Claim API Reference

This page contains information about return values and errors, as well as details about each API call.

Host Names

In the HTTP requests documented below, use the following host name:

sandbox.services.apexedi.com for testing

Valid credentials are required for both production and testing. The https protocol is required for both production and testing.

When submitting test claims on the sandbox system, use the following payer IDs:

Medical: TST01
Dental: TST02

The HTTP status code indicates the success or failure of the call. On successful calls, the body of the response is encoded as a JSON object. On failed calls, the body of the response generally contains additional information. In some cases, it is simply an error message. In other cases, particularly when a claim has errors, the response contains structured error information encoded as JSON.

Common Error Responses
Invalid or Missing Vendor Credentials HttpStatusCode: 401 (Unauthorized) HttpResponseMessage.Headers.WwwAuthenticate == "Invalid or unknown credentials or vendor not authorized" body = "101: Invalid or unknown vendor credentials or vendor not authorized."
Client Has Not Accepted Business Associate Agreement The client must accept a Business Associate Agreement (BAA) with Apex EDI before submitting personal health information (PHI) to Apex EDI. If the client has not accepted a BAA, then attempts by a vendor to call the API on behalf of the client will fail with a 401 error. This condition can be detected in software by the vendor by parsing as an integer the portion of the text in the body of the response before the first colon (:). If this integer is 201, then the client has not yet accepted a BAA. If there is no colon in the body of the response, the portion of the message before the first color is not an integer, or the value of the integer is not 201, then the cause of the authorization error is something other than a failure on the part of the client to accept a BAA. HttpStatusCode: 401 (Unauthorized) HttpResponseMessage.Headers.WwwAuthenticate == "Client has not accepted Business Associate Agreement (BAA)" body = "201: Client has not signed the Business Associate Agreement."
Calling API With Incorrect REST Verb - GET when POST is required HttpStatusCode: 405 (MethodNotAllowed) Body: { "Message": "The requested resource does not support http method 'GET'." }
Claim or Importing Service Unresponsive HttpStatusCode: 503 (Service Unavailable) Body: { "Message":"Service is currently unavailable" }
Invalid vendorSiteId Used HttpStatusCode: 400 (Bad Request) Body: { "Message": "Invalid VendorSiteId" }
Missing Parameter, e.g., vendorSiteId HttpStatusCode: 404 (Not Found) Body: { "Message": "No HTTP resource was found that matches the request URI 'http://sandbox.services.apexedi.com/api/v3/claims/submit/'." }
Parameter Has No Content for VendorSiteId HttpStatusCode: 400 (Bad Request) Body: { "Message": "Value cannot be null.\r\nParameter name: vendorSiteId" }

Common Error Responses

Invalid or Missing Vendor Credentials

HttpStatusCode: 401 (Unauthorized)
HttpResponseMessage.Headers.WwwAuthenticate == "Invalid or unknown credentials or vendor not authorized"
body = "101: Invalid or unknown vendor credentials or vendor not authorized."

Client Has Not Accepted Business Associate Agreement

The client must accept a Business Associate Agreement (BAA) with Apex EDI before submitting personal health information (PHI) to Apex EDI. If the client has not accepted a BAA, then attempts by a vendor to call the API on behalf of the client will fail with a 401 error. This condition can be detected in software by the vendor by parsing as an integer the portion of the text in the body of the response before the first colon (:). If this integer is 201, then the client has not yet accepted a BAA. If there is no colon in the body of the response, the portion of the message before the first color is not an integer, or the value of the integer is not 201, then the cause of the authorization error is something other than a failure on the part of the client to accept a BAA.

HttpStatusCode: 401 (Unauthorized)
HttpResponseMessage.Headers.WwwAuthenticate == "Client has not accepted Business Associate Agreement (BAA)"
body = "201: Client has not signed the Business Associate Agreement."

Calling API With Incorrect REST Verb - GET when POST is required

HttpStatusCode: 405 (MethodNotAllowed)
Body:
{
"Message": "The requested resource does not support http method 'GET'."
}

Claim or Importing Service Unresponsive

HttpStatusCode: 503 (Service Unavailable)
Body:
{
"Message":"Service is currently unavailable"
}

Invalid vendorSiteId Used

HttpStatusCode: 400 (Bad Request)
Body:
{
"Message": "Invalid VendorSiteId"
}

Missing Parameter, e.g., vendorSiteId

HttpStatusCode: 404 (Not Found)
Body:
{
"Message": "No HTTP resource was found that matches the request URI 'http://sandbox.services.apexedi.com/api/v3/claims/submit/'."
}

Parameter Has No Content for VendorSiteId

HttpStatusCode: 400 (Bad Request)
Body:
{
"Message": "Value cannot be null.\r\nParameter name: vendorSiteId"
}

API Calls

GetPayers

/api/v3/payers/get_list?vendorSiteId=<vendorSiteId>&type=<payertype>

where payertype = dental or medical, and vendorSiteId is the assigned Vendor Site ID

Curl Example

curl -X POST https://sandbox.services.apexedi.com/api/v3/payers/get_list?vendorSiteId=XXSiteId&type=medical
--header "Authorization: Basic <vendorkey:vendorPassword as base64 encoded string>"
--header "Content-Type: application/json"

Responses

NOTE: The 'ApexPayerId' will be phased out at a future date, the preferred Payer ID is 'PayerId'.

Successful List of Dental Payers Returned:

HttpStatusCode: 200 (OK)

Body:

[
  {
    "Type": "Dental",
    "Name": "Delta Dental KS (Kansas)",
    "ApexPayerId": "APX10112",
    "PayerId": "CDKS1",
    "NationalPayerId": "",
    "EraAvailability": "RequiresEnrollment",
    "OffersEligibility": true,
    "ClaimEnrollmentRequired": false
  },
  {
    "Type": "Dental",
    "Name": "Delta Dental MD (Maryland)",
    "ApexPayerId": "APX10114",
    "PayerId": "23166",
    "NationalPayerId": "",
    "EraAvailability": "RequiresEnrollment",
    "OffersEligibility": true,
    "ClaimEnrollmentRequired": false
  },
  {
    "Type": "Dental",
    "Name": "Delta Dental MA (Masschusetts)",
    "ApexPayerId": "APX10115",
    "PayerId": "04614",
    "NationalPayerId": "",
    "EraAvailability": "NotAvailable",
    "OffersEligibility": true,
    "ClaimEnrollmentRequired": false
  },
]

Successful List of Medical Payers Returned:

HttpStatusCode: 200 (OK)

Body:

[
  {
    "Type": "Medical",
    "Name": "American Family Care (Molina)",
    "ApexPayerId": "APX10008",
    "PayerId": "UTMOL",
    "NationalPayerId": "",
    "EraAvailability": "RequiresEnrollment",
    "OffersEligibility": true,
    "ClaimEnrollmentRequired": false
  },
  {
    "Type": "Medical",
    "Name": "DMBA (Deseret Mutual Benefits Administrators)",
    "ApexPayerId": "APX10010",
    "PayerId": "DMRAT",
    "NationalPayerId": "",
    "EraAvailability": "RequiresEnrollment",
    "OffersEligibility": true,
    "ClaimEnrollmentRequired": true
  },
  {
    "Type": "Medical",
    "Name": "IHC Direct Med",
    "ApexPayerId": "APX10011",
    "PayerId": "UHIHC",
    "NationalPayerId": "",
    "EraAvailability": "RequiresEnrollment",
    "OffersEligibility": true,
    "ClaimEnrollmentRequired": false
  },
]

No Payer Parameter Supplied:

HttpStatusCode: 404 (Not Found)

Body:

{
  "Message": "No HTTP resource was found that matches the request URI 'http://sandbox.services.apexedi.com/api/v3/payers/get_list'.",
  "MessageDetail": "No action was found on the controller 'Payers' that matches the request."
}

SubmitClaims

(Medical) /api/v3/claims/submit?vendorSiteId=<vendorSiteId>

(Dental) /api/v3/claims/submitDental?vendorSiteId=<vendorSiteId>

where vendorSiteId is the assigned Vendor Site ID

The body of the HTTP request is a JSON object with the required fields DocumentType and Claims. DocumentType must be of type MedicalClaim or DentalClaim. Claims is a list of one or more claims in JSON format.

If the request is not well-formed, then the HTTP status code will be 400, and the body of the response will contain information about the errors. If the request is well-formed, then the status will 200, and the response will indicate which, if any, of the claims was accepted for transmission. It will also contain any validation errors that were detected.

When submitting test claims on the sandbox system, use the following payer IDs:
Medical: TST01
Dental: TST02

NOTE: For sandbox or production, live or test payer, you must always use a unique Apex_VendorClaimId within each Client for each claim submitted.

Curl Example

curl -X POST https://sandbox.services.apexedi.com/api/V3/claims/submit?vendorSiteId=XXSiteId ^
--header "Authorization: Basic <vendorkey:vendorPassword as base64 encoded string>" ^
--header "Content-Type: application/json" ^
--data <Claim data as json>

Example Medical JSON claim data (required fields only)

{
    "DocumentType":"MedicalClaim",
    "Claims":[
    {
        "Apex_PayerId":"TST01",
        "NOTE for Apex VendorClaimId":"This must be unique for each claim within each Client",
        "Apex_VendorClaimId":"636336444143562077",
        "F00_PayerName":"ACME HEALTH INSURANCE CO.",
        "F01A_InsuredId":"904XT2654",
        "F02_PatientNameLast":"SMITH",
        "F02_PatientNameFirst":"JOHN",
        "F03_PatientDob":"1961-04-20",
        "F03_PatientSex":"M",
        "F04_InsuredNameLast":"SMITH",
        "F04_InsuredNameFirst":"JOHN",
        "F05_PatientCity":"BROOKLYN",
        "F05_PatientState": "NY",
        "F05_PatientZip":"11223",
        "F06_PatientRelationshipToInsured":"Self",
        "F07_InsuredAddress1":"15892 ELM AVE",
        "F07_InsuredCity": "BROOKLYN",
        "F07_InsuredState": "NY",
        "F07_InsuredZip":"11223",
        "F11A_InsuredDob":"1961-04-20",
        "F11A_InsuredSex":"M",
        "F12_PatientAuthorization":"Yes",
        "F21_IcdIndicator":"10",
        "F21_DiagnosisCodes":["H906", "A043"],
        "F24_ClaimLines":[
        {
            "F24A_DateOfServiceFrom":"2021-11-12",
            "F24B_PlaceOfServiceCode":"11",
            "F24D_HcpcsProcedureCode":"99213",
            "F24E_DiagnosisPointers":["A", "B"],
            "F24F_Charges":32.0,
            "X12_ProviderControlNumber": "EDI.RGA000.15",
        }],
        "NOTE for F25 Fields": "If using Sandbox, one of EIN or SSN must be used",
        "F25_FederalTaxIdEin":"123456789",
        "F25_FederalTaxIdSsn":"123456789",
        "F28_TotalCharge":32.0
        "F31_PhysicianOrSupplierSignatureIsOnFile":true,
        "F33_BillingProviderNameLast":"ACME HEARING CLINIC",
        "F33_BillingProviderAddress1":"1734 9TH AVE SE #4",
        "F33_BillingProviderCity":"EDGEWOOD",
        "F33_BillingProviderState":"ST",
        "F33A_BillingProviderNpi":"11111222226"
    }]
}

