pVerify Eligibility verification

A leading Insurance Verification Software that provides Insurance Eligibility Verification, Medicare Eligibility Verification,  and
all Payer Health Insurance Verification 

Meet us for a webinar and then take us for a test drive!

pVerify’s Patient Insurance Eligibility Verification

Speciality Specific | All Payer Coverage | Realtime Accurate Results 

Established in 2006, pVerify has been a reputable leader in specialized Insurance Verification and continues to lead the industry in innovation and solution development. With pVerify provides a new concept in eligibility verification and speciality benefits customization, called Eligibility Summary, that allows in-depth specialty-focused customized parsing of verified eligibility data for 100% of payers in the market. With the largest payer list in the medical industry, pVerify can verify benefits from all EDI payers plus Non-EDI payers (including vision payers) via our Batch Verification Processing Solution.

pVerify's Insurance Verification Solutions are 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 Patient 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.