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CGX/PGX Verification Directions for Commercial Payers


 

1. Login as normal.
 
2. In the Instant Eligibility screen Enter Payer, Provider, and Subscriber (patient) information.
 
For Commercial Payers like United Healthcare, Aetna, CIGNA, Blue Plans choose Service Type to Inquiry as Diagnostic Lab (5) if not already selected from the drop down, if you don’t find Diagnostic Lab (5) in the Drop down for a Payer, it means you will need to use Health Benefit Plan Coverage (30) for that Payer. Press VERIFY. *Medicare Service Codes in Inquiry will be preset and does not need additional action.

*Additional service codes beyond mentioned above may result in extra fees. Always consult your pVerify Rep before adding additional Service Types for verifications.
 

 

3. The dashboard will display current verification information. ALWAYS scroll down to view Health Benefit Plan Coverage or Diagnostic Lab details to confirm desired qualification needs. (Qualification needs vary by client and will not be specified by pVerify)

 
 

4. Example of Health Benefit Plan Coverage (Commercial Payer). *ALWAYS scroll down to view details to confirm desired qualification needs. (Qualification needs vary by client and will not be specified by pVerify)

 
 

5. Example of Diagnostic Labs (Commercial Payer.) *ALWAYS scroll down to view details to confirm desired qualification needs. (Qualification needs vary by client and will not be specified by pVerify)