Patient Eligibility Verification Guarantee

NextGen Patient Insurance Eligibility Verification

pVerify’s Specialty-Specific Batch Eligibility Patient Benefits Verification Solution for NextGen Users

Nextgen® integrated Batch Eligibility Verification by pVerify®

pVerify is the only company to offer combination of EDI based eligibility and manual, live-operator assisted process to return all the relevant information complete and contextual, with Human enabled AI and built in Business Rules.  

pVerify’s Blended Process ( EDI based verification combined with manual process) to ensure 100% customization of our eligibility reports to individual client’s needs (e.g. Medical Benefits as well as Vision Benefits including annual Visit restrictions, Routine Vision co-pay etc. PLUS ASC/Hospital Outpatient benefits) and 100% payer coverage (even those who do not support EDI based eligibility.)

These are few unique features of pVerify that separates it from traditional clearinghouses: 

Effortless, automatic outbound/inbound connection from Nextgen to pVerify, customized to your needs

Easy and automated verification of your entire appointment calendar

Full Batch Eligibility Report customized for your specialty for each Date of Service

Clear and discrete display of eligibility information in Nextgen

Automatic recording of benefits in your system as a discrete patient note from verification

Best in Class Business Analysis,  Customer Support, and Human enabled AI with Business Rules 

NextGen®-interfaced Batch Eligibility Verification by pVerify®

pVerify® is now integrated with Nextgen’s API to deliver unmatched batch Eligibility & Benefits reporting (customized to individual Specialty and Practice needs) by first collecting insurance information from upcoming appointments, processing the information in the pVerify Cloud to generate a custom eligibility report, and finally writing back the most important report items as discrete data in Nextgen.  

Unique to Nextgen is the ability to quickly show the following discrete data in each patient’s custom tab: 

  • Specialty-Specific Co-pays, Deductibles, out-of-pocket remaining, prior auth requirements, and additional info based on your specialty 100% 100%
  • Exception Reporting: Highlighted discrepancies in patient demographics ( e.g. incorrect spelling of patient name or incorrect DOB)  100% 100%
  • Expert Medicare Reporting: Receive all relevant Medicare data to unique needs (e.g. Hospice Dates and NPI, Therapy Cap, HMO/MA Payer) 100% 100%
  • All Payer based verification combined with manual process to ensure 100% customization of our eligibility reports and 100% payer coverage 100% 100%

Automated Write-back Example

Effortless, automatic outbound/inbound connection from Nextgen to pVerify, customized to your specialty, required verification timing, and write back integration to record benefits in your system as a discrete patient note from verification results.

Nextegen Custom Tab (below) showing Active Status, Copay, Coinsurance, Deductible Remaining and other eligibility information. Custom Tab (right) showing unique Quicknote with pVerify inserted full eligibility information. 

 
 
NextGen and NextGen logo are trademarks of NXGN Management, LLC. NextGen Healthcare helps ambulatory care organizations transition to value-based care by empowering them to nurture measurably healthier patient communities at a lower cost. NextGen solutions, optimized by physicians, developed with input from our 90,000 providers, and based on almost 25 years of ambulatory expertise, help ease the burdens of HIT and enable practices to improve individual outcomes and nurture a healthier population. pVerify is not affiliated with, sponsored by, or endorsed by NextGen Healthcare.

Customized Batch Report Example

Full Batch Report customized to your specialty, set to your required verification schedule, with color-coded and highlighted results to flag actionable details for every date of service, created with Human enabled AI and quality review

Eligibility to Collection Cycle 

pVerify now offers a complete cycle of eligibility and benefits for ALL patients scheduled for given date of service. Results are displayed in a unique color-coded, Microsoft Excel Spreadsheet format (see the screenshot above) as well as a direct write-back note into a respected patient's record for integrated EMRs. pVerify’s integrated batch eligibility verification solution highlights eligibility and benefits specific to your specialty & procedures and is customized to your practice needs. It also ensures that you are billing to the right payer and using correct Demographic details (clean claim) to avoid cost denials downstream.

Our automated, date-of-service verification and color-coded highly actionable Eligibility Summary Reports can bring unprecedented efficiency to your front-office workflow. Coupled with our patient estimator and “card-on-file” payment processing, our integrated service can significantly reduce patient bad debt and improve front-office collections.