pVerify Eligibility Verification

pVerify’s insurance 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.

We can delivery eligibility reports in 3 ways.  Click the links to find out more!

1. Via our online portal
2. Via a batch Excel spreadsheet
3. Directly into your practice management system via an integration

Stop using payer sites and verification hotlines to check eligibility. Reduce labor costs and unreliable information. What’s free is, in fact, very expensive. Let us show you how a paid solution by pVerify can ultimately reduce cost.

Although many providers use EDI 270/271 to receive electronic eligibility data from payers, HIPAA does not mandate this data to be contextual or consistent across payers. While some payers do return specialty-specific benefits, few currently provide procedure-specific (CPT or HCPCS) benefits in EDI format. Yet many healthcare providers need this information and the only way to do it today is via phone, a process which can take up to 15 minutes (or $4 in labor cost) per verification!

Additionally, EDI 270/271 does not distinguish between in and out-of-network providers, a key piece of information in determining a patient’s financial obligation.

pVerify provides medical eligibility verification, medicaid eligibility verification, medicare eligibility verification, insurance eligibility verification, and health insurance eligibility verification with a unique system to process and convert raw eligibility data provided by payers into actionable information, creating relevant specialty-specific information. Our advanced parsing technology, coupled with our expert manual intervention, ensures that all pertinant information is available across payers, including non-EDI payers.