Beyond the Basics: Smarter Coverage.
Enhanced Patient Coverage Insights: Improve Transparency & Reduce Risk
Designed for Accuracy. Built for Efficiency.
Validate Patient Data. Reduce Claim Rejections.
Use the Patient Demographic Validator (PDV) to verify key eligibility details with minimal information—such as a name and location—while maintaining data integrity and privacy.
Identify Missing Coverage. Decrease Bad Debt.
Missing coverage is a costly problem. Insurance Discovery automatically identifies active insurance using only a name and date of birth, reducing self-pay burdens, decreasing accounts receivables, and improving timely collections—all in just 30 seconds to 2 minutes.
Retrieve Medicare ID in Moments
Prevent claim delays with real-time Medicare Beneficiary ID (MBI) retrieval. Using basic patient details—such as SSN, date of birth, or age—providers can quickly verify Medicare coverage and access key plan details, including Medicare Advantage options.
Medicare Eligibility Checks Made Easy.
No more toggling between screens. pVerify’s Medicare Eligibility Checks provide a single-screen view of Part A, Part B, Home Health, Medicare Secondary Payer, HMO, Medicare Advantage Plans, and remaining deductibles—clearly organized for quick, informed decision-making.
Estimate Out-Of-Pocket Costs, Efficiently and Accurately.
Give patients the price transparency they need to make informed decisions about their care. Using eligibility-powered data, calculate accurate out-of-pocket estimates—all at the point of care.
The Insight Advantage.
Finances Made Fluent. Revenues Realized.
Reduce Claim Denials
Get the Right Patient Data, Right on Time
Accurate patient data reduces claim denials and speeds up billing. With real-time verification via portal or API, providers can ensure timely, accurate coverage checks before services are rendered.
Clarify Costs
Help Patients Make Informed Decisions
Upfront cost estimates empower patients to make informed financial decisions. By providing clear, accurate pricing information, providers can facilitate timely payments and improve revenue cycle efficiency.
Decrease Bad Debt
Identify Accurate Coverage
Insurance verification complexity makes accuracy even more critical. pVerify’s tailored coverage insights ensure providers access the right patient data—helping reduce bad debt and improve financial performance.
How A 100+ Location Ophthalmology Group Solved Complex Billing Issues & Saved Over $1.3 Million/Year
The front-office verification staff for one of the largest vertically integrated eye care groups in the U.S. faced huge eligibility verification challenges due to the complexity of the California market.
California has the highest percentage of people covered by HMOs and IPAs, with capitation IPAs playing a big role in benefit determinations. Insurance is designed to prioritize patient financial considerations, which often puts providers in complex benefit determination scenarios. IPA rules often result in providers discovering their patients are no longer in their associated IPA – leaving them unpaid for services rendered with no avenue to recoup losses.
The company was able to scale to over 100 practice locations and save over $1.3 million per year by entrusting their eligibility verification processing to pVerify, avoiding costly expansion and staff retraining.
