Healthcare Eligibility Solutions
A Complete list of our Solutions
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.
An expert in all things Medicare, pVerify provides Medicare patient Verification in our Medicare Eligibility - Summary Dashboard, Unlimited Self Batch Verification, First Class Batch Solution, and API Connections.
Automate verification to pVerify with our First-Class Batch Solution to verify patients and review on a color-coded and highlighted Excel report. Self-Batch Eligibility is available at no extra cost.
Dental Payers Verification is now available as a real-time Eligibility Verification Solution. With the requirements of a Dental NPI and Tax ID, pVerify users can now verify 180 Dental payers in their secure Premium Portal. Dental is available via single patient verification, First-Class Batch Solution, and API Connection.
As of September 2021 pVerify now offers real-time Vision Payer Verification in the Premium Portal and API Integration for VSP, Eyemed, March Vision, Premier, Davis, Spectera, and MORE! Beyond the detailed vision benefits available with Advanced Eligibility, Material Coverage Details, PCP information, and Copay/Co-insurance details are available.
Vision Prior Authorization Coming Soon
Integration and APIs
pVerify’s enhanced Healthcare Eligibility and Medical APIs endpoint’s advanced configuration features allows Developers to get the data they want without wading through complex objects for 10 unique Healthcare API Solutions.
FHIR, HL7, 270/271, RESTful API, SalesForce and MORE!
Business Rules Engine
Take the knowledge from your senior verification specialists and build it into each patient result – allowing all staff to share historic knowledge without constantly memorizing existing materials.
pVerify will first verify a patient’s full Medicare Coverage, if a Medicare Advantage Payer is present pVerify will verify the Medicare Advantage Plan using human-enabled AI, machine learning, and our proprietary methods.
Beyond Eligibility Solutions
Obtain Prior Authorization with pVerify’s automated offering.
Estimate patient financial responsibility powered by Eligibility results and your unique fee schedules for quick and easy cost estimates.
Collect payment during appointment with contactless QR code, card-on-file and customized card-on-file payment plans with no contract commitment.
pVerify’s Claim Status allows users to check the current status from the payer to discover the claim was accepted, or denied, and review the Status Codes to determine if action is required.
Additional Medicare Solutions
Same or Similar
pVerify’s Same or Similar allows users to review a patient’s 5-year Claim History in near real-time with interpretation flags for easy and actionable decisions.
pVerify Inpatient SNF Solution provides details on current SNF and Hospice stays, as close as 72 hours after admission, including the provider's NPI.
pVerify’s Medicare CMN allows users to review a patient’s CMN history for approved certificates along with the initial and last claim date, to see what rentals have been approved.
Find a patient’s new MBI ID with their Name and SSN/old HICN.