Eligibility

View eligibility coverage for health care services covered by a payer. Use the methods below to obtain eligibility related data. For a formal definition, please review the Service Description.

Available Methods
GetEligibilityPayers Returns a list of active eligibility payers, their eligibility payer IDs, and their transmission method (real-time or batch). For examples contact Apex EDI for documentation.
SubmitEligibility Submits an eligibility request to the payer for the given parameters. To retrieve the response of this request, call the 'GetEligibilityResponse' method using the integer value that's returned on this method call.
GetEligibilityResponse Returns the response of a previously submitted eligibility request sent through the 'SubmitEligibility' method. If a real-time response is not available, a message reading 'Response is still pending. Please try again later.' will be returned. By setting the 'return271Response' to true, it will return the raw ANSI 271 string. If set to false, it will return an HTML-formatted version of the eligibility response.
GetProviders Returns a list of active providers and their Apex provider IDs for the given client's username and password. For examples contact Apex EDI for documentation.

URL Formatting Helper Methods

  • C#
  • Java
public static string FormatApexEligibilityUrl(string methodCall, string ApexEligibilityUrl, string content)
    {
        return String.Format("{0}{1}{2}", ApexEligibilityUrl, methodCall + "?", content);
    }
public static String FormatApexEligibilityUrl(String methodCall, String ApexEligibilityUrl, String content)
    {
        return String.format("{%s%s%s", ApexEligibilityUrl, methodCall + "?", content);
    }