In this article, we will show you where you can find our Payer List, as well as how to use it.
Finding the Payer List
There are two ways to access our Payer List.
While you are logged in to your Apex account, a link to the Payer List can almost always be found at the bottom of the webpage. Look for the "Quick Links" column, and click on the "Apex Payer List" link.
The second way to find our payer list does not require you to be logged into your Apex account. After navigating to our main website, https://www.apexedi.com, scroll all the way to the bottom of the webpage. Under the "Need Help?" column, you will see a link to the Payer List.
Medical and Dental Payer Lists
When navigating to the Payer List page, please note that you will be directed by default to our Medical Payer List; however, you can easily toggle back and forth between Medical and Dental. There are no functional differences between the two lists, but there may be some different payer links depending on whether you are viewing the Dental or Medical Payer List.
In the upper left corner, you will see a button which you can use to toggle between the Medical and Dental Payer Lists. If the button reads "Show Dental," as in the example above, this indicates that you are looking at our Medical Payer List. (Conversely, when the button reads "Show Medical," this means you are currently viewing our Dental Payer List.)
Searching for a Payer
Because there is an abundance of payers out there, payer lists are usually quite long. You can use the search bar in the upper right of the payer list to search for a payer either by name or by Payer ID. Be advised that the Payer ID's that show up on this list are unique ID's that have been assigned by Apex in order to differentiate between different payers with the same ID. *See note at bottom of the article to see more on this.
Understanding the Payer List
The search tool will pull the payer(s) with information that most closely matches the search criteria. Once you have found the payer you are looking for you will be able to see how the name is spelled in our system, as well as the Payer ID assigned by Apex.
The list will also display a green dot on certain details regarding the connection we have with the payer(s), such as: if the payer accepts electronic claims; if Apex has an active ERA connection; if Apex has a connection to run eligibility with the payer; or if enrollment is required by the payer before electronic claims can be submitted.
*IMPORTANT NOTE: We utilize Payer ID's which may differ from what is listed on your patient's insurance card. The reason for this is there may be multiple branches of the same payer or a very different payer who share the same Payer ID. In order to minimize confusion, Apex assigns each payer a unique ID in order to assign a claim to a specific electronic payer destination. When filing claims through us you should be using the Payer ID provided by Apex on our payer list. If there is any confusion about which Payer ID should be used, you can contact support and we will work with you to find the correct connection for your claims.
While Apex assigns its own Payer ID for our clients to use to direct their claims to a payer, we have other Payer ID's which are for internal use and may be used on the claim when sending to a payer directly or through a necessary trading partner. These ID's may match what is found on a patient's insurance card, but they should not be used on your claims unless it matches the Apex Payer ID.
If you are unable to send a Payer ID on your claim submissions to Apex, our system will try to identify the correct payer using the payer name and payer address. The following is the priority for how our system identifies the payer destination:
- Apex Payer ID
- Payer Name
- Payer Address