligiblity call.
To submit batch eligibility, repeat the steps for each eligibility request.
- Automate patient eligibility by submitting a request for every pateint on the doctor's daily schedule.
- Display eligibility information on the daily schedule thus improving available data and processing of patient at the time when the patient checks in.
- Log eligibility details to the patient ledger for billing accuracy.