Eligibility Exemplified.
Facilitating Faster Patient Care.
The Leader in All-Payer Realtime Patient Insurance Eligibility Verification with Instant, API and Batch Solutions that blend technology with human-enabled AI to simplify the complex landscape of the patient care cycle for Medical, Dental, and Vision Healthcare Providers.
Upcoming 2023 Solution Highlights
Insurance Discovery
NOW Supporting Medi-Cal and Blue Cross of CA
Find over 50% of unknown coverage
Advanced Eligibility
• Medical
• Dental
• Vision
• IPA & ACO
CPT Benefits
Investigation
CPT Code Level Eligibility and Benefits Details
Patient Estimation
● Estimate API Inquiry
● Eligibility + Estimator
● 835 Remits
Fast-PASS ePA
Real-time Prior Authorization
Easy API coverts 278 to/from API Format
Insurance Discovery
NOW Supporting Medi-Cal and Blue Cross of CA
Find over 50% of unknown coverage
Advanced Eligibility
• Medical
• Dental
• Vision
• IPA & ACO
CPT Benefits
Investigation
CPT Code Level Eligibility and Benefits Details
Patient Estimation
● Estimate API Inquiry
● Eligibility + Estimator
● 835 Remits
Fast-PASS ePA
Real-time Prior Authorization
Easy API coverts 278 to/from API Format
pVerify vs Clearinghouse and Payer Sites
pVerify Eligibility
Cloud-based Portal, Batch, API or Integrated
- Realtime Dental, Vision, and Medical Eligibility
- Business Rules Engine (AI Supported)
- Multiple Service Types per Verification
- Robust APIs (270/271, HL7, FHIR, REST API)
- Highly Parsed Benefits – at a deeper level
- Turn-key First-Class Batch Reports
- Unlimited Self-Batch Eligibility
- Easy-to-read User-friendly Premium Portal
- Hands-on API Development Support
- API Consulting Services
- Human-enabled AI and Machine Learning
- Unlimited Users, Providers, and Locations
- HIPAA Compliant and secure cloud-based Portal
Clearinghouse
Long-term Contract
- Restricted Payer List | No non-EDI Payers
- Limited to one Service Type per Verification
- Complex Display | No Parsing of Key Data
- Minimal Customer Support
- Large Setup Fee
- Long-term Contract
Free Payer Site
Manual Verification Only
- Payer-Specific
- Multiple Web Portals
- Completely Manual
- No Parsing of Key Data
- Complex Displays
- Minimal Customer Support