Example Medical JSON claim data (extended example)

{
    "DocumentType":"MedicalClaim",
    "Claims":[
    {
        "Apex_PayerId":"TST01",
        "NOTE for Apex VendorClaimId":"This must be unique for each claim within each Client",
        "Apex_VendorClaimId":"636336444143562077",
        "F00_PayerName":"ACME HEALTH INSURANCE CO.",
        "F00_PayerAddress1":"PO BOX 8943",
        "F00_PayerAddress2":null,
        "F00_PayerCity":"BROOKLYN",
        "F00_PayerState":"NY",
        "F00_PayerZip":"11223",
        "F01_ClaimType":"Group",
        "F01A_InsuredId":"904XT2654",
        "F02_PatientNameLast":"SMITH",
        "F02_PatientNameFirst":"JOHN",
        "F02_PatientNameMiddle":null,
        "F02_PatientSuffix":null,
        "F03_PatientDob":"1961-04-20",
        "F03_PatientSex":"M",
        "F04_InsuredNameLast":"SMITH",
        "F04_InsuredNameFirst":"JOHN",
        "F04_InsuredNameMiddle":null,
        "F04_InsuredSuffix":null,
        "F05_PatientAddress1":"10545 404TH AVE",
        "F05_PatientAddress2":null,
        "F05_PatientCity":"BROOKLYN",
        "F05_PatientState":"NY",
        "F05_PatientZip":"11223",
        "F05_PatientPhone":null,
        "F06_PatientRelationshipToInsured":"Self",
        "F07_InsuredAddress1":"15892 ELM AVE",
        "F07_InsuredAddress2":null,
        "F07_InsuredCity":"BROOKLYN",
        "F07_InsuredState":"NY",
        "F07_InsuredZip":"11223",
        "F07_InsuredPhone":null,
        "F09_OtherInsuredNameLast":"SMITH",
        "F09_OtherInsuredNameFirst":"JOHN",
        "F09_OtherInsuredNameMiddle":null,
        "F09_OtherInsuredSuffix":null,
        "F09A_OtherInsuredGroupNum":null,
        "F09B_OtherInsuredDOB":null,
        "F09B_OtherInsuredSex":null,
        "F09C_OtherEmployerName":null,
        "F09_PatientRelationshipToInsured":null,
        "F09D_OtherPlanName":null,
        "F10A_PatientCondEmployment":false,
        "F10B_PatientCondAutoAccident":false,
        "F10B_PatientCondAutoAccidentState":null,
        "F10C_PatientCondOtherAccident":false,
        "F11_InsuredsPolicyGroupOrFecaNumber":"65636",
        "F11A_InsuredDob":"1961-04-20",
        "F11A_InsuredSex":"M",
        "F11C_PlanName":null,
        "F11D_OtherPlan":false,
        "F12_PatientAuthorization":"Yes",
        "F12_PatientAuthorizationDate":"2016-09-20",
        "F13_InsuredAuthorization":"Y",
        "F14_DateOfCurrentIllnessOrSymptom":null,
        "F14_LastMenstrualPeriodDate":null,
        "F15_InitialTreatmentDate":null,
        "F15_LastSeenDate":null,
        "F15_AcuteManifestionDate":null,
        "F15_AccidentDate":null,
        "F15_LastXRayDate":null,
        "F15_HearingAndVisionPrescriptionDate":null,
        "F15_AssumedCareStartDate":null,
        "F15_AssumedCareEndDate":null,
        "F15_PropertyCasualtyFirstContactDate":null,
        "F16_LastWorkedDate":null,
        "F16_AuthorizedReturnToWorkDate":null,
        "F17_ReferringProviderNameLast":null,
        "F17_ReferringProviderNameFirst":null,
        "F17_ReferringProviderNameMiddle":null,
        "F17_ReferringProviderSuffix":null,
        "F17_SupervisingProviderNameLast":null,
        "F17_SupervisingProviderNameFirst":null,
        "F17_SupervisingProviderNameMiddle":null,
        "F17_SupervisingProviderSuffix":null,
        "F17_OrderingProviderNameLast":null,
        "F17_OrderingProviderNameFirst":null,
        "F17_OrderingProviderNameMiddle":null,
        "F17_OrderingProviderSuffix":null,
        "F17A_ReferringProviderIdNumber":null,
        "F17A_SupervisingProviderIdNumber":null,
        "F17A_OrderingProviderIdNumber":null,
        "F17B_ReferringProviderNpi":null,
        "F17B_SupervisingProviderNpi":null,
        "F17B_OrderingProviderNpi":null,
        "F18_HospitalizationDateFrom":null,
        "F18_HospitalizationDateTo":null,
        "F19_ClaimSupplementalInfoNoteText":null,
        "F21_IcdIndicator":"10",
        "F21_DiagnosisCodes":["H906",
        "A043"],
        "F22_MedicaidResubmissionCode":null,
        "F22_OriginalReferenceNumber":null,
        "F23_PriorAuthorizationNumber":null,
        "F23_ReferralNumber":null,
        "F23_ClinicalLaboratoryImprovementAmendmentNumber":null,
        "F23_MammographyCertificationNumber":null,
        "F24_ClaimLines":[
        {
            "F24A_DateOfServiceFrom":"2021-11-12",
            "F24A_DateOfServiceTo":"2021-11-12",
            "F24B_PlaceOfServiceCode":"11",
            "F24C_Emg":false,
            "F24D_HcpcsProcedureCode":"99213",
            "F24D_Modifiers":null,
            "X12_Description":null,
            "F24E_DiagnosisPointers":["A",
            "B"],
            "F24F_Charges":0.0,
            "F24G_DaysOrUnits":1.0,
            "F24H_EarlyPeriodicScreeningDiagnosisAndTreatment":false,
            "F24H_FamilyPlannning":false,
            "F24J_Shaded_RendProviderTaxonomyCode":null,
            "F24J_Shaded_RendProviderStateLicenseNumber":null,
            "F24J_Shaded_RendProviderUpinNumber":null,
            "F24J_Shaded_RendProviderCommercialNumber":null,
            "F24J_Shaded_RendProviderLocationNumber":null,
            "F24J_RenderingNpi":null,
            "X12_Anesthesia":false,
            "X12_ContractMonetaryAmount":null,
            "X12_ContractTypeCode":null,
            "X12_AdjudicationOrPaymentDate":null,
            "X12_LineContractualObligationAdjustments":null,
            "X12_LineCorrectionAndReversalAdjustments":null,
            "X12_LineOtherAdjustments":null,
            "X12_LinePayorInitiatedReductions":null,
            "X12_LinePatientResponsibilityAdjustments":null,
            "X12_MeasurementId":null,
            "X12_MeasurementQualifier":null,
            "X12_MeasurementValue":0.0,
            "X12_NdcCode":null,
            "X12_NdcQuantity":0.0,
            "X12_DrugQuantityInternationalUnits":null,
            "X12_DrugQuantityGrams":null,
            "X12_DrugQuantityMilligrams":null,
            "X12_DrugQuantityMilliliters":null,
            "X12_DrugQuantityUnits":null,
            "X12_NdcPharmacyPrescriptionNumber":null,
            "X12_NdcLinkSequenceNumber":null,
            "X12_PrimaryPayerPaidAmount":1000,
            "X12_ProviderControlNumber":null,
            "F24_Shaded_LineNoteText":null
        }],
        "NOTE for F25 Fields": "If using Sandbox, one of EIN or SSN must be used",
        "F25_FederalTaxIdEin":"123456789",
        "F25_FederalTaxIdSsn":"123456789",
        "F26_PatientAcctNumber":null,
        "F27_AcceptAssignment":"Assigned",
        "F28_TotalCharge":0.0,
        "F29_PatientAmountPaid":null,
        "F29_PayerAmountPaid":null,
        "F31_PhysicianOrSupplierSignatureIsOnFile":false,
        "F32_FacilityName":"ACME HEARING CLINIC",
        "F32_FacilityAddress1":"1734 9TH AVE SE #4",
        "F32_FacilityAddress2":null,
        "F32_FacilityCity":"BROOKLYN
        "F32_FacilityState":"NY",
        "F32_FacilityZip":"11223",
        "F32A_FacilityNpi":"1111122222",
        "F32B_FacilityIdStateLicenseNumber":null,
        "F32B_FacilityIdProviderCommercialLicenseNumber":null,
        "F32B_FacilityIdLocationNumber":null,
        "F33_BillingProviderNameLast":"JONES",
        "F33_BillingProviderNameFirst":"JANE",
        "F33_BillingProviderNameMiddle":null,
        "F33_BillingProviderSuffix":"AU.D.",
        "F33_BillingProviderAddress1":"1734 9TH AVE SE #4",
        "F33_BillingProviderAddress2":null,
        "F33_BillingProviderCity":"DULLES",
        "F33_BillingProviderState":"VA",
        "F33_BillingProviderZip":"20189",
        "F33_BillingProviderPhoneNumber":"9998887777",
        "F33A_BillingProviderNpi":"11111222226",
        "F33B_BillingProviderTaxonomyCode":null,
        "F33B_BillingProviderSsn":null,
        "X12_PlaceOfServiceCode":null,
        "X12_RendProviderNameLast":null,
        "X12_RendProviderNameFirst":null,
        "X12_RendProviderNameMiddle":null,
        "X12_RendProviderSuffix":null,
        "X12_RendProviderTaxonomyCode":null,
        "X12_RendProviderStateLicenseNumber":null,
        "X12_RendProviderUpinNumber":null,
        "X12_RendProviderCommercialNumber":null,
        "X12_RendProviderLocationNumber":null,
        "X12_RenderingNPI":null,
        "X12_AcuteManifestationCode":null,
        "X12_ClaimAdjudicationDate":null,
        "X12_ClaimPrimaryPayerPaidAmount":null,
        "X12_ClaimContractualObligationAdjustments":null,
        "X12_ClaimCorrectionAndReversalAdjustments":null,
        "X12_ClaimOtherAdjustments":null,
        "X12_ClaimPayorInitiatedReductions":null,
        "X12_ClaimPatientResponsibilityAdjustments":null,
        "X12_MedicalRecordNumber":null,
        "X12_SpectacleLenses":null,
        "X12_ContactLenses":null,
        "X12_SpectacleFrames":null,
        "X12_DisabilityDateFrom":null,
        "X12_DisabilityDateTo":null,
        "X12_ClaimContractMonetaryAmount":null,
        "X12_ClaimContractTypeCode":null,
        "X12_ClaimContractCode":null,
        "X12_DelayReasonCode":null,
        "X12_OtherPayerName":null
    }]
}

Example Dental JSON claim data (required fields only)

