pVerify Eligibility Verification

100% payer coverage

pVerify’s eligibility verification is guaranteed to be complete for payers large and small. Benefit information is customized to your practice and procedures, facilitating prompt collections from patients and third-party payers.

Stop using payer sites and verification hotlines to check eligibility. Reduce labor costs and unreliable information. What’s free is, in fact, very expensive. Let us show you how a paid solution by pVerify can ultimately reduce cost.


Free Payer Site

  • Payer-specific
  • Limited batch verification
  • No parsing of key data
  • Completely manual
  • No contract

Clearinghouse

  • Limited to EDI payers
  • Standard batch
  • No parsing
  • Semi-automated
  • Long-term contract

Although many providers use EDI 270/271 to receive electronic eligibility data from payers, HIPAA does not mandate this data to be contextual or consistent across payers. While some payers do return specialty-specific benefits, few currently provide procedure-specific (CPT or HCPCS) benefits in EDI format. Yet many healthcare providers need this information and the only way to do it today is via phone, a process which can take up to 15 minutes (or $4 in labor cost) per verification!

Additionally, EDI 270/271 does not distinguish between in and out-of-network providers, a key piece of information in determining a patient’s financial obligation.

pVerify uses a unique system to process and convert raw eligibility data provided by payers into actionable information, creating relevant specialty-specific information. Our advanced parsing technology, coupled with our expert manual intervention, ensures that all pertinant information is available across payers, including non-EDI payers.