Enhanced Patient Coverage Insights
JSON twin: https://www.healthaidb.com/software/enhanced-patient-coverage-insights.json
Company Name
pVerify
Product URL
https://pverify.com/solutions/enhanced-patient-coverage-insights/
Company URL
https://pverify.com
Categories
Summary
pVerify's Enhanced Patient Coverage Insights provides real-time insurance eligibility verification and patient financial responsibility estimation to improve billing accuracy and reduce claim denials.
Description
pVerify's Enhanced Patient Coverage Insights is a cloud-based solution that offers real-time insurance eligibility verification, patient demographic validation, insurance discovery, Medicare Beneficiary ID retrieval, and out-of-pocket cost estimation. It integrates with existing healthcare systems via APIs and is designed to streamline administrative workflows, enhance financial transparency, and improve revenue cycle management for healthcare providers.
Api Available
yes
Certifications
Company Founding
2006
Company Offices
Compliance
Customers
- One of the largest vertically integrated eye care groups in the U.S.
Data Residency
US-only
Data Standards
- RESTful API
- FHIR
- HL7
- ANSI X12 270/271
- SOAP
Deployment Model
Features
- Real-time eligibility verification
- Patient Demographic Validator (PDV)
- Insurance discovery
- Medicare MBI retrieval and eligibility view
- Coverage details (copays, coverage limits, deductibles, coinsurance)
- Out-of-pocket cost estimation at point-of-care
- Single-screen Medicare benefits view
- Portal and developer API access
- Eligibility widget for consumer-facing sites
- Automated payer verification workflows
- Claims denial reduction insights
Id
SW2092
Integration Partners
Integrations
- EHRs
- PMs
- billing software
- DoseSpot
- Etactics
Languages Supported
Last Updated
2025-10-11
License
commercial
Market Segment
Optional Modules
- Claims History & Compliance Tracking
- Advanced Eligibility / Same-or-Similar solutions
- Drop-in UI / low-code Eligibility Widget
- CallShaper telemarketing verification integration
Os Platforms
Pricing Details
Tiered subscription offerings; public pricing not listed — contact vendor or request a demo for quotes and trial information.
Pricing Model
enterprise_quote
Privacy Features
- BAA available
- Patient data validation to minimize unnecessary data collection
Product Code
SW2092
Product Name
Enhanced Patient Coverage Insights
Ratings
- 4.5 out of 5 stars on Capterra
Regions Available
Related Urls
Release Year
2010
Security Features
- Encryption
- Audit logs
- SSO/SAML support
Specialties
Support Channels
- email
- phone
- chat
- ticketing
- community
- 24x7
System Requirements
Target Users
- billing_staff
- revenue_cycle_teams
- front_desk/registration
- health IT developers
- RCM_companies
- hospital_administrators
- clinicians (administrative workflows)
Training Options
- documentation
- webinars
- live_online
- onsite
- certification
Type
product
User Reviews
- Ease of use, very little downtime, great response time on support issues, great API functions, and the user interface is easy and fast!
- We use pVerify every week, and it’s such a great resource for anyone looking to verify insurance benefits!
- Pverify is the perfect solution for anyone in healthcare who accepts insurance. Ease of setup, level of customer support, and pricing are all reasons I would recommend.
- We like pVerify and intend to expand its use. pVerify was quick to set up, it’s easy for my employees to use, and the price point is fair.
- Excellent. From onboarding to ongoing insurance verifying and support, everything has run smoothly. [pVerify] is proactive with communication as well.
- This is such a powerful time-saving tool. It takes only a few seconds to pull selected information needed in order to perform benefit verifications specific to my industry.
- Great addition to my practice. My overall experience has been a positive one. It has given me greater control over our revenue. It’s a simple way to verify patient insurance and help us to collect payments accurately upfront.
- Best verification system I have encountered…First of all, I have the BEST Client Support Representative. She actually listens, provides feedback, and understands our needs.
- pVerify is very responsive and customer-focused. If you are looking for APIs for dental insurance verification, I highly recommend them!