{
	"DocumentType": "DentalClaim",
	"Claims": [
		{
			"NOTE for Apex VendorClaimId":"This must be unique for each claim within each Client",
			"Apex_VendorClaimId": "D123456789",
			"Apex_PayerId": "TST02",
			"F01_TypeOfTransaction": "ActualServices",
			"F03_PayerName": "DELTA DENTAL",
			"F04_OtherCoverage": false,
			"F12_InsuredLastName": "GAN",
			"F12_InsuredFirstName": "NAM",
			"F15_InsuredID": "123456789",
			"F32_TotalFee": "12345",
			"F36_PatientSignature": "SIGNATURE ON FILE",
			"F38_PlaceOfTreatment": "11",
			"F40_OrthoTreatment": false,
			"F43_Prosthesis": false,
			"X12_TINorSSNQualifier": "EI",
			"F53_TreatingDentistSignature": "Z",
			"X12_ServiceDate": "2021-10-08",
			"F18_PatientRelationship": "Self",
			"F12_InsuredLastName": "GON",
			"F12_InsuredFirstName": "MELL",
			"F12_InsuredAddress": "125 street",
			"F12_InsuredCity": "Small Town",
			"F12_InsuredST": "UT",
			"F12_InsuredZip": "12345",
			"F13_InsuredDOB": "1990-01-01",
			"F14_InsuredSex": "M",
			"F15_InsuredID": "123456789",
			"X12_SubscriberEntityTypeQualifier": "1",
			"F18_PatientRelationship": "Self",
			"X12_ServiceDate": "2021-10-08",
			"LineItems": [
				{
					"F29_ProcedureCode": "D9430",
					"F24_DateOfServiceFrom": "2021-10-08",
					"F31_LineFee": "100"
				}
			],
			"F32_TotalFee": "12345",
			"F36_PatientSignature": "SIGNATURE ON FILE",
			"F40_OrthoTreatment": false,
			"F43_Prosthesis": false,
			"F48_BillingDentistLastName": "Z",
			"F48_BillingDentistAddress": "123",
			"F48_BillingDentistCity": "123",
			"F48_BillingDentistST": "TR",
			"F48_BillingDentistZip": "84003",
			"F48_BillingDentistNPI": "1234567893",
			"F51_BillingDentistTaxID": "32145987",
			"X12_TINorSSNQualifier": "EI",
			"F53_TreatingDentistSignature": "Z"
		}
	]
}

Example Dental JSON claim data (extended example)

{
	"DocumentType": "DentalClaim",
	"Claims": [
		{
			"NOTE for Apex VendorClaimId":"This must be unique for each claim within each Client",
			"Apex_VendorClaimID": "D123456789",
			"Apex_PayerId": "TST02",
			"F01_TypeOfTransaction": "ActualServices",
			"F02_PriorAuthNum": null,
			"F03_PayerName": "My Payer Name",
			"F03_PayerAddress1": "PO BOX 123",
			"F03_PayerAddress2": null,
			"F03_PayerCity": "City",
			"F03_PayerState": "ST",
			"F03_PayerZip": "12345",
			"F04_OtherCoverage": false,
			"F05_OtherInsuredLastName": null,
			"F05_OtherInsuredFirstName": null,
			"F05_OtherInsuredMI": null,
			"F05_OtherInsuredSuffix": null,
			"F06_OtherInsuredDOB": null,
			"F07_OtherInsuredSex": null,
			"F08_OtherInsuredPolicy": null,
			"F09_OtherInsuredGrpNumber": null,
			"F10_OtherPatientRelationship": "2",
			"F11_OtherPayerName": null,
			"F11_OtherPayerAddress": null,
			"F11_OtherPayerCity": null,
			"F11_OtherPayerST": null,
			"F11_OtherPayerZip": null,
			"F12_InsuredLastName": "GON",
			"F12_InsuredFirstName": "MELL",
			"F12_InsuredMI": "GETH",
			"F12_InsuredSuffix": null,
			"F12_InsuredAddress": "123 st",
			"F12_InsuredCity": "Small Town",
			"F12_InsuredST": "UT",
			"F12_InsuredZip": "12345",
			"F13_InsuredDOB": "1990-01-10",
			"F14_InsuredSex": "M",
			"F15_InsuredID": "123456789",
			"F16_InsuredGroupNumber": "11111",
			"F17_InsuredEmployerName": null,
			"F18_PatientRelationship": "Self",
			"F20_PatientLastName": "GON",
			"F20_PatientFirstName": "MELL",
			"F20_PatientMI": "GETH",
			"F20_PatientSuffix": null,
			"F20_PatientAddress": "123 st",
			"F20_PatientCity": "Small Town",
			"F20_PatientST": "UT",
			"F20_PatientZip": "12345",
			"F20_PatientDOB": "1990-01-10",
			"F22_PatientSex": "M",
			"F23_PatientID": "123456",
			"F32_TotalFee": "12345",
			"F33_MissingTeeth": [],
			"F34_DiagnosiseCodeQualifier": null,
			"F34a_DiagnosisCode": null,
			"F35_Remarks": null,
			"F36_PatientSignature": "SIGNATURE ON FILE",
			"F36_PatientSignatureDate": "2022-10-08",
			"NOTE for F37_InsuredSignature": "For blank or null value, 'N' is sent for CLM08, else 'Y'",
			"F37_InsuredSignature": "SIGNATURE ON FILE",
			"F37_InsuredSignatureDate": "2022-10-08",
			"F38_PlaceOfTreatment": "11",
			"F40_OrthoTreatment": false,
			"F41_DateAppliancePlaced": null,
			"F42_MonthsTreatment": null,
			"F43_Prosthesis": false,
			"F44_ProsthesisDateOfPriorPlacement": null,
			"F45_TreatmentResultingFrom": null,
			"F46_AccidentDate": null,
			"F47_AutoAccidentState": null,
			"F48_BillingDentistLastName": "Z",
			"F48_BillingDentistFirstName": "Z",
			"F48_BillingDentistMI": "Z",
			"F48_BillingDentistSuffix": "Z",
			"F48_BillingDentistAddress": "123",
			"F48_BillingDentistCity": "123",
			"F48_BillingDentistST": "TR",
			"F48_BillingDentistZip": null,
			"F48_BillingDentistNPI": "1234567893",
			"F50_BillingDentistLicense": null,
			"F51_BillingDentistTaxID": "32145987",
			"X12_TINorSSNQualifier": "EI",
			"F52_BillingDentistPhone": "98151987",
			"F52a_BillingDentistID": null,
			"F53_TreatingDentistSignature": "Z",
			"F53_TreatingDentistSignatureDate": null,
			"X12_RenderingProvLastName": null,
			"X12_RenderingProvFirstName": null,
			"X12_RenderingProvMI": null,
			"X12_RenderingProvSuffix": null,
			"F53_TreatingDentistNPI": "1651984",
			"F55_TreatingDentistLicense": "15984",
			"X12_TreatmantLocationName": null,
			"F56_TreatmentAddress": null,
			"F56_TreatmentCity": null,
			"F56_TreatmentST": null,
			"F56_TreatmentZip": null,
			"X12_TreatmantLocationNPI": null,
			"F56a_DentistSpecialtyCode": "1984981x",
			"F58_TreatingDentistAddlID": null,
			"X12_Paytoaddress": null,
			"X12_PaytoCity": null,
			"X12_PaytoST": null,
			"X12_PaytoZip": null,
			"X12_AttachmentReportType": null,
			"X12_AttachmentControlNumber": null,
			"X12_AttachmentTransmissionCode": null,
			"X12_PatientAmountPaid": null,
			"X12_PredeterminationID": null,
			"X12_ClaimFrequencyCode": null,
			"X12_PayerControlNumber": null,
			"X12_SubscriberIdentificationCodeQualifier": "1",
			"X12_SubscriberEntityTypeQualifier": "1",
			"X12_ServiceDate": "2021-10-08",
			"LineItems": [
				{
					"F24_DateOfServiceFrom": "2021-10-08",
					"F24_DateOfServiceTo": null,
					"F25_AreaOfOralCavity": null,
					"F26_ToothSystem": null,
					"Teeth": [
						{
							"F27_Tooth": null,
							"F28_ToothSurface": [
								null,
								null,
								null,
								null,
								null
							]
						}
					],
					"F29_ProcedureCode": "D9430",
					"F29a_DiagnosisPointer": null,
					"F29b_Quantity": null,
					"F30_Description": null,
					"F31_LineFee": "1568",
					"F31a_OtherFee": null,
					"X12_LineControlNumber": null,
					"X12_LineTreatingDentistLastname": null,
					"X12_LineTreatingDentistFirstname": null,
					"X12_LineTreatingDentistMI": null,
					"X12_LineTreatingDentistSuffix": null,
					"X12_LineTreatingDentistNPI": null,
					"X12_LineTreatingDentistSpecialtyCode": null,
					"X12_PrimaryPaidAmount": null,
					"X12_UnitsPaid": null,
					"X12_AdjudicationDate": null,
					"X12_PlaceOfServiceCode": null,
					"Adjustments": null
				},
				{
					"F24_DateOfServiceFrom": "2021-10-08",
					"F24_DateOfServiceTo": null,
					"F25_AreaOfOralCavity": [
						"00",
						"01"
					],
					"F26_ToothSystem": null,
					"Teeth": [
						{
							"F27_Tooth": null,
							"F28_ToothSurface": [
								null,
								null,
								null,
								null,
								null
							]
						}
					],
					"F29_ProcedureCode": "D0120",
					"F29a_DiagnosisPointer": null,
					"F29b_Quantity": null,
					"F30_Description": null,
					"F31_LineFee": "48",
					"F31a_OtherFee": null,
					"X12_LineControlNumber": null,
					"X12_LineTreatingDentistLastname": null,
					"X12_LineTreatingDentistFirstname": null,
					"X12_LineTreatingDentistMI": null,
					"X12_LineTreatingDentistSuffix": null,
					"X12_LineTreatingDentistNPI": null,
					"X12_LineTreatingDentistSpecialtyCode": null,
					"X12_PrimaryPaidAmount": null,
					"X12_UnitsPaid": null,
					"X12_AdjudicationDate": null,
					"X12_PlaceOfServiceCode": null,
					"Adjustments": [
						{
							"X12_AdjustmentGroupCode": "15D",
							"X12_AdjustmentReasonCode": "asdf",
							"X12_AdjustmentAmount": "1684"
						}
					]
				}
			]
		}
	]
}

Responses

Successful submission, claim accepted.

There is one entry for each submitted claim. In this case, only one claim was submitted. If multiple claims are submitted, some may be accepted and others not accepted.

HttpStatusCode: 200 (OK)

Body:

{
  "ClaimResults": [
    {
      "VendorClaimId": "636336610085492300",
      "Status": "Accepted",
      "Errors": [],
      "RequestId": "f5500469a78847da90e2818239a6290e"
    }
  ],
  "DocumentLevelErrors": []
}

Successful submission, claim rejected.

There is one entry for each submitted claim. In this case, only one claim was submitted, and it was rejected. If multiple claims are submitted, some may be accepted and others not accepted. Validation errors are included for particular invalid fields.

