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.
Best in Class Eligibility Features
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:
Traditional details such as Plan Active Status and Deductible Info
Get Benefits information by Office, Inpatient, OutPatient, Ambulatory Facility Center, and MORE!
Speciality Specific customization to acquire copays, coinsurance, prior authorization, visits allowed vs remaining, routine exam, telehealth, and MORE!
Medicare: Home Health Care and Skilled Nursing Care spell information, Hospice Episode information and dates
Eligibility Dates: Effective and Expired
Medicare Part D: Pharmacy Payer Name, Plan Number, and Network ID.
Highlighting Medicare Advantage (Part C) including HMO/PPO Alerts with Medicare Advantage Payer names.
Identify Primary Payer if Medicare is secondary (helps you avoid Medicare Denials CO 22 and 109)
Download PDF detailed reports of patient Eligibility Verification
Subscriber Demographics Information (required for clean claims)
Search, review, and re-verify patient’s stored by pVerify’s HIPAA Compliant Cloud for up to 60-90 days.
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
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.
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.
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.
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.
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.
Free Payer Site
- Multiple Web Portals
- No Parsing of Key Data
- Completely Manual
- Complex Displays
- Limited Batch Verification
- No Contract
- Limited to EDI payers
- Restricted Payer List
- Standard Batch
- No Parsing
- Complex Display
- Large Setup Fee
- Long-term Contract
- One Service Type per Verification
pVerify EligibilityCloud-based Portal, Batch, API or Integrated
- 100% payer Coverage
- Custom Batch Verification
- Complete Parsing
- Fully Automated
- User-friendly Dashboard
- Cloud-based Portal
- No app/software to Download
- Multiple Service Types per Verification
- Unlimited Providers, Locations, and Users
- NO CONTRACT OPTION