Common Failed By Apex Messages (Apex)

Below is a list of common issues that are caught by the Apex EDI system and solutions on how to fix them. These messages will show in your Failed by Apex tab, which you can learn more about here. We will not be including errors that are obvious, such as a missing name or date, but other issues that aren't as easily solved. Should you not find your specific error message, please contact Apex Support at 800-840-9152 or email [e-mail]. Please note that this list will be updated regularly, so check frequently to see if there are newly added messages.

Failed Message	What this message means	How to correct it
The payer address you are using has been marked as invalid in the Apex system. Please verify the address with the payer and correct the address	This could be an issue due to either the address itself or the enrollment of the provider.	Enrollment: Check to see if the information in box 33 is showing the correct provider who has been enrolled to send to this payer. If not, then click on the dropdown box and select the correct provider. If the provider is correct, contact Apex Support for further help. Address: The address you are sending could be linking to a different payer. If the address you're sending matches what is on the insurance card, please contact Apex Support for help in correcting this issue.
Payer Requires Group Number	This payer has their electronic link set to only accept claims that have the Group Number included.	You will need to get this group number from either the subscriber or the insurance card and include it in box 11
Claim was received with an unknown provider. Please select a provider on the form or contact your Apex Account Manager	The claim was sent to Apex either without a provider listed, or it was sent in a format different from what our system is set to look for.	Be sure to verify that your Practice Management Software is sending the provider's information correctly. If it is correct, contact Apex support as they may need to adjust the information our system is looking for.
the Adjudication Date has been entered, but the Primary Paid Amount is missing. Please enter an amount or delete the Adjudication Date.	Information was included to indicate that secondary information was to be sent out on the claim, but it's missing required information	You will need to fill out the secondary information in box 24. For help on that, click here if you are a Medical client and here if you are a Dental client.
Primary Paid Amount has been entered, but the Adjudication Date is missing. Please enter an Adjudication Date or delete the Primary Paid Amount and resubmit the claim.	Information was included to indicate that secondary information was to be sent out on the claim, but it's missing required information	You will need to fill out the secondary information in box 24. For help on that, click here if you are a Medical client and here if you are a Dental client.
You have an overdue Apex invoice. Please verify that you have a valid payment method and billing email on file with Apex in your "Manage Account" area. If needed, please contact Apex support to bring your account current.	Apex has been having a few issues with charging your current form of payment.	You will need to contact Apex support to have this block lifted by the Accounting department. You will need to be able to pay the amount due, so be sure to have a current form of payment available.
On line item 1, the Procedure Code is not valid for the given Date of Service.	The procedure code was likely deleted before the date of service present in box 24	Verify that you have the correct procedure code, you can use the website https://www.findacode.com/index.html to see if the code was discontinued or not. You can also go to the insurance website to verify their list of approved codes.
On line 1, the Modifier could not be found in our list of valid modifiers.	One of the modifiers listed in box 24 is not a valid modifier in our system.	Verify that the modifier is correct and accepted by the insurance. If it is, then contact Apex support to push the claim through.
This claim was sent with a “Secondary Claim” indicator. However, there is no other secondary claim information provided on the claim. Either correct and resubmit the claim from your practice software, or enter the primary payer information and other insured information and save your changes	This means that your Practice Management Software sent an indicator to Apex that the claim is a secondary claim, however there is missing information that is required for a secondary claim.	If it is a secondary claim, then you will need to put the required information into the claim. For help on that, click here if you are a Medical client and here if you are a Dental client. If it is not a secondary claim, then you will need to resend the claim without the secondary indicator.