HttpStatusCode: 200 (OK)

Body:

{
    "ClaimResults": [
        {
            "VendorClaimId": "636331353325402950",
            "Status": "NotAccepted",
            "Errors": [
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Insured/Subscriber Date of Birth is missing or invalid."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Diagnosis Code 1 is invalid."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Diagnosis Code 1 is not valid for the given Date of Service."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Diagnosis Code 2 is invalid."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Diagnosis Code 2 is not valid for the given Date of Service."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "the 'FROM' and/or 'TO' Date of Service is invalid. Verify the 'TO' Date of Service is after the 'FROM' Date of Service. Please correct and resubmit the claim."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "the Procedure Code is not valid for the given Date of Service."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Insured/Subscriber Date of Birth is missing or invalid."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Diagnosis Code 1 is invalid."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Diagnosis Code 1 is not valid for the given Date of Service."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Diagnosis Code 2 is invalid."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "Diagnosis Code 2 is not valid for the given Date of Service."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "the 'FROM' and/or 'TO' Date of Service is invalid. Verify the 'TO' Date of Service is after the 'FROM' Date of Service. Please correct and resubmit the claim."
                },
                {
                    "Type": "Validation",
                    "Code": "Validation",
                    "Location": null,
                    "SupplementalInformation": "the Procedure Code is not valid for the given Date of Service."
                }
            ],
            "RequestId": "cf8bc4e25b794d0f83592d6ab688ba0e"
        }
    ],
    "DocumentLevelErrors": []
}

Bad Request. The input is not in the correct format, required fields are missing, or the list of claims is empty.

HttpStatusCode: 400 (Bad Request)

Body:

{
  "Message": "Entire claim submission requires correction and resubmission",
  "ModelState": {
    "Claims": [
      "At least one claim is required"
    ]
}

Bad Request. Some fields are not formatted properly.

HttpStatusCode: 400 (Bad Request)

Body:

{
  "Message": "The request is invalid.",
  "ModelState": {
    "Claims[0].F03_PatientDob": [
      "F03_PatientDob 19510220 is not a valid date in the format yyyy-mm-dd"
    ],
    "Claims[0].F11A_InsuredDob": [
      "F11A_InsuredDob 19510220 is not a valid date in the format yyyy-mm-dd"
    ],
    "Claims[0].F12_PatientAuthorizationDate": [
      "F12_PatientAuthorizationDate 20160920 is not a valid date in the format yyyy-mm-dd"
    ],
    "Claims[0].F24_ClaimLines[0].F24A_DateOfServiceFrom": [
      "F24A_DateOfServiceFrom 20161112 is not a valid date in the format yyyy-mm-dd"
    ],
    "Claims[0].F24_ClaimLines[0].F24A_DateOfServiceTo": [
      "F24A_DateOfServiceTo 20161112 is not a valid date in the format yyyy-mm-dd"
    ]
  }
}

Claims Submission Failure. One or more claim fields missing.

HttpStatusCode: 400 (Bad Request)

Body:

{
    "Message": "The request is invalid.",
    "ModelState":
    {
        "Claims[0].X12_RendProviderNameLast":
        [
            "The X12_RendProviderNameLast field is required."
        ]
    }
}

Import Service returns a NULL result

HttpStatusCode: 204 (NoContent)

Body:

{
    "Message":"ImportServices could not import claims, ImportResult == NULL"
}

Client Account Is In Bad State

HttpStatusCode: 200 (OK)

Body:

{
    "ClaimResults": [],
    "DocumentLevelErrors": [
        {
            "Type": "System",
            "Code": "InvalidSourceDocument",
            "Location": "line number ",
            "SupplementalInformation": "Unknown client 'XYZ' for source file 'C:\\\\ApexServices\\\\Importing\\\\WorkArea\\\\FVIODNXDMPIJBCGSA5RDDZPD\\\\M0829170942.XYZ'"
        }
    ]
}

GetClaimStatusWithHistoryByDate

/api/V3/claims/status/get_with_history_by_date?vendorSiteId=<vendorSiteId>&startDate=<YYYY-MM-DD>&endDate=<YYYY-MM-DD>

Curl Example

curl -X POST "https://sandbox.services.apexedi.com/api/v3/claims/status/get_with_history_by_date?vendorSiteId=XXSiteId&startDate=2022-04-30&endDate=2022-05-12"
--header "Authorization: Basic <vendorkey:vendorPassword as base64 encoded string>"
--header "Content-Type: application/json"

GetClaimStatusWithHistoryByClaims

/api/V3/claims/status/get_with_history_by_claims?vendorSiteId=<vendorSiteId>

Curl Example

curl -X POST "https://sandbox.services.apexedi.com/api/v3/claims/status/get_with_history_by_claims?vendorSiteId=XXSiteId"
--header "Authorization: Basic <vendorkey:vendorPassword as base64 encoded string>"
--header "Content-Type: application/json"
--data "[\"Mnnnnnnnnn0\",\"Mnnnnnnnnn1\",\"Mnnnnnnnnn2\"]"

For both history APIs, the current status of a given claim is returned, together with a history of all statuses and their payer responses. For every payer response, current or historical, there will be a related document ID that is required for retrieving the data for that payer response report. This is done via the GetPayerResponseDocument API. For the GetClaimStatusWithHistoryByDate API, the start and end date parameters are used for querying the StatusChangeDate field, for related claims.

If the resulting JSON string array is parsed into a JSON object, access to the doc IDs within each object structure can be done with the following example paths:

Current Status:

(string)(jObj[0]["RelatedDocumentId"])

History Item:

(string)(jObj[0]["HistoryEntries"][3]["RelatedDocumentId"])

NOTE: if a status does not have a related document ID, it means that it is a status generated internally by Apex (e.g., when a claim is imported, or when it was sent to the payer).

Responses

Successful List of Statuses with Histories returned

HttpStatusCode: 200 (OK)

Body:

[
  {
    "ClaimNumber": "M63963844",
    "VendorId": 375,
    "VendorSiteId": "XXSiteId",
    "VendorClaimId": "ZZZZZZZ",
    "CurrentState": "Accepted",
    "StateChangeDate": "2021-04-28",
    "PayerAction": "AckAccept",
    "PayerActionDate": "2021-04-29",
    "PayerControlNumber": "E123456789",
    "CreateDate": "2021-04-28",
    "LastUpdateDate": "2021-04-29",
    "SubmittedDate": null,
    "RelatedDocumentType": "ClaimStatusCsResponse",
    "RelatedDocumentId": "AHRIZZZZZZZZZZZZZZZZZZZZZZZZZEQ5,
    "RelatedDocumentVersion": 1,
    "TotalClaimAmount": 205.00,
    "PayerAmount": null,
    "Adjustments": null,
    "PatientAmount": null,
    "PayerName": null,
    "PaymentMethod": null,
    "PaymentReferenceNumber": null,
    "PaymentEffectiveDate": null,
    "ServiceDate": "2021-04-22",
    "DisplayDate": "2021-04-22",
    "ActorType": "Payer",
    "ActorText": null,
    "ClearingHouseStatus": "Unknown",
    "PayerStatus": "Accepted",
    "StatusText": "Accepted",
    "PayerStatusList": [
      "Accepted"
    ],
    "PatientLastName": "Doe",
    "PatientFirstName": "Mister",
    "PatientMiddleName": "",
    "PatientSuffix": "",
    "ProviderLastName": "DoctorLastName",
    "ProviderFirstName": "DoctorFirstName",
    "ProviderMiddleName": "P",
    "OrganizationName": null,
    "SubClaims": [],
    "HistoryEntries": [
      {
        "HistoryType": "OtherClaimHistory",
        "ClaimHistoryId": null,
        "OtherClaimHistoryId": 0000000000,
        "EntryDate": "2021-04-27",
        "EntryType": "Unknown",
        "RelatedDocumentType": "Unknown",
        "RelatedDocumentId": null,
        "RelatedDocumentVersion": null,
        "Documentation": "",
        "OriginalValue": "",
        "NewValue": "",
        "ActorType": "ClearingHouse",
        "ActorText": "Apex",
        "ClearingHouseStatus": "Ready",
        "PayerStatus": "Unknown",
        "StatusText": "Ready",
        "Action": "",
        "PayerAction": "Unknown",
        "NewState": "Unknown",
        "HistoryDetailStrings": [],
        "PaymentReferenceNumber": null,
        "PayerControlNumber": null,
        "ServiceChargeAmount": 0.0,
        "ServiceLines": 0
      },
      {
        "HistoryType": "ClaimHistory",
        "ClaimHistoryId": 0000000001,
        "OtherClaimHistoryId": null,
        "EntryDate": "2021-04-28",
        "EntryType": "ClaimImport",
        "RelatedDocumentType": "Unknown",
        "RelatedDocumentId": null,
        "RelatedDocumentVersion": null,
        "Documentation": "",
        "OriginalValue": "",
        "NewValue": "",
        "ActorType": "ClearingHouse",
        "ActorText": "Apex",
        "ClearingHouseStatus": "Ready",
        "PayerStatus": "Unknown",
        "StatusText": "Sent to Payer",
        "Action": "",
        "PayerAction": "None",
        "NewState": "Unknown",
        "HistoryDetailStrings": [],
        "PaymentReferenceNumber": null,
        "PayerControlNumber": null,
        "ServiceChargeAmount": 205.00,
        "ServiceLines": 2
      },
      {
        "HistoryType": "ClaimHistory",
        "ClaimHistoryId": 000000002,
        "OtherClaimHistoryId": null,
        "EntryDate": "2021-04-28",
        "EntryType": "StatusChange",
        "RelatedDocumentType": "ProprietaryReport",
        "RelatedDocumentId": "AGYZZZZZZZZZZZZZZZZZZZZZZZZNI5",
        "RelatedDocumentVersion": 1,
        "Documentation": "",
        "OriginalValue": "{\"CurrentState\":\"Submitted\",\"PayerAction\":\"None\"}",
        "NewValue": "{\"CurrentState\":\"Accepted\",\"PayerAction\":\"Accepted\"}",
        "ActorType": "Payer",
        "ActorText": "Payer (Relay277CF Custom)",
        "ClearingHouseStatus": "Unknown",
        "PayerStatus": "Accepted",
        "StatusText": "Accepted",
        "Action": "Accepted",
        "PayerAction": "Accepted",
        "NewState": "Unknown",
        "HistoryDetailStrings": [
          "Claim Level Status - Relay277CF"
        ],
        "PaymentReferenceNumber": null,
        "PayerControlNumber": null,
        "ServiceChargeAmount": 0.00,
        "ServiceLines": 0
      },
      {
        "HistoryType": "ClaimHistory",
        "ClaimHistoryId": 0000000003,
        "OtherClaimHistoryId": null,
        "EntryDate": "2021-04-28",
        "EntryType": "StatusChange",
        "RelatedDocumentType": "InterchangeStatus",
        "RelatedDocumentId": "AGXZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZC5",
        "RelatedDocumentVersion": 1,
        "Documentation": "",
        "OriginalValue": "{}",
        "NewValue": "{}",
        "ActorType": "Payer",
        "ActorText": "Payer (999)",
        "ClearingHouseStatus": "Unknown",
        "PayerStatus": "Accepted",
        "StatusText": "Accepted",
        "Action": "Accepted",
        "PayerAction": "Accepted",
        "NewState": "Unknown",
        "HistoryDetailStrings": [],
        "PaymentReferenceNumber": null,
        "PayerControlNumber": null,
        "ServiceChargeAmount": 0.00,
        "ServiceLines": 0
      },
      {
        "HistoryType": "ClaimHistory",
        "ClaimHistoryId": 00000000000000042,
        "OtherClaimHistoryId": null,
        "EntryDate": "2021-04-28",
        "EntryType": "StatusChange",
        "RelatedDocumentType": "ClaimStatus",
        "RelatedDocumentId": "AEIZZZZZZZZZZZZZZZZZZZZZZZZZZZZZHC5",
        "RelatedDocumentVersion": 1,
        "Documentation": "",
        "OriginalValue": "{\"PayerAction\":\"Accepted\",\"PayerControlNumber\":null}",
        "NewValue": "{\"PayerAction\":\"AckReceipt\",\"PayerControlNumber\":\"2111811194224\"}",
        "ActorType": "Payer",
        "ActorText": "Payer (277)",
        "ClearingHouseStatus": "Unknown",
        "PayerStatus": "Accepted",
        "StatusText": "Accepted",
        "Action": "Received",
        "PayerAction": "AckReceipt",
        "NewState": "Unknown",
        "HistoryDetailStrings": [
          "Claim Level Status",
          "Status Details - Category Code: (A1) The claim/encounter has been received. This does not mean that the claim has been accepted for adjudication.,  Status: Accepted for processing., Entity: "
        ],
        "PaymentReferenceNumber": null,
        "PayerControlNumber": "11111111111111",
        "ServiceChargeAmount": 0.00,
        "ServiceLines": 0
      },
      {
        "HistoryType": "ClaimHistory",
        "ClaimHistoryId": 0000000000043,
        "OtherClaimHistoryId": null,
        "EntryDate": "2021-04-29",
        "EntryType": "StatusChange",
        "RelatedDocumentType": "ClaimStatusCsResponse",
        "RelatedDocumentId": "AHRZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZZQE5",
        "RelatedDocumentVersion": 1,
        "Documentation": "",
        "OriginalValue": "{\"PayerAction\":\"AckReceipt\",\"PayerControlNumber\":\"2111811194224\"}",
        "NewValue": "{\"PayerAction\":\"AckAccept\",\"PayerControlNumber\":\"E136P00S000\"}",
        "ActorType": "Payer",
        "ActorText": "Payer (277CS)",
        "ClearingHouseStatus": "Unknown",
        "PayerStatus": "Accepted",
        "StatusText": "Accepted",
        "Action": "Accepted",
        "PayerAction": "AckAccept",
        "NewState": "Unknown",
        "HistoryDetailStrings": [
          "Claim Level Status",
          "Status Details - Category Code: (A2) The claim/encounter has been accepted into the adjudication system.,  Status: Entity acknowledges receipt of claim/encounter., Entity: Payer (PR)"
        ],
        "PaymentReferenceNumber": null,
        "PayerControlNumber": "E99999999999999",
        "ServiceChargeAmount": 0.00,
        "ServiceLines": 0
      }
    ],
    "HasOtherSubscriber": false,
    "LastProcessDate": "2021-04-28"
  }
]

