Patient Insurance Verification Solution

Patient Eligibility Verification Portal

pVerify Premium

Create combinations of solutions in order to improve your patient cycle, collections, and efficiency.

One portal, all your solutions.

Solutions

  • Advanced Eligibility
  • Business Rule Engine
  • Medicare MBI Lookup
  • Insurance Discovery
  • Inpatient SNF
  • Patient Estimator
  • Same or Similar
  • Patient Payments
  • ACO – Preventative Services
  • Claim Status
  • Recursive Medicare MA Verification

Build pVerify directly into your workflow

Patient Insurance Verification Solution

A Leading Insurance Verification Software that supports Multi-Specialty Medical Practices and Providers with specific verification needs, while showcasing the Largest List of Health Insurance Payers.

Why pVerify?

pVerify spent the last decade focusing on Provider needs, how to collect the most information for each specialty from over 1500 payers, and enhancing our systems to be the most user-friendly in the industry. In 2020, we moved to our Premium Portals and brought on solutions such as Patient Estimator, Patient Payments, Inpatient Skilled Nursing Facility, Same or Similar, and more.

It is our mission to stay on the tip of technology and continue to develop solutions that make our clients lives easier while improving their revenue and ROI.

Create your own Combination

pVerify’s provides the widest offering of combinations of services. It all begins with Advanced Eligibility and our intentional separation of details for easier review and understanding. With Self-Batch Eligibility and our First-Class Batch Reports, verifying large numbers of patients is no longer an issue. Get all the results you need in one place, then make one -click to Estimate and Payments,  or add additional Solutions, such as Claim Status and Inpatient Skilled Nursing Facility.

First-Class Batch

Received and processed days before the appointment, pVerify provides a completed report in Excel format with all of your requested patient benefit information. With details at a deeper level,  information is separated and highlighted individually for easier review and understanding. Color-coded font and highlighted rows help identify and flag specific patients: High Deductible, Medicare Risk, HMO Detection, and others, per request. Each patient is linked to their full patient record within the pVerify Premium Portal for additional patient benefit review.

Self-Batch Eligibility

pVerify now offers a Self Batch Eligibility Feature for all Premium clients. Created for most basic verification needs: confirm active status for all EDI payers and/or for Specialist benefits to receive active status, standard benefit details such as HMO/PPO Payers, deductible and OOP remaining, and more. Viewed in a similar color-coded file, Self-Batch Eligibility is for clients that want to verify patient in-mass but do not require a custom report with enhanced details reporting.

Integrations with EHR/Practice Management Software

pVerify’s integrations automate patient extraction for a specific DOS to verify in advance and return the benefits directly into the integrated system (most often as a patient note). In addition to the inserted data, pVerify offers the Patient Insurance Verification Solution​ plus First-Class Batch Report for easy filtering and patient review. Examples of existing integrations: AdvancedMD, Allscripts, NextGen, Centricity, Raintree, and MORE!

Patient Insurance Verification Solution

APIs

pVerify offers extensive capabilities with our robust APIs, Widgets, Drop-IN UI and MORE. Add eligibility as a consumer facing solutions or automate on the billing end of your processes.

*Find the Developers Tab for more information

Connect to learn about the Premium Portal Solutions!

Eligibility Pricing

Subscription and Monthly Plans

pVerify Premium

Customized Advanced Eligibility

First-Class Batch

Outsourced Patient Verification

API Solutions

Realtime API Connection
Plans starting at

$250 per month

Plans starting at

$400 per month

Plans starting at

$250 per month

Advanced Eligibility

Proprietary research into payers' eligibility response for maximum verification success
YES YES YES

Specialty Specific

In-depth, specialty-focused, customized parsing of verified patient benefits
YES YES YES

All EDI Payer Coverage

Medicare, Medicaids, and Commercial Payers (EDI)
YES YES YES

Instant Eligibility (Real-time)

Real-time single patient verification
YES YES YES

Unlimited Users

Unlimited users with unique log-in details and passwords
YES YES YES

Unlimited Providers and Locations

Unlimited Provider NPIs for patient verification and unlimited locations to restrict patient details by location and users
YES YES YES

Business Rule Engine

Insert of existing benefit knowledge into each Eligibility return
YES YES YES

Patient Batch Upload

Verify patients in batches
YES YES YES

Self Service Batches

Medicare, Medicaid, and Specialist Benefits for Commercial Payers
YES YES YES

Add-on Products

Supports the Estimator, Patient Payments, and MORE!
YES YES Yes

Integrate with EMR/PM

Compatible with system integrations
YES YES YES

Outsourced Batch Patient Processing

Outsource patient verification prior to their appointment
YES

Non-EDI Payer Coverage

Verification of difficult and non-electronic payers
YES YES
Request Pricing Request Pricing Request Pricing

