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pVerify Eligibility Check

pVerify Eligibility Check allows practices to run eligibility against their patient schedule for nearly all payers (electronic and not) and get customized results back to a patient tab in AdvancedMD, in addition to a color-coded Excel spreadsheet for a day of service.

pVerify enhances your eligibility by vastly reducing the work needed to do eligibility checks. Our service runs in the background against your patient schedule, and returns a human-curated spreadsheet of important eligibility data to you, in addition to writing eligibility data to a custom tab in AdvancedMD.

pVerify is a customizable and highly flexible and automated solution for taking control of your eligibility needs. If you are suffering from claim denials due to inaccurate eligibility information, work overload due to having to call many payers for eligibility, or not enough/wrong information in your eligibility data, you need pVerify.
We offer near effortless setup, flexible reporting, and easy access to the full eligibility report on our website, in addition to real-time eligibility checking, patient estimates, and patient payments.

Our pricing is transaction-based & offers volume discounts.

pVerify Eligibility Check works like this: You tell us you want to use our system, and give any parameters such as only certain providers, certain appointment types, etc. We then build a custom integration for your practice with AdvancedMD, to get the schedule and insurance data on a daily basis. Next, we run this data through our eligibility checking system for EDI payers, or use human-enabled methods such as phone call or website lookup for non-EDI payers. Parsing and QA of this data is then done to ensure accuracy, and to call out issues such as wrong DOB or other information. Finally, the report is sent back to AdvancedMD to a custom tab for the patient, and the report for the whole DOS is saved in our portal for you to download.

Outcomes are:

  • Much reduced staff time spent on eligibility (on our case study, a 90% reduction)
  • Higher successful claims submission (50% in our case study)
  • Access to much more eligibility data that is typically available. For example Obamacare plans, Family OOP max, specialty specific copays (PT, Chiro, etc.)

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

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“With AdvancedMD we got everything in one package, and the ability to ensure that we get maximum allowable Medicaid reimbursement.”

Charlotte Kientzy
Practice billing manager

“The money I have invested in AdvancedMD is miniscule compared to the return. I have never been more efficient – ever – in my professional life as I am now.”

Jed Shay, MD
The Pain Care Center

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“[Our] patients are very well-educated and well-informed, and they want to see results quickly. The practice has to run extremely efficiently and be accessible to them. The nice thing about [AdvancedMD] is it has allowed me to be more efficient both in and out of the office. Now I don’t have to come back into the office, which is great for my family and everything else. It saves me a lot of time – probably an hour a day on the three days I work in the second office.”

Keith Berkowitz, MD
Center for Balanced Health

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“With the new scheduler and EHR, we get a lot of the information up front, so when the patient comes in, unless they have something changed insurance-wise they’re already verified and ready to be taken back right away, it also makes it much easier for billing.”

Nancy Sutter
Office manager