Errors

Invalid Date

HttpStatusCode: 400 Bad Request
Body:
{
    "Message": "The request is invalid.",
    "MessageDetail": "The parameters dictionary contains a null entry for parameter 'startDate'
    [or 'endDate'] of non-nullable type 'System.DateTime' for method
    ['System.Web.Http.IHttpActionResult Get(System.String, System.DateTime, System.DateTime)'     in 'OneTouchWebServiceV3.Controllers.ClaimsController'. An optional parameter must be a
    reference type, a nullable type, or be declared as an optional parameter."
}

Invalid VendorSiteID Used

HttpStatusCode: 400 (Bad Request)
Body:
{
"Message": "Invalid VendorSiteId"
}

Missing or Blank VendorSiteID

HttpStatusCode: 404 (Not Found)
Body:
{
"Message":"No HTTP resource was found that matches the request URI 'http://sandbox.services.apexedi.com/api/V3/claims/status/get_by_date'."
}

Missing Claim Numbers (by Claim)

HttpStatusCode: 400 Bad Request
Body:
{
"Message": "The request is invalid.",
"MessageDetail": "No claim numbers have been included"
}

Illegal Date Range

HttpStatusCode: 400 Bad Request
Body:
{
"Message": "The request is invalid.",
"MessageDetail": "Query period exceeds the allowed 30 day limit for status search (08/01/2022 - 02/01/2022 = 182 days"
}

GetClaimStatusByDate

/api/V3/claims/status/get_by_date?vendorSiteId=<vendorSiteId>&startDate=<YYYY-MM-DD>&endDate=<YYYY-MM-DD>

Only the current status of a given claim is returned. The start and end date parameters are used to query the most recent StateChangeDate for related claims. The payer response related document ID should be used to get the payer response document for that current status via the GetPayerResponseDocument API

Curl Example

curl -X POST "https://sandbox.services.apexedi.com/api/v3/claims/status/get_by_date?vendorSiteId=XXSiteId&startDate=2017-04-12&endDate=2017-05-12"
--header "Authorization: Basic <vendorkey:vendorPassword as base64 encoded string>"
--header "Content-Type: application/json"

NOTE: if a status does not have a related document ID, it means that it is a status generated internally by Apex (e.g., when a claim is imported, or when it was sent to the payer).

Responses

Successful List of Statuses returned

HttpStatusCode: 200 (OK)

Body:

[
  {
    "VendorId": 333,
    "VendorSiteId": "444_XYZ",
    "ClaimNumber": "M28587618",
    "CurrentState": "Complete",
    "StateChangeDate": "2017-03-08",
    "PayerAction": "ProcessedAsPrimary",
    "PayerActionDate": "2017-02-13",
    "PayerControlNumber": "7284901234 0984823419",
    "CreateDate": "2017-02-13",
    "LastUpdateDate": "2017-03-08",
    "RelatedDocumentType": "RemittanceAdvice",
    "RelatedDocumentId": "RJL39LKFKLEPRJLXLKERUOWEKMAKSDJFOEIRASEKRU9824LKJLKAJ9",
    "TotalClaimAmount": 1735.00,
    "PayerAmount": 0.00,
    "Adjustments": 1735.00,
    "PatientAmount": 1735.00,
    "PayerName": null,
    "PaymentMethod": null,
    "PaymentReferenceNumber": "YK93459691",
    "PaymentEffectiveDate": "0001-01-01",
    "VendorClaimId": "288537"
  },
  {
    "VendorId": 333,
    "VendorSiteId": "444_XYZ",
    "ClaimNumber": "M28719741",
    "CurrentState": "Complete",
    "StateChangeDate": "2017-04-12",
    "PayerAction": "ProcessedAsPrimary",
    "PayerActionDate": "2017-02-21",
    "PayerControlNumber": "OFC4342348700",
    "CreateDate": "2017-02-21",
    "LastUpdateDate": "2017-04-12",
    "RelatedDocumentType": "RemittanceAdvice",
    "RelatedDocumentId": "AHL2C6IOEWL2MJ6UT5JXOO3WXRBQD336DGUHEHKJJC5GTR2XRSYUU5",
    "TotalClaimAmount": 1735.00,
    "PayerAmount": 0.00,
    "Adjustments": 1735.00,
    "PatientAmount": 0.00,
    "PayerName": null,
    "PaymentMethod": null,
    "PaymentReferenceNumber": "080522Z000823",
    "PaymentEffectiveDate": "0001-01-01",
    "VendorClaimId": "288868"
  }
]

Errors

Invalid Date

HttpStatusCode: 400 Bad Request
Body:
{
"Message": "The request is invalid.",
"MessageDetail": "The parameters dictionary contains a null entry for parameter 'startDate' [or 'endDate'] of non-nullable type 'System.DateTime' for method 'System.Web.Http.IHttpActionResult Get(System.String, System.DateTime, System.DateTime)' in 'OneTouchWebServiceV3.Controllers.ClaimsController'. An optional parameter must be a reference type, a nullable type, or be declared as an optional parameter."
}

Invalid VendorSiteID Used

HttpStatusCode: 400 (Bad Request)
Body:
{
"Message": "Invalid VendorSiteId"
}

Missing or Blank VendorSiteID

HttpStatusCode: 404 (Not Found)
Body:
{
"Message":"No HTTP resource was found that matches the request URI 'http://sandbox.services.apexedi.com/api/V3/claims/status/get_by_date'."
}

GetPayerResponseDocuments

/api/v3/claims/responses/get_by_doc_id?vendorSiteId=<vendorSiteId>

Curl Example

curl -X POST https://sandbox.services.apexedi.com/api/v3/claims/responses/get_by_doc_id?vendorSiteId=XXSiteId ^
--header "Authorization: Basic <vendorkey:vendorPassword as base64 encoded string> " ^
--header "Content-Type: application/json" ^
--data "[\"AFPO53XLSSMNA3VV7YFMZ5NEGAOJQZLEOWEW3RYQNOFGUTD5AXI5\",\"AGAXJYIN4WXXE47IVWOSKG2MSBMNNHUGBNR3GX6FBBGPNTVGQ5\",\"AFNLV3FNBUL43DFVWDXJHXCAN2FQXY3EQ5AHCYPDE6FW5GWM5\"]"

Responses

Successful List of Payer Response Returned:

NOTE: For RemittanceAdvice objects, payers usually put all claims paid with one payment in one RemittanceAdvice. However a payer may choose to separate claims into different groups for the same Remittance payment. When this occurs there will be a separate RemittanceAdvice returned for each group, each with the same PaymentDetails section containing the same check number and payment amount. The claims in each Remittance, however, will be unique. There will be a separate document ID for each group associated with the same payment.

