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. 

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:

list1_bg Traditional details such as Plan Active Status and Deductible Info

list1_bg Get Benefits information by Office, Inpatient, OutPatient, Ambulatory Facility Center, and MORE!

list1_bg Speciality Specific customization to acquire copays, coinsurance, prior authorization, visits allowed vs remaining, routine exam, telehealth, and MORE!

list1_bg Medicare: Home Health Care and Skilled Nursing Care spell information, Hospice Episode information and dates 

list1_bg Eligibility Dates: Effective and Expired 

list1_bg Medicare Part D: Pharmacy Payer Name, Plan Number, and Network ID. 


list1_bg Highlighting Medicare Advantage (Part C) including HMO/PPO Alerts with Medicare Advantage Payer names.  

list1_bg Identify Primary Payer if Medicare is secondary (helps you avoid Medicare Denials CO 22 and 109)

list1_bg Download PDF detailed reports of patient Eligibility Verification 

list1_bg Subscriber Demographics Information (required for clean claims)

list1_bg Search, review, and re-verify patient’s stored by pVerify’s HIPAA Compliant Cloud for up to 60-90 days. 

list1_bg 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.

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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.

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.