Patient Insurance Eligibility verification
A leading Insurance Verification Software that provides Medicare, Medicaid, and Commercial Patient’s Eligibility Verification
pVerify provides a demonstration followed by a FREE TRIAL for all of our solutions.
Meet us for a webinar and then take us for a test drive!
Patient Insurance Verification
Speciality Specific | All Payer Coverage | Real-time Accurate Results
pVerify provides a new concept in eligibility insurance verification, called Eligibility Summary, that allows customized parsing of verified eligibility data for 99% of payers in the market. Unique to pVerify, no other eligibility verification service or clearinghouse provides as detailed and custom results. Our patient eligibility verification is guaranteed to be complete for payers large and small, 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. Established in 2006, pVerify has been a leader in specialized Insurance Verification and continues to lead the industry in innovation and solution development.
Best in Class Eligibility Features
pVerify's Insurance Verifcation Software is available in 4 ways:
Individual Patient, Unlimited Batch Processing, EMR/PM Integration and API Development
pVerify's Eligibility Solutions are available in 4 ways:
Cloud-based Portal for realtime single patient verification
Batch verification in customized Excel reports
API’s real-time system of secure exchange supporting 1-to-1 transactions
Integration with an established EMR or Practice Management system
All of pVerify’s Unique Eligibility Verification Solutions Include:
Traditional details such as Plan Active Status and Deductible Info
Get Benefits information by Office, Inpatient, OutPatient, Ambulatory Facility Center, and MORE!
Speciality Specific customization to acquire copays, coinsurance, prior authorization, visits allowed vs remaining, routine exam, telehealth, and MORE!
Medicare: Home Health Care and Skilled Nursing Care spell information, Hospice Episode information and dates
Eligibility Dates: Effective and Expired
Medicare Part D: Pharmacy Payer Name, Plan Number, and Network ID.
Highlighting Medicare Advantage (Part C) including HMO/PPO Alerts with Medicare Advantage Payer names.
Identify Primary Payer if Medicare is secondary (helps you avoid Medicare Denials CO 22 and 109)
Download PDF detailed reports of patient Eligibility Verification
Subscriber Demographics Information (required for clean claims)
Search, review, and re-verify patient’s stored by pVerify’s HIPAA Compliant Cloud for up to 60-90 days.
ACO/ Preventative Service HCPC codes to determine which patients are due for their Annual Wellness Exam, amoung others for Medicare
pVerify’s real-time Patient Eligibility Verification will ensure that you don’t end up dealing with costly denials (e.g. denial codes CO 24 and CO120) and submit 50% cleaner claims.
Schedule a Demo
More pVerify Solutions
Same or Similar
pVerify is the ONLY company that provides a patient’s complete 5-year record across all 4 jurisdictions, 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.
MBI Lookup
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 is available without an NPI.
Preventive Care
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.
Claim Status
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.
Patient Estimator
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.
Free Payer Site
- Payer-Specific
- Multiple Web Portals
- No Parsing of Key Data
- Completely Manual
- Complex Displays
- Limited Batch Verification
- No Contract
Clearinghouse
- Limited to EDI payers
- Restricted Payer List
- Standard Batch
- No Parsing
- Complex Display
- Semi-Automated
- Large Setup Fee
- Long-term Contract
- One Service Type per Verification
pVerify's Eligibility
Cloud-based Portal, Batch, API or Integrated- 100% payer Coverage
- Custom Batch Verification
- Complete Parsing
- Fully Automated
- User-friendly Dashboard
- Cloud-based Portal
- No app/software to Download
- Multiple Service Types per Verification
- Unlimited Providers, Locations, and Users
- NO CONTRACT OPTION
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.