HttpStatusCode: 200 (OK)

Body:

{
  "RemittanceAdvices": [
    {
      "PaymentDetails": {
        "HandlingCode": "Notification",
        "TotalActualProviderPayment": 0.0,
        "TransactionType": "Credit",
        "PaymentMethod": "None",
        "PaymentFormat": "Unknown",
        "TransactionEffectiveDate": "2017-03-07",
        "ProductionDate": "2017-03-07",
        "PaymentReferenceNumber": "QK57791333",
        "SenderAbaTransitRoutingNumber": null,
        "SenderCanadianBankNumber": null,
        "SenderAccountNumber": null,
        "SenderSoftwareVersion": "1083",
        "PayerId": null,
        "PayerSupplementalId": null,
        "PayerTaxId": "1411289245",
        "PayerSupplementalTaxId": "PE0047856",
        "ReceiverId": "B00099999800",
        "ReceiverAbaTransitRoutingNumber": null,
        "ReceiverCanadianBankNumber": null,
        "ReceiverBankIdNumber": null,
        "ReceiverDepositAccountNumber": null,
        "ReceiverSavingsAccountNumber": null,
        "Currency": null
      },
      "Payer": {
        "Name": "ACCEPTABLE HEALTHCARE INSURANCE COMPANY",
        "BusinessContact": null,
        "TechnicalContacts": [
          {
            "Name": "",
            "Methods": [
              {
                "EmailAddress": null,
                "PhoneNumber": null,
                "PhoneNumberExtension": null,
                "FaxNumber": null
              }
            ]
          }
        ],
        "WebSite": null,
        "PhysicalAddress": {
          "SendToAttentionOf": null,
          "Address1": "P O BOX 999888",
          "Address2": null,
          "City": "ATLANTA",
          "State": "GA",
          "ZipCode": "303999888",
          "CountryCode": null,
          "CountrySubCode": null
        },
        "PayerId": "87878",
        "CmsPlanId": null,
        "PayerIdentificationNumber": "87878",
        "SubmitterIdentificationNumber": null,
        "HealthIndustryNumber": null,
        "TaxpayerIdentificationNumber": null,
        "PharmacyProcessorNumber": null,
        "NaicCode": null,
        "BcbsPlanCode": null
      },
      "Payee": {
        "Name": "TIP-TOP DIAGNOSTICS LLC",
        "NationalProviderId": null,
        "TaxIdNumber": "343434343",
        "CmsPlanId": null,
        "StateLicenseNumber": null,
        "PharmacyNumber": null,
        "PayeeId": "5959595959",
        "OtherPayeeId": null,
        "DeliveryMethod": "Unknown",
        "PhysicalAddress": {
          "SendToAttentionOf": null,
          "Address1": "23558 PLEASING LANE STE 504A",
          "Address2": null,
          "City": "FLORENCE",
          "State": "OH",
          "ZipCode": "431408685",
          "CountryCode": null,
          "CountrySubCode": null
        },
        "DeliveryUrl": null
      },
      "SubsidiaryProviderId": "5959595959",
      "ProviderFiscalYearEnd": null,
      "ClaimPayments": [
        {
          "PatientControlNumber": "EDI.JONES000",
          "PayerControlNumber": "5846876875 0068512147",
          "ClaimType": "PointOfService",
          "PayerStatus": "ProcessedAsPrimary",
          "TotalClaimCharges": 250.0,
          "PaymentAmount": 0.0,
          "PatientResponsibility": 0.0,
          "PlaceOfService": "Office",
          "ClaimFrequency": "AdmitThroughDischarge",
          "DischargeFraction": null,
          "ClaimLevelAdjustments": null,
          "Patient": {
            "SocialSecurityNumber": null,
            "StandardUniqueHealthIdentifier": null,
            "MemberIdentificationNumber": null,
            "HealthInsuranceClaimNumber": null,
            "MedicaidIdentificationNumber": null,
            "Address": null,
            "EntityType": "Individual",
            "CommonName": "JONES",
            "FirstName": "SALLY",
            "MiddleName": null,
            "Suffix": null
          },
          "Subscriber": {
            "TaxIdentificationNumber": null,
            "StandardUniqueHealthIdentifier": null,
            "MemberIdentificationNumber": "161616161616",
            "GroupPolicyNumber": null,
            "GroupName": null,
            "EntityType": "Individual",
            "CommonName": "JONES",
            "FirstName": "SALLY",
            "MiddleName": null,
            "Suffix": null
          },
          "OtherSubscriber": null,
          "CorrectedEntity": {
            "CorrectedUniqueId": "515151515",
            "OtherInsuredGroupNumber": null,
            "EntityType": "Individual",
            "CommonName": null,
            "FirstName": null,
            "MiddleName": "A",
            "Suffix": null
          },
          "RenderingProvider": null,
          "CrossoverPayer": null,
          "CorrectedPriorityPayer": null,
          "OutpatientAdjudicationInformation": null,
          "InpatientAdjudicationInformation": null,
          "ServicePayments": [ 
            {
              "AdjudicatedProcedure1": {
                "Type": "Unknown",
                "ProcedureCode": "G0479",
                "Description": null,
                "Modifiers": []
              },
              "AdjudicatedProcedure2": null,
              "LineItemChargeAmount": 250.0,
              "LineItemProviderPaymentAmount": 0.0,
              "ServiceDates": {
                "Start": "2017-01-05",
                "End": null
              },
              "NubcRevenueCode": null,
              "PaidUnitsOfServiceCount": 1.0,
              "OriginalUnitsOfServiceCount": null,
              "Adjustments": [
                {
                  "GroupCode": "PayorInitiatedReductions",
                  "Adjustments": [
                    {
                      "Reason": "226",
                      "Amount": 250.0,
                      "Quantity": null
                    }
                  ]
                }
              ],
              "AmbulatoryPatientGroupNumber": null,
              "AmbulatoryPatientClassification": null,
              "AuthorizationNumber": null,
              "AttachmentCode": null,
              "PriorAuthorizationNumber": null,
              "PredeterminationOfBenefitsId": null,
              "LocationNumber": null,
              "RateCode": null,
              "LineItemControlNumber": "EDI.JONES000.367",
              "RenderingProviderIds": null,
              "HealthCarePolicyNumbers": null,
              "AllowedActualAmount": null,
              "LateFilingReductionAmount": null,
              "TaxAmount": null,
              "TotalClaimBeforeTaxesAmount": null,
              "FederallyMandatedPayments": null,
              "Remarks": [
                {
                  "PaymentRemark": "N706",
                  "PrescriptionDrugCode": null
                }
              ]
            }
          ],
          "GroupOrPolicyNumber": "747474",
          "MemberIdentificationNumber": null,
          "EmployeeIdentificationNumber": null,
          "RepricedClaimReferenceNumber": null,
          "AdjustedRepricedClaimReferenceNumber": null,
          "AuthorizationNumber": null,
          "ClassOfContractCode": "CHOYC+",
          "MedicalReferenceId": null,
          "OriginalReferenceNumber": null,
          "PriorAuthorizationNumber": null,
          "PredeterminationOfBenefitsId": null,
          "InsurancePolicyNumber": null,
          "SocialSecurityNumber": null,
          "StatementDate": {
            "Start": "2017-01-05",
            "End": "2017-01-05"
          },
          "CoverageExpirationDate": null,
          "ClaimReceivedDate": "2017-01-10",
          "PrimaryPayerContact": {
            "Name": "HIGH POINT SERVICE CENTER",
            "Methods": [
              {
                "EmailAddress": null,
                "PhoneNumber": "8778778778",
                "PhoneNumberExtension": null,
                "FaxNumber": null
              }
            ]
          },
          "SecondaryPayerContact": null,
          "CovergeAmount": null,
          "PromptPayDiscountAmount": null,
          "PerDayLimitAmount": null,
          "PatientAmountPaid": null,
          "InterestAmount": null,
          "NegativeLedgerAmount": null,
          "TaxAmount": null,
          "TotalClaimBeforeTaxesAmount": null,
          "FederallyMandatedPayments": null,
          "CoveredQuantityActual": null,
          "NonCoveredQuantityEstimated": null,
          "CoinsuredQuantityActual": null,
          "LifetimeReservedQuantityActual": null,
          "LifetimeReservedQuantityEstimated": null,
          "NotReplacedBloodUnits": null,
          "OutlierDays": null,
          "PrescriptionQuantity": null,
          "Visits": null
        },
        {
          "PatientControlNumber": "EDI.JOHSUE000",
          "PayerControlNumber": "6385088433 0263858372",
          "ClaimType": "PointOfService",
          "PayerStatus": "ProcessedAsPrimary",
          "TotalClaimCharges": 1735.0,
          "PaymentAmount": 0.0,
          "PatientResponsibility": 1735.0,
          "PlaceOfService": "Office",
          "ClaimFrequency": "AdmitThroughDischarge",
          "DischargeFraction": null,
          "ClaimLevelAdjustments": null,
          "Patient": {
            "SocialSecurityNumber": null,
            "StandardUniqueHealthIdentifier": null,
            "MemberIdentificationNumber": null,
            "HealthInsuranceClaimNumber": null,
            "MedicaidIdentificationNumber": null,
            "Address": null,
            "EntityType": "Individual",
            "CommonName": "JOHNSON",
            "FirstName": "SUE",
            "MiddleName": null,
            "Suffix": null
          },
          "Subscriber": {
            "TaxIdentificationNumber": null,
            "StandardUniqueHealthIdentifier": null,
            "MemberIdentificationNumber": "939393939",
            "GroupPolicyNumber": null,
            "GroupName": null,
            "EntityType": "Individual",
            "CommonName": "JOHNSON",
            "FirstName": "SUE",
            "MiddleName": null,
            "Suffix": null
          },
          "OtherSubscriber": null,
          "CorrectedEntity": {
            "CorrectedUniqueId": null,
            "OtherInsuredGroupNumber": null,
            "EntityType": "Individual",
            "CommonName": null,
            "FirstName": null,
            "MiddleName": "A",
            "Suffix": null
          },
          "RenderingProvider": null,
          "CrossoverPayer": null,
          "CorrectedPriorityPayer": null,
          "OutpatientAdjudicationInformation": null,
          "InpatientAdjudicationInformation": null,
          "ServicePayments": [ 
            {
              "AdjudicatedProcedure1": {
                "Type": "Unknown",
                "ProcedureCode": "80307",
                "Description": null,
                "Modifiers": []
              },
              "AdjudicatedProcedure2": null,
              "LineItemChargeAmount": 250.0,
              "LineItemProviderPaymentAmount": 0.0,
              "ServiceDates": {
                "Start": "2017-02-21",
                "End": null
              },
              "NubcRevenueCode": null,
              "PaidUnitsOfServiceCount": 1.0,
              "OriginalUnitsOfServiceCount": null,
              "Adjustments": [
                {
                  "GroupCode": "PatientResponsibility",
                  "Adjustments": [
                    {
                      "Reason": "1",
                      "Amount": 87.79,
                      "Quantity": null
                    },
                    {
                      "Reason": "45",
                      "Amount": 162.21,
                      "Quantity": null
                    }
                  ]
                }
              ],
              "AmbulatoryPatientGroupNumber": null,
              "AmbulatoryPatientClassification": null,
              "AuthorizationNumber": null,
              "AttachmentCode": null,
              "PriorAuthorizationNumber": null,
              "PredeterminationOfBenefitsId": null,
              "LocationNumber": null,
              "RateCode": null,
              "LineItemControlNumber": "EDI.JOHSUE000.244",
