Advanced Eligibility The Leader in Eligibility Software | Robust APIs and Advanced Eligibility

Eligibility Exemplified.

The Leader in All-Payer Patient Insurance Verification Software with Real-time, API and Batch Solutions with comprehensive Patient Eligibility, Estimation and Payment Collection for Medicare, Medicaid, Commercial, Dental and Vision Payers.

Advanced Eligibility
Eligibility Exemplified

Eligibility Exemplified.

The Leader in All-Payer Patient Insurance Verification Software with Real-time, API and Batch Solutions with comprehensive Patient Eligibility, Estimation and Payment Collection for Medicare, Medicaid, Commercial, Dental and Vision Payers.

Industry Leaders choose pVerify®

100+ Million Transactions

%

Reduction of Claim Rejection and Denials

%

Less Staff Time Spent on Eligibility

%

Complete Payer Coverage EDI and Non-EDI

Why Choose pVerify

pVerify tailors Eligibility Verification specifically to your practice and make it easy for you to see the details you need.  The addition of The Patient Estimator and Patient Payments complete the patient cycle, allowing for correct estimates of a patients financial responsibility and contactless payment collection.

Powered by its own APIs pVerify aimed it’s focus on studying over 1350 payer responses to compile unique eligibility settings for each. Championing the highest level of benefits parsing with consumable API endpoints, pVerify’s team of expert developers stride forward to refine and maximize benefit reporting.

Advanced Eligibility

Why Choose pVerify

Advanced Eligibility

pVerify tailors Eligibility Verification specifically to your practice and make it easy for you to see the details you need.  The addition of The Patient Estimator and Patient Payments complete the patient cycle, allowing for correct estimates of a patients financial responsibility and contactless payment collection. 

Powered by its own APIs pVerify aimed it’s focus on studying over 1350 payer responses to compile unique eligibility settings for each. Championing the highest level of benefits parsing with consumable API endpoints, pVerify’s team of expert developers strides forward to refine and maximize benefit reporting.

Don’t just verify, pVerify! 

pVerify® interfaces with EHR Leaders

Patient Insurance Eligibility Verification

With the largest Medical Insurance Eligibility Verification Payer List in the industry, pVerify is the only company to go beyond the traditional EDI payers to provide the eligibility benefits from the smaller and time-consuming non-EDI Payers. We provide details at a deeper level, with information separated and highlighted individually for easier review and understanding.

Patient Financial Responsibility Estimator

The Patient Estimation Solution Software Tool is uniquely positioned in the market to provide patient estimates based on their verified benefits and your fee schedules. Leveraging the specialty-based Eligibility results and tying into our Patient Payments offering allows a full cycle from eligibility to estimate to payment within minutes.

Patient Payments and Contactless Collection

Collect payment at check-in with contactless QR code, card-on-file, and customized payment plans. With competitive rates and no contracts, estimate patient financial responsibility and collect payment right in your pVerify portal.

Inpatient Skilled Nursing Facility Details

Most Eligibility Verification services acquire Home Health, Hospice, and Skilled Nursing Faculty episode details directly from the patient’s verified benefits which only is available after the stay has ended. pVerify offers a solution that provides details on current Skilled Nursing Facility and Hospital patients, as early as 72hrs after a patient’s initial admission. 

Durable-Medical-equipment-suppliers-solutions

Medicare Claim History – Same or Similar

In order for a supplier to be paid for issuing an item to a patient, that patient cannot have received that piece of equipment or one considered similar for a specific window of time. Therefore, each patient’s claim history must be reviewed prior to issuing any item.

pVerify’s Same or Similar goes beyond any other solution to take the guess work out of a very complex system by creating a “flag” to determine if the patient qualifies for a new item or if they have already received one similar. This interpretation flag saves suppliers a significant amount of time, reduces denials and prevents revenue loss by interpreting the Claim History for the user.

pVerify vs Clearinghouse and Payer Sites

pVerify Eligibility

Cloud-based Portal, Batch, API or Integrated

  • All Payer Coverage
  • Multiple Service Types per Verification
  • Multiple APIs Available
  • Parsed Eligibility Benefits
  • First-Class Batch Reports
  • User-friendly Dashboard
  • Personalized API Support
  • Business Rules Engine (AI Powered)
  • Unlimited Providers and Users

Clearinghouse

Long-term Contract

  • Restricted Payer List | No non-EDI Payers
  • Limited to one Service Type per Verification
  • Complex Display | No Parsing of Key Data
  • Minimal Customer Support
  • Large Setup Fee
  • Long-term Contract

Free Payer Site

Manual Verification Only

  • Payer-Specific
  • Multiple Web Portals
  • Completely Manual
  • No Parsing of Key Data
  • Complex Displays
  • Minimal Customer Support

Only pVerify Provides this Set of Advantages.

Advanced Eligibility

  • Faster verification
  • Improved cash flow
  • Fewer denials
  • Less patient delinquency
  • Easy-to-see eligibility info
  • Reduced labor costs
  • Full report customization
  • Human checking for accuracy

Whats New

The Importance of Patient Eligibility Verification to the Revenue Cycle

The Importance of Patient Eligibility Verification to the Revenue Cycle

There are a number of options available to verify patient availability and all of them will more or less impact the revenue stream in a number of ways. One concern is in how well the mode of verifying the patient ahead of time improves the rate of payment from both provider and patient. Another consideration is in the amount of time employees spend in the verification process – for example, manual verification will cost more in employee time than electronic verification.

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