JSON twin: https://www.healthaidb.com/software/pverify-enhanced-patient-coverage-insights.json
pVerify
https://pverify.com/solutions/enhanced-patient-coverage-insights/
pVerify Enhanced Patient Coverage Insights is a real-time insurance eligibility and benefits insight solution that delivers upfront coverage details, out-of-pocket estimates, and Medicare verification to reduce denials and improve revenue cycle performance.
A cloud/API-based eligibility and coverage intelligence product that verifies patient demographics, discovers active insurance, retrieves Medicare MBIs, checks Medicare Parts and plan types, and produces point-of-care out-of-pocket cost estimates to improve transparency, reduce bad debt, and decrease claim rejections. Accessible via portal or API and marketed to providers, billing/RCM firms, and health IT vendors.
yes
2006
P1350
2025-09-07
commercial_proprietary
Tiered subscription offerings; public pricing not listed — contact vendor or request a demo for quotes and trial information.
enterprise_quote
2006
product
1.0
{
"company_name": "pVerify",
"company_url": "https://pverify.com/",
"company_offices": [
"United States"
],
"company_founding": "2006",
"product_url": "https://pverify.com/solutions/enhanced-patient-coverage-insights/",
"categories": [
"administrative",
"revenue cycle management",
"insurance discovery",
"eligibility verification",
"price transparency"
],
"market_segment": [
"enterprise",
"smb"
],
"links": [
"https://pverify.com/solutions/enhanced-patient-coverage-insights/",
"https://pverify.com/",
"https://pverify.com/about/",
"https://pverify.com/pricing/",
"https://pverify.com/resources/",
"https://elion.health/products/pverify-enhanced-patient-coverage-insights",
"https://www.capterra.com/p/238921/pVerify/",
"https://www.trustradius.com/products/pverify/reviews",
"https://appexchange.salesforce.com/appxListingDetail?listingId=a0N4V00000GrnpNUAR",
"https://pverify.com/industries/healthcare-providers-suppliers/"
],
"summary": "pVerify Enhanced Patient Coverage Insights is a real-time insurance eligibility and benefits insight solution that delivers upfront coverage details, out-of-pocket estimates, and Medicare verification to reduce denials and improve revenue cycle performance.",
"description": "A cloud/API-based eligibility and coverage intelligence product that verifies patient demographics, discovers active insurance, retrieves Medicare MBIs, checks Medicare Parts and plan types, and produces point-of-care out-of-pocket cost estimates to improve transparency, reduce bad debt, and decrease claim rejections. Accessible via portal or API and marketed to providers, billing/RCM firms, and health IT vendors.",
"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_proprietary",
"deployment_model": [
"SaaS",
"hybrid (API/batch)"
],
"os_platforms": [
"Web",
"iOS",
"Android"
],
"features": [
"Real-time eligibility verification",
"Patient Demographic Validator (PDV)",
"Insurance discovery (identify active insurance from minimal data)",
"Medicare MBI retrieval and Medicare eligibility view",
"Coverage details (copays, coverage limits, deductibles, coinsurance)",
"Out-of-pocket cost estimation at point-of-care",
"Single-screen Medicare benefits (Part A/B, HMO, MA, MSP, deductibles)",
"Portal and developer API access",
"Eligibility widget (drop-in UI) for consumer-facing sites",
"Automated payer verification workflows",
"Claims denial reduction insights",
"Batch processing support",
"Email notifications and webhooks"
],
"optional_modules": [
"Claims History & Compliance Tracking",
"Advanced Eligibility / Same-or-Similar solutions",
"Drop-in UI / low-code Eligibility Widget",
"CallShaper telemarketing verification integration"
],
"integrations": [
"Zapier",
"CallShaper",
"CRM systems (via webhooks/API)",
"EHR / EMR vendors (custom integrations)",
"Practice management / RCM systems",
"Payer networks (medical, dental, vision via payer list)"
],
"data_standards": [
"REST (RESTful API)",
"FHIR",
"HL7",
"ANSI X12 270/271",
"SOAP"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA"
],
"certifications": [],
"security_features": [
"Encryption (in transit and at rest)",
"Audit logs",
"SSO/SAML support"
],
"privacy_features": [
"HIPAA-compliant platform (BAA available)",
"Patient data validation to minimize unnecessary data collection"
],
"data_residency": "",
"customers": [
"DoseSpot",
"Etactics"
],
"user_reviews": [
"pVerify is very responsive and customer focused.",
"Easy to use.",
"Great addition to my practice.",
"Need better pricing options.",
"pVerify doesn't do cost estimates anymore."
],
"ratings": [
""
],
"support_channels": [
"email",
"phone",
"ticketing",
"developer_portal"
],
"training_options": [
"documentation",
"webinars",
"live_online"
],
"release_year": "2006",
"integration_partners": [
"DoseSpot",
"Etactics",
"Salesforce AppExchange"
],
"id": "P1350",
"slug": "pverify-enhanced-patient-coverage-insights",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/pverify-enhanced-patient-coverage-insights.json"
}
}