              "RenderingProviderIds": null,
              "HealthCarePolicyNumbers": null,
              "AllowedActualAmount": 87.79,
              "LateFilingReductionAmount": null,
              "TaxAmount": null,
              "TotalClaimBeforeTaxesAmount": null,
              "FederallyMandatedPayments": null,
              "Remarks": null
            },
            {
              "AdjudicatedProcedure1": {
                "Type": "Unknown",
                "ProcedureCode": "83516",
                "Description": null,
                "Modifiers": [
                  "91"
                ]
              },
              "AdjudicatedProcedure2": null,
              "LineItemChargeAmount": 232.0,
              "LineItemProviderPaymentAmount": 0.0,
              "ServiceDates": {
                "Start": "2017-02-21",
                "End": null
              },
              "NubcRevenueCode": null,
              "PaidUnitsOfServiceCount": 4.0,
              "OriginalUnitsOfServiceCount": null,
              "Adjustments": [
                {
                  "GroupCode": "PatientResponsibility",
                  "Adjustments": [
                    {
                      "Reason": "1",
                      "Amount": 69.61,
                      "Quantity": null
                    },
                    {
                      "Reason": "45",
                      "Amount": 162.39,
                      "Quantity": null
                    }
                  ]
                }
              ],
              "AmbulatoryPatientGroupNumber": null,
              "AmbulatoryPatientClassification": null,
              "AuthorizationNumber": null,
              "AttachmentCode": null,
              "PriorAuthorizationNumber": null,
              "PredeterminationOfBenefitsId": null,
              "LocationNumber": null,
              "RateCode": null,
              "LineItemControlNumber": "EDI.JOHSUE000.245",
              "RenderingProviderIds": null,
              "HealthCarePolicyNumbers": null,
              "AllowedActualAmount": 69.61,
              "LateFilingReductionAmount": null,
              "TaxAmount": null,
              "TotalClaimBeforeTaxesAmount": null,
              "FederallyMandatedPayments": null,
              "Remarks": null
            },
            {
              "AdjudicatedProcedure1": {
                "Type": "Unknown",
                "ProcedureCode": "82542",
                "Description": null,
                "Modifiers": [
                  "91"
                ]
              },
              "AdjudicatedProcedure2": null,
              "LineItemChargeAmount": 462.0,
              "LineItemProviderPaymentAmount": 0.0,
              "ServiceDates": {
                "Start": "2017-02-21",
                "End": null
              },
              "NubcRevenueCode": null,
              "PaidUnitsOfServiceCount": 6.0,
              "OriginalUnitsOfServiceCount": null,
              "Adjustments": [
                {
                  "GroupCode": "PatientResponsibility",
                  "Adjustments": [
                    {
                      "Reason": "1",
                      "Amount": 157.74,
                      "Quantity": null
                    },
                    {
                      "Reason": "45",
                      "Amount": 304.26,
                      "Quantity": null
                    }
                  ]
                }
              ],
              "AmbulatoryPatientGroupNumber": null,
              "AmbulatoryPatientClassification": null,
              "AuthorizationNumber": null,
              "AttachmentCode": null,
              "PriorAuthorizationNumber": null,
              "PredeterminationOfBenefitsId": null,
              "LocationNumber": null,
              "RateCode": null,
              "LineItemControlNumber": "EDI.JOHSUE000.246",
              "RenderingProviderIds": null,
              "HealthCarePolicyNumbers": null,
              "AllowedActualAmount": 157.74,
              "LateFilingReductionAmount": null,
              "TaxAmount": null,
              "TotalClaimBeforeTaxesAmount": null,
              "FederallyMandatedPayments": null,
              "Remarks": null
            },
            {
              "AdjudicatedProcedure1": {
                "Type": "Unknown",
                "ProcedureCode": "80299",
                "Description": null,
                "Modifiers": [
                  "91"
                ]
              },
              "AdjudicatedProcedure2": null,
              "LineItemChargeAmount": 141.0,
              "LineItemProviderPaymentAmount": 0.0,
              "ServiceDates": {
                "Start": "2017-02-21",
                "End": null
              },
              "NubcRevenueCode": null,
              "PaidUnitsOfServiceCount": 3.0,
              "OriginalUnitsOfServiceCount": null,
              "Adjustments": [
                {
                  "GroupCode": "PatientResponsibility",
                  "Adjustments": [
                    {
                      "Reason": "1",
                      "Amount": 70.5,
                      "Quantity": null
                    },
                    {
                      "Reason": "45",
                      "Amount": 70.5,
                      "Quantity": null
                    }
                  ]
                }
              ],
              "AmbulatoryPatientGroupNumber": null,
              "AmbulatoryPatientClassification": null,
              "AuthorizationNumber": null,
              "AttachmentCode": null,
              "PriorAuthorizationNumber": null,
              "PredeterminationOfBenefitsId": null,
              "LocationNumber": null,
              "RateCode": null,
              "LineItemControlNumber": "EDI.JOHSUE000.247",
              "RenderingProviderIds": null,
              "HealthCarePolicyNumbers": null,
              "AllowedActualAmount": 70.5,
              "LateFilingReductionAmount": null,
              "TaxAmount": null,
              "TotalClaimBeforeTaxesAmount": null,
              "FederallyMandatedPayments": null,
              "Remarks": null
            },
            {
              "AdjudicatedProcedure1": {
                "Type": "Unknown",
                "ProcedureCode": "G0483",
                "Description": null,
                "Modifiers": []
              },
              "AdjudicatedProcedure2": null,
              "LineItemChargeAmount": 650.0,
              "LineItemProviderPaymentAmount": 0.0,
              "ServiceDates": {
                "Start": "2017-02-21",
                "End": null
              },
              "NubcRevenueCode": null,
              "PaidUnitsOfServiceCount": 1.0,
              "OriginalUnitsOfServiceCount": null,
              "Adjustments": [
                {
                  "GroupCode": "PatientResponsibility",
                  "Adjustments": [
                    {
                      "Reason": "1",
                      "Amount": 269.48,
                      "Quantity": null
                    },
                    {
                      "Reason": "45",
                      "Amount": 380.52,
                      "Quantity": null
                    }
                  ]
                }
              ],
              "AmbulatoryPatientGroupNumber": null,
              "AmbulatoryPatientClassification": null,
              "AuthorizationNumber": null,
              "AttachmentCode": null,
              "PriorAuthorizationNumber": null,
              "PredeterminationOfBenefitsId": null,
              "LocationNumber": null,
              "RateCode": null,
              "LineItemControlNumber": "EDI.JOHSUE000.248",
              "RenderingProviderIds": null,
              "HealthCarePolicyNumbers": null,
              "AllowedActualAmount": 269.48,
              "LateFilingReductionAmount": null,
              "TaxAmount": null,
              "TotalClaimBeforeTaxesAmount": null,
              "FederallyMandatedPayments": null,
              "Remarks": null
            }
          ],
          "GroupOrPolicyNumber": "6Q8787",
          "MemberIdentificationNumber": null,
          "EmployeeIdentificationNumber": null,
          "RepricedClaimReferenceNumber": null,
          "AdjustedRepricedClaimReferenceNumber": null,
          "AuthorizationNumber": null,
          "ClassOfContractCode": "CHOYC+",
          "MedicalReferenceId": null,
          "OriginalReferenceNumber": null,
          "PriorAuthorizationNumber": null,
          "PredeterminationOfBenefitsId": null,
          "InsurancePolicyNumber": null,
          "SocialSecurityNumber": null,
          "StatementDate": {
            "Start": "2017-02-21",
            "End": "2017-02-21"
          },
          "CoverageExpirationDate": null,
          "ClaimReceivedDate": "2017-02-28",
          "PrimaryPayerContact": {
            "Name": "HIGH POINT SMALL GROUP",
            "Methods": [
              {
                "EmailAddress": null,
                "PhoneNumber": "8668668668",
                "PhoneNumberExtension": null,
                "FaxNumber": null
              }
            ]
          },
          "SecondaryPayerContact": null,
          "CovergeAmount": 655.12,
          "PromptPayDiscountAmount": null,
          "PerDayLimitAmount": null,
          "PatientAmountPaid": null,
          "InterestAmount": null,
          "NegativeLedgerAmount": null,
          "TaxAmount": null,
          "TotalClaimBeforeTaxesAmount": null,
          "FederallyMandatedPayments": null,
          "CoveredQuantityActual": null,
          "NonCoveredQuantityEstimated": null,
          "CoinsuredQuantityActual": null,
          "LifetimeReservedQuantityActual": null,
          "LifetimeReservedQuantityEstimated": null,
          "NotReplacedBloodUnits": null,
          "OutlierDays": null,
          "PrescriptionQuantity": null,
          "Visits": null
        },
        {
          "PatientControlNumber": "EDI.WILFR000",
          "PayerControlNumber": "7992341002 3542340901",
          "ClaimType": "PointOfService",
          "PayerStatus": "ProcessedAsPrimary",
          "TotalClaimCharges": 1735.0,
          "PaymentAmount": 0.0,
          "PatientResponsibility": 1735.0,
          "PlaceOfService": "Office",
          "ClaimFrequency": "AdmitThroughDischarge",
          "DischargeFraction": null,
          "ClaimLevelAdjustments": null,
          "Patient": {
            "SocialSecurityNumber": null,
            "StandardUniqueHealthIdentifier": null,
            "MemberIdentificationNumber": null,
            "HealthInsuranceClaimNumber": null,
            "MedicaidIdentificationNumber": null,
            "Address": null,
            "EntityType": "Individual",
            "CommonName": "WILLIAMS",
            "FirstName": "FRED",
            "MiddleName": null,
            "Suffix": null
          },
          "Subscriber": {
            "TaxIdentificationNumber": null,
            "StandardUniqueHealthIdentifier": null,
            "MemberIdentificationNumber": "383838383",
            "GroupPolicyNumber": null,
            "GroupName": null,
            "EntityType": "Individual",
            "CommonName": "WILLIAMS",
            "FirstName": "FRED",
            "MiddleName": null,
            "Suffix": null
          },
          "OtherSubscriber": null,
          "CorrectedEntity": {
            "CorrectedUniqueId": null,
            "OtherInsuredGroupNumber": null,
            "EntityType": "Individual",
            "CommonName": "WILLIAMS",
            "FirstName": "FRED",
            "MiddleName": "J",
            "Suffix": null
          },
          "RenderingProvider": null,
          "CrossoverPayer": null,
          "CorrectedPriorityPayer": null,
          "OutpatientAdjudicationInformation": null,
          "InpatientAdjudicationInformation": null,
          "ServicePayments": [ 
            {
              "AdjudicatedProcedure1": {
                "Type": "Unknown",
                "ProcedureCode": "80307",
                "Description": null,
