Prior Authorization

Automate Prior Authorization

Instant Prior Authorization



Simplify and Automate your Prior Authorization Process

Easy API converts data to/from EDI 278 format

pVerify’s Prior Authorization connects provider organizations to major payers via API to automate and simplify submitting and tracking requests for prior authorization. Our solution streamlines operations within a single easy-to-use application via secure portal or API. Provider costs are reduced, and decisions are communicated in real time, reducing delays.

Instant Prior Authorization

Prior Authorization Solutions

Instant Prior Authorization

Automated Case Creation and Case Submission

Instant Prior Authorization

Real-time touchless case approvals when applicable

Instant Prior Authorization

Simplified submission of additional clinical information

Streamline Prior Authorization

Connect with an Prior Authorization Specialist to discuss our current Instant Prior Authorization offerings and future releases

Prior Authorization houses a suite of capabilities including:

  • EHR and API Connectivity
  • Real-time Decisions in over 50% of Submissions
  • Case Creation Validation
  • Case Status Updates
  • Streamlined supporting Documents

More pVerify Solutions

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.
Patient Eligibility Solutions

Insurance Discovery

Prevent A/R by detecting existing insurance for self-pay and unconfirmed coverage with a patient’s name and date of birth. 

Find Patients Insurance

Healthcare APIs

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