pVerify’s Complete Patient Eligibility Verification
A Leader in Realtime Patient Insurance Verification Software for Medicare, Medicaids, and Commercial Payers
Secure and Reinforced HIPAA Compliant Cloud Based Environment
pVerify provides a FREE TRIAL for all of our solutions for US Medical Providers.
Most Comprehensive and Customized Eligibility Reports:
Verify Eligibility for All Payers with pVerify’s Batch Verification Reports
pVerify tailors batch eligibility reports specifically to your practice. If you’re a specialist, we delete data intended for primary care MDs. And make it easy for you to see if prior authorization is required (or if a patient is enrolled in an SNF). The possibilities for customization are nearly endless. What’s more, pVerify will check medical eligibility, and with batch processing, we perform Quality Assurance on every transaction to ensure the data are accurate.
pVerify premiere solution, Eligibility Summary, allows customized parsing of eligibility data for 99% of payers in the market. Unique to pVerify, no other eligibility service or clearinghouse provides as detailed and custom results with the greatest payer coverage in the industry. Benefit information is customized to your practice and procedures, facilitating prompt collections from patients and third-party payers.
Batch Excel Solution
pVerify tailors batch eligibility reports specifically to your practice. The results will be returned in a fully verified, color-coded excel of your patient’s complete benefits at the Service Type Level, including: Active Status, Plan Details & HMO/PPO detection, Copays/Deductibles/Coinsurance, If prior authorization is required, Home Health/Hospice Dates, Limitations, exception notes, and MORE!
API | Integration
pVerify offers SOAP Web-Services and RESTful API Solution. Our advanced configuration features allow you to get the data you want without wading through complex objects. Whether you need structured XML or JSON, both can be easily incorporated into your interface. Our real-time exchange system facilitates secure exchange of healthcare eligibility and related transactions, supporting one-to-one transactions for 6 unique API Solutions – Eligibility, Same or Similar, Estimates, SNF, Claim Status, and MBI Lookup. pVerify will work with you to deliver optimal results for your API needs.
Largest Payer Coverage Available
Reduction of Claim Denials
Save Time and Money on Staffing
Complete, Accurate, and Realtime Results
Are you a large Medical Practice Provider, Specialist, Revenue Cycle Manager?
Unique to pVerify, no other insurance verification service or clearinghouse provides as detailed and custom results.
- We will check medical eligibility and provide a batch eligibility report on all your patients for each day, delivered on an agreed-upon day prior to each date of service.
- You get up-to-date, easy-to-see info on copays, coinsurance, and deductibles.
- If a patient changed plans, you know in time to obtain prior authorization.
- If a claim is denied, you can go back up to 90 days to show eligibility for coverage at the time of visit.
Specialists and other providers with unique requirements get customized reports with a human touch that no other Eligibility Service can provide.
pVerify vs Clearinghouse and Payer Sites
Free Payer SiteManual Verification Only
- Multiple Web Portals
- No Parsing of Key Data
- Completely Manual
- Complex Displays
- Limited Batch Verification
- No Contract
- Nonexistent Support
pVerify EligibilityCloud-based Portal, Batch, API or Integrated
- 100% payer Coverage
- Multiple APIs Available
- Custom Batch Verification
- Complete Parsing
- Fully Automated
- User-friendly Dashboard
- Cloud-based Portal
- No app/software to Download
- Personalized API Support
- Business Rules Engine (AI Capabilities)
- Multiple Service Types per Verification
- Unlimited Providers, Locations, and Users
- NO CONTRACT OPTION
- SlowLimited to EDI payers
- Restricted Payer List
- Standard Batch
- No Parsing
- Complex Display
- Large Setup Fee
- Long-term Contract
- One Service Type per Verification
- Minimal API Development Support
- Slow Customer Support
More pVerify Solutions
pVerify provides a patient’s complete 5-year record across all 4 jurisdictions in a single verification, with accuracy and near-realtime. Run a patient’s Same or Similar directly from their Eligibility Results without retyping patient info with pVerify’s complimentary radio button. Solution requires existing NPI and PTAN numbers.
pVerify gives a scalable solution for obtaining the NEW Medicare MBI number, by submitting the patient’s SSN, DOB and Name. Available in single patient, batch processing, pVerify’s MBI Lookup requires existing NPI and PTAN numbers.
pVerify returns 54 actionable Preventive/ Screening HCPCS Codes, including information on services like Annual Wellness Visit & Cancer Screening. With pVerify’s report, you can filter out of the list of patients the ones due for their next Annual Wellness Exam, for example.
pVerify’s Claim Status provides a quick glance at a patient’s Claim History, including Procedure Codes, Charge Amounts, and Status Codes up to a 12-month history. Staff can now check the current status of what the payer has on file as of that day and review the Status Codes to determine if action is required.
Use your own fee schedule (either global or per payer) or use the up-to-date medicare non-facility pricing in pVerify’s Patient Responsibility Estimator. Built into the Eligibility Solutions, quickly estimate and collect copay at check-in.
Only pVerify provides this set of advantages.
pVerify Draws Rave Reviews!
Valley Behavioral Health has partnered with pVerify utilizing their Eligibility Verification Custom Excel Batch tool since Nov 2018. Our first impression of this company was that they were very professional, attentive and listened to our needs. They took our request and within a couple weeks of our introduction, they effortlessly built us customized discrete eligibility data that has proven hands down to be a great ROI. We have been extremely happy with their diligent and efficient business relationship and their quickness in responding to our needs. We have no problem making recommendations to other agencies within the state of Utah looking for proven valuable eligibility dataKathy McCall
Utilizing pVerify’s automated verification service, we are able to validate our patient’s benefits thoroughly and consistently in advance of their visit…This allows us to identify issues relating to patient’s coverage and take corrective action before the patient being seen..I highly recommend pVerify eligibility solutions for any busy practiceAlbert Castillo
Since using pVerify, we have significantly reduced claim rejections, lowered administrative cost (by reducing the time it takes to verify eligibilities) and has improved our cash flow. pVerify has contributed immensely to our practice and I am so happy that we began using them. pVerify truly is an efficient and cost-effective tool designed to facilitate the eligibility verification process.Beth Carvajal
pVerify® was founded in 2006 by a team of accomplished Healthcare Professionals with a singular focus: streamline the front-end patient insurance eligibility and benefit verification processes so as to not only improve the patient collections but also to reduce back-office denials.It’s HIPAA Complaint, SaaS offering includes robust set of REST APIs, fully-customizable Eligibility Portal and Mobile SDKs that have been powering mission-critical, front-end eligibility processes solutions for leading healthcare software companies as well as ambulatory practices in the healthcare sector.