Eligibility Pricing

Subscription and Monthly Plans

pVerify Premium

Customized Advanced Eligibility with add-on Solutions

Plans starting at

$250 per month

Advanced Eligibility

Proprietary research into payers' eligibility response for maximum verification success

Focused per specialty

In-depth, specialty-focused, customized parsing of verified patient benefits

All EDI Payer Coverage

Medicare, Medicaids, and Commercial Payers (EDI)

Instant Eligibility (Real-time)

Real-time single patient verification

Unlimited Users

Unlimited users with unique log-in details and passwords

Unlimited Providers

Unlimited Providers NPIs for patient verification

Unlimited Locations

Unlimited locations to restrict patient details by location and users

Patient Upload Processing

Verify patients in batches

Self-Batch Eligibility

Medicare, Medicaid, and Specialist Benefits for Commercial Payers

Add-on Products

Supports the Estimator, Patient Payments, and MORE!

Unlimited Support

Phone, Email, and Ticket Support

Integrate with EMR/PM

Compatible with system integrations

First-Class Batch

Outsourced Patient Verification

Plans starting at

$400/ per month

Advanced Eligibility

Proprietary research into payers' eligibility response for maximum verification success

Focused per specialty

In-depth, specialty-focused, customized parsing of verified patient benefits

All EDI Payer Coverage

Medicare, Medicaids, and Commercial Payers (EDI)

Instant Eligibility (Real-time)

Real-time single patient verification

Unlimited Users

Unlimited users with unique log-in details and passwords

Unlimited Providers

Unlimited Providers NPIs for patient verification

Unlimited Locations

Unlimited locations to restrict patient details by location and users

Patient Upload Processing

Verify patients in batches

Self-Batch Eligibility

Medicare, Medicaid, and Specialist Benefits for Commercial Payers

Add-on Products

Supports the Estimator, Patient Payments, and MORE!

Unlimited Support

Phone, Email, and Ticket Support

Integrate with EMR/PM

Compatible with system integrations

Automated/Outsourced Batch Report Processing

Outsource patient verification prior to their appointment

Non-EDI Payer Coverage

Verification of difficult and non-electronic payers

Health Insurance Eligibility Verification

Learn more with a custom DEMO or Free Trial of our Health Insurance Eligibility Verification Solutions

Meet with a pVerify Representative to assess your current work flow and unique requests to determine the best combination of pVerify’s Patient Insurance Verification Solution​ for your needs.

Complete List of pVerify Premium Solutions

Advanced Eligibility

Patient Insurance Verification Solution

Advanced Eligibility

pVerify’s All Payer Advanced Eligibility Solution in real-time, Batch Reporting, and API Development

Medicare Eligibility

Patient Insurance Verification Solution

Medicare Eligibility

An expert in all things Medicare, pVerify provides Medicare patient Verification in our Medicare Eligibility – Summary Dashboard, Unlimited Self-Batch Eligibility, First-Class Batch Solution, and API Connections

First-Class Batch Reports

Outsource patient verification to pVerify with detailed DOS Batch Patient Verification with customized and complete Excel Reports

Claim Status

pVerify’s Claim Status provides a quick glance at a patient’s claims to determine most recent status

Patient Estimator

pVerify Patient Estimates gives you quick and easy cost estimates for patient responsibility

Patient Payments

Collect payment during appointment with contactless QR code, card-on-file, and customized card-on-file payment plans

Same or Similar

pVerify’s Same or Similar provides a patient’s complete 5-year Claim History for L, A, E, B, & K Codes

Inpatient SNF

pVerify Inpatient SNF Solution provides details on current SNF and Hospice stays, as close as 72 hours after admission

Medicare CMN

pVerify provides details on payable Certificates of Medical Necessity (CMNs) for specific Medicare beneficiaries and, for specific Healthcare Common Procedure Coding System (HCPCS) codes

MBI Lookup

Find a Medicare patient’s MBI ID with their name, DOB, and SSN/HICN.

Medicare Preventive Services (ACO)

Find a Medicare patient’s Eligibility dates for preventive services like Annual Wellness Exam (AWV) and 54 HCPCs codes

Healthcare APIs

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