                "Modifiers": []
              },
              "AdjudicatedProcedure2": null,
              "LineItemChargeAmount": 250.0,
              "LineItemProviderPaymentAmount": 0.0,
              "ServiceDates": {
                "Start": "2017-02-06",
                "End": null
              },
              "NubcRevenueCode": null,
              "PaidUnitsOfServiceCount": 1.0,
              "OriginalUnitsOfServiceCount": null,
              "Adjustments": [
                {
                  "GroupCode": "PatientResponsibility",
                  "Adjustments": [
                    {
                      "Reason": "1",
                      "Amount": 87.79,
                      "Quantity": null
                    },
                    {
                      "Reason": "45",
                      "Amount": 162.21,
                      "Quantity": null
                    }
                  ]
                }
              ],
              "AmbulatoryPatientGroupNumber": null,
              "AmbulatoryPatientClassification": null,
              "AuthorizationNumber": null,
              "AttachmentCode": null,
              "PriorAuthorizationNumber": null,
              "PredeterminationOfBenefitsId": null,
              "LocationNumber": null,
              "RateCode": null,
              "LineItemControlNumber": "EDI.WILFR000.1",
              "RenderingProviderIds": null,
              "HealthCarePolicyNumbers": null,
              "AllowedActualAmount": 87.79,
              "LateFilingReductionAmount": null,
              "TaxAmount": null,
              "TotalClaimBeforeTaxesAmount": null,
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      "Payer": {
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      "VendorClaimId": "282828",
      "DocumentId": "UURERW3859968JXKKNMHSAHJ3485KXJDJ34JASFI83424KSDJFFP43",
      "CreateDate": "2017-04-12",
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      "Level": "Claim",
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        "ClaimProcessDate": "2017-03-07",
        "Submitter": {
          "EntityType": "Organization",
          "CommonName": "APEX EDI INC",
          "FirstName": null,
          "MiddleName": null,
          "Suffix": null
        },
        "SubmitterPrimaryId": "AW95595595",
        "SubmitterBatchNumber": "0",
        "TransactionStatus": [
          {
            "EffectiveDate": "2017-03-07",
            "Action": "Accept",
            "TotalChargeAmount": 160057.0,
            "StatusMessage": null,
            "Details": {
              "StatusCategory": "AckReceipt",
              "Status": "20",
              "Entity": "None"
            },
            "AdditionalDetails": null
          }
        ],
        "TotalAcceptedCount": 89.0,
        "TotalAcceptedAmount": 160057.0,
        "TotalRejectedCount": null,
        "TotalRejectedAmount": null
      },
      "BillingProvider": {
        "NationalProviderId": "5959595959",
        "TaxpayerNumber": "343434343",
        "StateLicenseNumber": null,
        "UpinNumber": null,
        "CommercialNumber": null,
        "LocationNumber": null,
        "SocialSecurityNumber": null,
        "InformationTraceId": "0",
        "TotalAcceptedCount": 89.0,
        "TotalAcceptedAmount": 160057.0,
        "TotalRejectedCount": null,
        "TotalRejectedAmount": null,
        "ProviderStatus": null,
        "PhysicalAddress": null,
        "EntityType": "Organization",
        "CommonName": "TIP-TOP DIAGNOSTICS LLC",
        "FirstName": null,
        "MiddleName": null,
        "Suffix": null
      },
      "Patient": {
        "SocialSecurityNumber": null,
        "StandardUniqueHealthIdentifier": null,
        "MemberIdentificationNumber": "2U4552525525",
        "HealthInsuranceClaimNumber": null,
        "MedicaidIdentificationNumber": null,
        "Address": null,
        "EntityType": "Unknown",
        "CommonName": "DAVIS",
        "FirstName": "BRITTANY",
        "MiddleName": null,
        "Suffix": null
      },
      "PatientControlNumber": "EDI.DAVBR000",
      "PayerControlNumber": "70655053C900X",
      "BillTypeId": null,
      "Status": [
        {
          "EffectiveDate": "2017-03-07",
          "Action": "Accept",
          "TotalChargeAmount": 4331.0,
          "StatusMessage": null,
          "Details": {
            "StatusCategory": "AckReceipt",
            "Status": "20",
            "Entity": "None"
          },
          "AdditionalDetails": null
        }
      ],
      "ClearinghouseControlNumber": "M28934184",
      "ClaimServiceDate": {
        "Start": "2015-06-26",
        "End": "2015-06-26"
      },
      "ServiceErrors": null,
      "Subscriber": null,
      "VendorClaimId": "289485",
      "DocumentId": "AG2OB5LRX42XN366XTSYMR46M743NFCMTVSRGQSNVTTNPESY5PE5C5",
      "CreateDate": "2017-03-07",
      "ResponseType": "ClaimStatus"
    },
    {
      "Level": "Claim",
      "TransactionDetails": {
        "SenderType": "Payer",
        "SenderName": "FIRST-RATE INSURANCE CO.",
        "SenderApplicationTraceId": "24242424242424242",
        "SenderTransmitterIdNumber": null,
        "SenderTaxIdNumber": null,
        "SenderPayerId": "06060",
        "SenderCmsPlanId": null,
        "ClaimReceivedDate": "2017-03-06",
        "ClaimProcessDate": "2017-03-07",
        "Submitter": {
          "EntityType": "Organization",
          "CommonName": "APEX EDI INC",
          "FirstName": null,
          "MiddleName": null,
          "Suffix": null
        },
        "SubmitterPrimaryId": "AW95595595",
        "SubmitterBatchNumber": "0",
        "TransactionStatus": [
          {
            "EffectiveDate": "2017-03-07",
            "Action": "Accept",
            "TotalChargeAmount": 160057.0,
            "StatusMessage": null,
            "Details": {
              "StatusCategory": "AckReceipt",
              "Status": "20",
              "Entity": "None"
            },
            "AdditionalDetails": null
          }
        ],
        "TotalAcceptedCount": 89.0,
        "TotalAcceptedAmount": 160057.0,
        "TotalRejectedCount": null,
        "TotalRejectedAmount": null
      },
      "BillingProvider": {
        "NationalProviderId": "5959595959",
        "TaxpayerNumber": "343434343",
        "StateLicenseNumber": null,
        "UpinNumber": null,
        "CommercialNumber": null,
        "LocationNumber": null,
        "SocialSecurityNumber": null,
        "InformationTraceId": "0",
        "TotalAcceptedCount": 89.0,
        "TotalAcceptedAmount": 160057.0,
        "TotalRejectedCount": null,
        "TotalRejectedAmount": null,
        "ProviderStatus": null,
        "PhysicalAddress": null,
        "EntityType": "Organization",
        "CommonName": "TIP-TOP DIAGNOSTICS LLC",
        "FirstName": null,
        "MiddleName": null,
        "Suffix": null
      },
      "Patient": {
        "SocialSecurityNumber": null,
        "StandardUniqueHealthIdentifier": null,
        "MemberIdentificationNumber": "2U4552525525",
        "HealthInsuranceClaimNumber": null,
        "MedicaidIdentificationNumber": null,
        "Address": null,
        "EntityType": "Unknown",
        "CommonName": "DAVIS",
        "FirstName": "BRITTANY",
        "MiddleName": null,
        "Suffix": null
      },
      "PatientControlNumber": "EDI.DAVBR000",
      "PayerControlNumber": "8068068068068",
      "BillTypeId": null,
      "Status": [
        {
          "EffectiveDate": "2017-03-07",
          "Action": "Accept",
          "TotalChargeAmount": 4195.0,
          "StatusMessage": null,
          "Details": {
            "StatusCategory": "AckReceipt",
            "Status": "20",
            "Entity": "None"
          },
          "AdditionalDetails": null
        }
      ],
      "ClearinghouseControlNumber": "M97979797",
      "ClaimServiceDate": {
        "Start": "2015-08-18",
        "End": "2015-08-18"
      },
      "ServiceErrors": null,
      "Subscriber": null,
      "VendorClaimId": "289486",
      "DocumentId": "IEKSLFIEL389LK845AS6D87ER354ASDF57ER6543ASDF5JYUOL4482",
      "CreateDate": "2017-03-07",
      "ResponseType": "ClaimStatus"
    },
    {
      "Level": "Claim",
      "TransactionDetails": {
        "SenderType": "Payer",
        "SenderName": "FIRST-RATE INSURANCE CO.",
        "SenderApplicationTraceId": "24242424242424242",
        "SenderTransmitterIdNumber": null,
        "SenderTaxIdNumber": null,
        "SenderPayerId": "00621",
        "SenderCmsPlanId": null,
        "ClaimReceivedDate": "2017-03-06",
        "ClaimProcessDate": "2017-03-07",
        "Submitter": {
          "EntityType": "Organization",
          "CommonName": "APEX EDI INC",
          "FirstName": null,
          "MiddleName": null,
          "Suffix": null
        },
        "SubmitterPrimaryId": "MW83942087",
        "SubmitterBatchNumber": "0",
        "TransactionStatus": [
          {
            "EffectiveDate": "2017-03-07",
            "Action": "Accept",
            "TotalChargeAmount": 160057.0,
            "StatusMessage": null,
            "Details": {
              "StatusCategory": "AckReceipt",
              "Status": "20",
              "Entity": "None"
            },
            "AdditionalDetails": null
          }
        ],
        "TotalAcceptedCount": 89.0,
        "TotalAcceptedAmount": 160057.0,
        "TotalRejectedCount": null,
        "TotalRejectedAmount": null
      },
      "BillingProvider": {
        "NationalProviderId": "5959595959",
        "TaxpayerNumber": "343434343",
        "StateLicenseNumber": null,
        "UpinNumber": null,
        "CommercialNumber": null,
        "LocationNumber": null,
        "SocialSecurityNumber": null,
        "InformationTraceId": "0",
        "TotalAcceptedCount": 89.0,
        "TotalAcceptedAmount": 160057.0,
        "TotalRejectedCount": null,
        "TotalRejectedAmount": null,
        "ProviderStatus": null,
        "PhysicalAddress": null,
        "EntityType": "Organization",
        "CommonName": "TIP-TOP DIAGNOSTICS LLC",
        "FirstName": null,
        "MiddleName": null,
        "Suffix": null
      },
      "Patient": {
        "SocialSecurityNumber": null,
        "StandardUniqueHealthIdentifier": null,
        "MemberIdentificationNumber": "2U4552525525",
        "HealthInsuranceClaimNumber": null,
        "MedicaidIdentificationNumber": null,
        "Address": null,
        "EntityType": "Unknown",
        "CommonName": "DAVIS",
        "FirstName": "BRITTANY",
        "MiddleName": null,
        "Suffix": null
      },
      "PatientControlNumber": "EDI.DAVBR000",
      "PayerControlNumber": "82490071234XX",
      "BillTypeId": null,
      "Status": [
        {
          "EffectiveDate": "2017-03-07",
          "Action": "Accept",
          "TotalChargeAmount": 4195.0,
          "StatusMessage": null,
          "Details": {
            "StatusCategory": "AckReceipt",
            "Status": "20",
            "Entity": "None"
          },
          "AdditionalDetails": null
        }
      ],
      "ClearinghouseControlNumber": "M74747474",
      "ClaimServiceDate": {
        "Start": "2015-09-15",
        "End": "2015-09-15"
      },
      "ServiceErrors": null,
      "Subscriber": null,
      "VendorClaimId": "289487",
      "DocumentId": "JRWEIJI893492JKJASKFJLIE8423LK34FJ1890FASDKEW8342KS89L",
      "CreateDate": "2017-03-07",
      "ResponseType": "ClaimStatus"
    }
  ]
}

Bad Document IDs Passed In

No errors, but no response documents returned, i.e., if 20 doc IDs are submitted, and 5 have invalid IDs, then only the 15 documents that had valid Doc IDs will be returned.

Invalid VendorSiteID Used:

HttpStatusCode: 400 (Bad Request)
Body:
{
"Message": "Invalid VendorSiteId"
}

Parameter Has No Content for VendorSiteId

HttpStatusCode: 400 (Bad Request)
Body:
{
"Message": "Value cannot be null.\r\nParameter name: vendorSiteId"
}

Missing vendorSiteId

HttpStatusCode: 404 (Not Found)
Body:
{
"Message":"No HTTP resource was found that matches the request URI 'http://sandbox.services.apexedi.com/api/v3/claims/get_by_doc_id/'."
}