Business Rule Engine (BRE)

Business Rules Engine



Going Beyond Eligibility

Do you ever wish you could get more from your Eligibility? 

pVerify’s Business Rule Engine (BRE) provides

  • Empowered productivity from clinical and administrative staff by delivering actionable and critical information.
  • A reliable system to circulate staff claims and benefit knowledge across unlimited locations containing detailed communication on specific patients or coverage.
  • BRE information is encapsulated in the 271 return making it available in all platforms, from the API GET to EMR Integration or directly in the pVerify Premium Portal.

Do you ever wish you could get more from
your Eligibility?

Business Rules Engine

Business Rule Examples

Business Rules Engine

Business Rules Triggers Include:

  • Plan Details including Plan Name/Policy Type, Group
    Names/Numbers, Subscriber or Demographic
  • Plan Codes, HRA/HSA, PT/OT Used amounts, PCP
    Name, Workers Comp.
  • IPAs, UMOs, Capitation Facility, Primary or
    Secondary Payer, MCOs and Plans Sponsors.
  • And MORE…
Business Rules Engine

Learn more our Business Rule Engine by Requesting a DEMO

Verify – Estimate – Collect

Our automated, date-of-service patient insurance verification brings unprecedented efficiency to your front-office workflow. Coupled our Healthcare Insurance Discovery Solution with our Patient Estimator and hands-free Patient Payment, our Solutions can significantly reduce patient debt and improve front-office collections.

Insurance Discovery for California Medicaid

Advanced Eligibility

Verify a patient ahead of time or during their procedure with pVerify’s All Payer Advanced Eligibility Solution in Instant, Batch, or API Eligibility, in real-time with accuracy down to the service received.
Insurance Discovery for California Medicaid

Patient Estimator

Estimate patient financial responsibility powered by Eligibility results and your unique fee schedules for quick and easy cost estimates.
Find Patients Insurance

Healthcare APIs

The Industry service leader in Realtime Healthcare APIs for Eligibility, Claim Status, & DME Solutions.