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Logo of pVerify

Instant Verification. Instant Impact.

Core Eligibility Verification: Reduce Denials & Accelerate Payments

Insurance verification is the backbone of revenue cycle success. Core Eligibility Verification enables multi-specialty provider groups, urgent care centers, and telehealth companies to instantly confirm coverage, reduce claim denials, and streamline billing workflows—eliminating inefficiencies and maximizing reimbursements.

Designed for Accuracy. Built for Efficiency.

Verification Across Major Coverage Types

Eligibility verification is critical to seamless patient care and financial accuracy. pVerify connects with 1,500+ medical, dental, and vision payers (EDI & Non-EDI) to deliver real-time coverage checks, helping providers streamline processes, reduce denials, and optimize revenue.

Your Business, Your Rules

pVerify’s Business Rules Engine automates eligibility verification to fit your workflow needs—eliminating manual claims reference checks and reducing training time. Customize rules based on plan details, codes, UMOs, and capitation facilities, ensuring accurate, automated verification at every step.

Flexible Integration Options

Choose the integration method that works best for your organization. Verify eligibility in real-time or in advance via portal, batch, API, or direct EHR integration. Whether accessing patient data in an Excel spreadsheet or integrating through APIs, pVerify ensures seamless workflow automation.

Automate and Generate

Coverage Insights. Increased Revenue. One Click.

Yes to Approvals

No to Claim Rejections

Nearly half of all claim denials happen at the front end of the revenue cycle. pVerify automates upfront verification, ensuring accurate coverage checks that reduce errors, increase approvals, and accelerate payments.

Reduce Workload

Realize Revenue

Simplified eligibility data means fewer errors, faster reviews, and less staff training. With clear, structured coverage details, pVerify reduces administrative workload, improves claim accuracy, and increases revenue potential.

Increase Efficiency

Reduce Effort

pVerify’s platform is designed for efficiency and ease of use. With intuitive eligibility breakdowns, even non-technical staff can access, interpret, and implement coverage details effortlessly—reducing operational bottlenecks.

Core Eligibility Verification: How It Works

Automate Rule-Based Workflows

With pVerify’s Business Rules Engine, you set the rules—we automate them. Create custom rule triggers for plan details, codes, UMOs, capitation, and payer hierarchy to ensure accurate, automated verification without manual oversight.

Flexible Integrations

Seamlessly integrate eligibility verification into your existing workflows. Access data through portal, EHR integration, or high-volume automation via API—allowing instant eligibility checks for office, surgery, and specialized services.
Reliable. Compliant. Proven.

Smarter Verification Starts Here