Version
1.0
Alternatives
See related products
Canonical JSON
{
"product_name": "Enhanced Patient Coverage Insights",
"company_name": "pVerify",
"product_url": "https://pverify.com/solutions/enhanced-patient-coverage-insights/",
"company_url": "https://pverify.com",
"related_urls": [
"https://elion.health/products/pverify-enhanced-patient-coverage-insights"
],
"product_code": "SW2092",
"summary": "pVerify's Enhanced Patient Coverage Insights provides real-time insurance eligibility verification and patient financial responsibility estimation to improve billing accuracy and reduce claim denials.",
"description": "pVerify's Enhanced Patient Coverage Insights is a cloud-based solution that offers real-time insurance eligibility verification, patient demographic validation, insurance discovery, Medicare Beneficiary ID retrieval, and out-of-pocket cost estimation. It integrates with existing healthcare systems via APIs and is designed to streamline administrative workflows, enhance financial transparency, and improve revenue cycle management for healthcare providers.",
"categories": [
"administrative Operations",
"revenue Cycle",
"insurance",
"eligibility Verification",
"price Transparency",
"Administrative",
"Revenue Cycle Management",
"Insurance Discovery",
"Eligibility Verification",
"Price Transparency"
],
"market_segment": [
"enterprise",
"smb"
],
"target_users": [
"billing_staff",
"revenue_cycle_teams",
"front_desk/registration",
"health IT developers",
"RCM_companies",
"hospital_administrators",
"clinicians (administrative workflows)"
],
"specialties": [
"General_medical",
"Hospital_outpatient",
"Ambulatory_clinic",
"Dme_suppliers",
"Home_health",
"Urgent_care",
"Ophthalmology",
"Pharmacies",
"Diagnostic_labs",
"Imaging_centers"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Tiered subscription offerings; public pricing not listed — contact vendor or request a demo for quotes and trial information.",
"license": "commercial",
"company_offices": [
"United States"
],
"company_founding": "2006",
"deployment_model": [
"SaaS",
"hybrid"
],
"os_platforms": [
"Web",
"iOS",
"Android"
],
"features": [
"Real-time eligibility verification",
"Patient Demographic Validator (PDV)",
"Insurance discovery",
"Medicare MBI retrieval and eligibility view",
"Coverage details (copays, coverage limits, deductibles, coinsurance)",
"Out-of-pocket cost estimation at point-of-care",
"Single-screen Medicare benefits view",
"Portal and developer API access",
"Eligibility widget for consumer-facing sites",
"Automated payer verification workflows",
"Claims denial reduction insights"
],
"optional_modules": [
"Claims History & Compliance Tracking",
"Advanced Eligibility / Same-or-Similar solutions",
"Drop-in UI / low-code Eligibility Widget",
"CallShaper telemarketing verification integration"
],
"integrations": [
"EHRs",
"PMs",
"billing software",
"DoseSpot",
"Etactics"
],
"data_standards": [
"RESTful API",
"FHIR",
"HL7",
"ANSI X12 270/271",
"SOAP"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA"
],
"certifications": [
"SOC 2",
"ISO 27001"
],
"security_features": [
"Encryption",
"Audit logs",
"SSO/SAML support"
],
"privacy_features": [
"BAA available",
"Patient data validation to minimize unnecessary data collection"
],
"data_residency": "US-only",
"customers": [
"One of the largest vertically integrated eye care groups in the U.S."
],
"user_reviews": [
"Ease of use, very little downtime, great response time on support issues, great API functions, and the user interface is easy and fast!",
"We use pVerify every week, and it’s such a great resource for anyone looking to verify insurance benefits!",
"Pverify is the perfect solution for anyone in healthcare who accepts insurance. Ease of setup, level of customer support, and pricing are all reasons I would recommend.",
"We like pVerify and intend to expand its use. pVerify was quick to set up, it’s easy for my employees to use, and the price point is fair.",
"Excellent. From onboarding to ongoing insurance verifying and support, everything has run smoothly. [pVerify] is proactive with communication as well.",
"This is such a powerful time-saving tool. It takes only a few seconds to pull selected information needed in order to perform benefit verifications specific to my industry.",
"Great addition to my practice. My overall experience has been a positive one. It has given me greater control over our revenue. It’s a simple way to verify patient insurance and help us to collect payments accurately upfront.",
"Best verification system I have encountered…First of all, I have the BEST Client Support Representative. She actually listens, provides feedback, and understands our needs.",
"pVerify is very responsive and customer-focused. If you are looking for APIs for dental insurance verification, I highly recommend them!"
],
"ratings": [
"4.5 out of 5 stars on Capterra"
],
"support_channels": [
"email",
"phone",
"chat",
"ticketing",
"community",
"24x7"
],
"training_options": [
"documentation",
"webinars",
"live_online",
"onsite",
"certification"
],
"release_year": "2010",
"integration_partners": [
"DoseSpot"
],
"id": "SW2092",
"slug": "enhanced-patient-coverage-insights",
"type": "product",
"version": "1.0",
"last_updated": "2025-10-11",
"links_json": {
"self": "https://www.healthaidb.com/software/enhanced-patient-coverage-insights.json"
}
}