Maximize Collections with Complete Eligibility Verification
Our Guarantee
Complete and parsed:
Our Eligibility Reports are guaranteed to be complete, including all key elements:
- Eligibility status (active or inactive; start and termination dates)
- Plan name, PCP name (for HMO patients)
- Applicable Co-pays
- Co-Insurance
- Annual Deductible and ‘Deductible Remaining’
- Medicare HMO and Secondary information (when applicable)
In addition, pVerify is the only company that guarantees to parse all the key benefits data such as co-pays and deductibles and presents then in a dashboard format as well as in a color-coded Microsoft Excel spreadsheet reports bringing unprecendented efficiency to the front-office.
Specific to your practice
pVerify’s advanced configurator allows for customization of batch eligibility reports based on your Specialty and your payer contracts.
In other words, if you are out-of-network with a certain plan, we can highlight out-of-network benefits for those payers…and if you are a Specialist, our reports will highlight Specialist Co-Pay as opposed to PCP co-pay. This makes it easy for your front-offices to collect appropriate co-pays during check-in process as well ensures that when you use our ‘Payment Estimator’, your patient obligation estimation is accurate too.
Specific to your procedure*
pVerify also offers CPT level or Procedure Level Verification as part of PVERIFY PREMIUM service. For example, we can validate if ‘routine-eye exam’ is a covered benefit for Ophthalmologists. OR if Orthotics are covered benefit for Podiatrists. For Bariatric Surgery Center, we not only validate the benefits but also include medical criteria and pre-cert requirements for approval.
Highest Availability:
Utilizing HIPPA compliant, scalable ‘cloud’ based computing, we offer highest availability. In fact, on major payers, we have redundant systems in place to ensure that you will see fewest ‘payer not responding’ errors.
Highest Success Rate:
pVerify is the only company that seamlessly blends electronic EDI based verification with proprietary manual process to provider 100% payer coverage (including non-EDI payers). In addition, we further improve the success rate using our recursive technology and utilizing innovative manual intervention process to cover ‘patient not found’ type errors.
Financial Guarantee*:
Healthcare providers utilizing the complete pVerify solution will be able to dramatically reduce patient A/R and patient delinquencies. By identifying patient demographic errors and by spotting patients with Medicare/Medicaid HMO plans, pVerify helps reduce insurance denials as well. The net result is that within 60 of deploying the pVerify suite, overall collections will increase by 10% or more. We are so sure about the return-on-investment (ROI) to you that we are backing this with our ‘Money-Guarantee’. If after 60 days of fully deploying pVerify suite, if it does not meet the above, we will refund you all the fees including set-up fees to you…
*At the time of deployment of pVerify suite, the provider’s office will furnish average collections (patient collections and insurance collections) report for preceeding three month period or average thereof. At the end of 60 day period of utilizing pVerify suite as per our guidelines, if the collections increased less than 10%, we will immediately refund the initial set-up fee and pVerify fees for the 2 month period. Applicable for batch verification clients only.
