JSON twin: https://www.healthaidb.com/software/apex-edi.json
Ensora Health
https://ensorahealth.com/product/clearinghouse/
Apex EDI (now marketed as Ensora Clearinghouse) is a HIPAA‑compliant claims clearinghouse that automates claims scrubbing, eligibility verification, ERA processing and payer submissions to reduce denials and speed reimbursements.
Cloud-based claims clearinghouse for medical, dental, vision and allied practices that provides automated claims scrubbing, real‑time eligibility checks, electronic remittance advice (ERA), reporting, integrated payer rules, trading‑partner enrollment and EHR/practice-management integrations. Formerly branded Apex EDI and now part of Ensora Health.
yes
2013
P0123
2025-09-07
proprietary (commercial)
Volume-based or unlimited-claims subscription plans; tier options vary by volume—contact vendor for specific pricing. Free trial/demo available.
subscription
1995
product
1.0
{
"company_name": "Ensora Health",
"company_url": "https://ensorahealth.com",
"company_offices": [
"United States"
],
"company_founding": "2013",
"product_url": "https://ensorahealth.com/product/clearinghouse/",
"categories": [
"claims-clearinghouse",
"revenue-cycle-management",
"administrative"
],
"market_segment": [
"enterprise",
"smb"
],
"links": [
"https://ensorahealth.com/product/clearinghouse/",
"https://ensorahealth.com/about-us/",
"https://ensorahealth.com/security/",
"https://ensorahealth.com/pricing/",
"https://ensorahealth.com/support/",
"https://elion.health/products/apex-edi",
"https://www.g2.com/products/apex-edi/reviews",
"https://www.capterra.com/p/172913/Apex-EDI/",
"https://cgsmedicare.com/hhh/edi/5010trading_partners.html"
],
"summary": "Apex EDI (now marketed as Ensora Clearinghouse) is a HIPAA‑compliant claims clearinghouse that automates claims scrubbing, eligibility verification, ERA processing and payer submissions to reduce denials and speed reimbursements.",
"description": "Cloud-based claims clearinghouse for medical, dental, vision and allied practices that provides automated claims scrubbing, real‑time eligibility checks, electronic remittance advice (ERA), reporting, integrated payer rules, trading‑partner enrollment and EHR/practice-management integrations. Formerly branded Apex EDI and now part of Ensora Health.",
"target_users": [
"medical billers",
"practice administrators",
"clinicians",
"billing managers",
"revenue cycle teams",
"practice owners",
"payers (as trading partners)"
],
"specialties": [
"medical (primary care & specialty)",
"dental",
"optometry/vision",
"chiropractic",
"rehabilitative therapy (PT/OT/ST)",
"behavioral health/mental health",
"veterinary (limited mentions in some listings)"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "subscription",
"pricing_details": "Volume-based or unlimited-claims subscription plans; tier options vary by volume—contact vendor for specific pricing. Free trial/demo available.",
"license": "proprietary (commercial)",
"deployment_model": [
"SaaS"
],
"os_platforms": [
"Web"
],
"features": [
"Medical claims processing (837 submission)",
"Real-time eligibility checks (270/271)",
"Automated claims scrubbing / payer rules",
"Real-time claim status reporting (vendor claim ID status)",
"Electronic remittance advice (ERA / 835) management",
"Batch upload/download of claim/statement files",
"Payer list / Apex Payer ID lookup",
"Reporting and advanced search for claims",
"Integrated EHR clearinghouse workflows (embed GoToClaimForm)",
"Unviewed file/ERA notifications",
"Provider enrollment assistance",
"Volume-based or unlimited claims pricing options",
"In-house support and knowledge base"
],
"optional_modules": [
"Integrated ERA posting/reconciliation",
"Eligibility API access",
"Private-label / white-label clearinghouse",
"Volume-based vs unlimited claims plans"
],
"integrations": [
"Any EHR via integration (OneTouch API / embedded web UI)",
"Practice management / billing systems via API/file upload",
"Payers (clearinghouse routing to payer networks)"
],
"data_standards": [
"ANSI X12 (837, 835, 270/271 family)",
"EDI/EDI X12",
"XML (API responses)"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA",
"HITRUST (Therapy Brands: HITRUST e1 noted for NewCrop)",
"NIST-aligned information security controls",
"PCI considerations referenced (for payments integrations)"
],
"certifications": [
"HITRUST e1 (documented for Therapy Brands NewCrop system)"
],
"security_features": [
"Encryption in transit (SSL/HTTPS)",
"Encryption at rest (AES-256, cloud KMS)",
"MFA / 2FA for administrative access",
"Role-based access controls / least privilege",
"Audit logging and SIEM monitoring",
"Vulnerability management and patching"
],
"privacy_features": [
"Logical data segmentation (tenant data segregation)",
"Business Associate Agreement (BAA) available (implied)",
"Access controls and least-privilege enforcement",
"Data encryption at rest and in transit"
],
"data_residency": "",
"customers": [
"Cardinal Hope Mental Health Counseling Services",
"Alta Pediatrics",
"Seattle Hearing and Balance Center",
"Vision Source",
"Mari McGovern"
],
"user_reviews": [
"RUN.....RUN.....DO NOT USE THIS… RUN.....RUN.....DO NOT USE THIS SERVICE. THEY ARE HORRIBLE. AFTER YEARS OF USING THEM (FAIRLY INCIDENT FREE) THEY HAVE PLUMMETED IN CUSTOMER SERVICE.",
"Horrible customer service. Been waiting for almost a week to get a demo and haven't yet. Called the other day to talk to Bobby and the guy said he didn't work with him but also proceeded to say he was at lunch and would send him a message for me on teams . Never got that call or email.",
"If a claim is straight forward Apex is easy to use but if there are any issues they are very difficult to deal with. We continue to be told it is our software to only find out it was the submission."
],
"ratings": [
"Trustpilot: 2.5/5 (9 reviews)",
"Glassdoor (employees): 3.8/5"
],
"support_channels": [
"phone",
"email",
"knowledge_base",
"ticketing",
"request_demo"
],
"training_options": [
"documentation",
"webinars",
"live_online",
"knowledge_base"
],
"release_year": "1995",
"integration_partners": [],
"id": "P0123",
"slug": "apex-edi",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/apex-edi.json"
}
}