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pVerify’s Advanced Eligibility

pverify eligibility

pVerify’s Advanced Eligibility provides AdvancedMD users a deeper level of custom eligibility than the standard verification. With 15 years of historical medical verification research on each payer and what each return per specialty, pVerify has acquired the knowledge to get more information from each eligibility check for medical, dental, and vision payers.

With pVerify, practices can run eligibility checks based on schedule, appointment type, patient demographic, and various other parameters for over 1500 payers (electronic or not). Customized benefit results are sent directly to your AdvancedMD patient record. From here, you can open filterable, color-coded verification (First-Class Batch) and issues reports in Excel.

Business Rules Engine

Taking eligibility to the next level, pVerify’s Advanced Eligibility includes a business rules engine that allows users to create knowledge-based rules to be returned on qualified eligibility results. These rules are a way of systematically inserting senior verification specialist knowledge directly into your eligibility process, so every staff member has access to internal historical knowledge without referring to spreadsheets or written documentation.

Patient Financial Responsibility Estimator

Reaching beyond eligibility, pVerify also features a patient financial responsibility estimator. Powered by real-time eligibility results and each provider’s custom fee schedules, pVerify’s powerful estimator helps providers give patients the price transparency they expect.

pVerify is a customizable, highly flexible, and automated solution to control your eligibility and estimation needs. If you are suffering from claim denials due to inaccurate or insufficient eligibility information or work overload from having to call too many payers for eligibility, you need pVerify.

Easy and flexible

We offer near effortless setup, flexible reporting, and easy access to your full eligibility report on our website.

New releases include Insurance Coverage Discovery and Real-time Vision Payer API.

Coming soon, we’ll have Prior Authorization and Estimations with Remit Data.

Advanced Eligibility with write-back into AdvancedMD offers:

Medicare specific solutions

  • Medicare-focused Advanced Eligibility
  • Recursive Medicare Advantage Payer Verifications
  • Medicare MBI Lookup Tool
  • Inpatient SNF (important if a practice serves a high % of Medicare patients)

Learn more

pVerify offers a LIVE walkthrough of their suite of solutions, so you can see firsthand what Advanced Eligibility could mean for your practice. Please fill out the form on the right to connect with a representative.


Category: Billing & Coding, Patient Engagement | Software Type: Medical Billing, Patient Engagement

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