Frequently Asked Questions

Get answers before you subscribe.
We already have access to Availity and many free payer sites; how is pVerify any different?

pVerify ™ is a single portal to verify eligibility instantly from 1150 insurance companies and it even covers non-EDI payers (through delayed verification process). Combination of our advanced parsing technology and proprietary process ensures that all the relevant information is available across all payer.  We also provide unique, color-coded Eligibility Summary Reports in Excel Spreadsheet format that makes it easy for your front-office to take appropriate actions. Furthermore, once verified, results are stored for 1 year in a searchable PDF format in case you need to access it again.

What are EDI and non-EDI payers?

EDI (electronic data interchange) refers to the structured transmission of data between organizations by electronics means. Most of the large, national payers support EDI eligibility transaction set 270/271, but there are many smaller and regional payers who still do not. pVerify™ is the only automated eligibility service provider to support non-EDI payers as well.

What is ‘parsing’?

Parsing refers to the process of extracting key benefits data such as co-pays, deductibles (in-network and out-of-network) etc. Only pVerify guarantees full parsing of data specific to your specialty. Once parsed, the data is then presented in a spreadsheet format where you can filter the data based on what you are looking for (e.g. sorting all patients with HMO plan or patients with inactive coverage).

How long does it take pVerify to verify eligibility?
While doing instant verification, pVerify takes as little as 3 to 5 seconds to verify eligibility. However, it takes longer for batch verification, since batch verification includes parsing as well as quality control.
What is the information that I require to carry out eligibility verification?
You can verify eligibility with as little information as the subscriber ID and date of birth. However, this would vary from payer to payer. For some it might be the patient’s SSN # and date of birth and for some it might be the patient’s name and date of birth. Some offer multiple search criteria.
Will I be able to calculate the patient responsibility for a particular visit?

Yes, pVerify lets you calculate the patient responsibility for a particular visit for the services that you provide based on payer fee schedules. pVerify Premium has a feature called patient estimator which lets you do this.

I don't have fee schedules for the various payers. How can pVerify be of any help?
Estimator has the Medicare fee schedules pre-loaded for your use. What you can do is to mark up the fee schedules from Medicare base rate or load payer specific fee schedules.
Does pVerify offer any guarantees for performance?
Yes! pVerify comes with a money-back guarantee. If the return on investment is not as advertised within 60 days of fully deploying pVerify, all fees, including setup and subscription, will be refunded.
What is card-on-file?
pVerify is integrated with leading PCI compliant payment gateways and lets you capture credit and check information. With proper authorization, offices can use this information to collect payment for future dues.
How is pVerify's eligibility report different from other verification services?
pVerify eligibility reports not only show parsed key benefits data (such as copay and deductible), we also provide additional details, providing a full view of the patient eligibility information.