Durable Medical Equipment integration using pVerify.
Use pVerify’s Eligibility, Same or Similar, SNF, and Medicare CMN Solutions to automate specific information regarding DME. Save time and money using the pVerify Medicare endpoint.
Same or Similar
Description: Quickly gives you access to Same/Similar checks across all 4 medicare jurisdictions, including L codes.
Request: Object contains memberId, patient name, DOB, hcpcsCodes as well as information such as date of service.
Response: Object contains requesstId in addition to status and an apiResponseMessage.
Description: This call is used to get the Same or Similar transaction result later using a unique request ID.
Request: The request headers contain payer information that is standard for same or similar
Response: Response returns a series of claims containing the Same or Similar request information.
Skilled Nursing Facility
Description: The pVerify API for SNF is like Same or Similar in that it will not deliver a result instantly, instead the user is expected to call the GET method 1 minute later.
Request: SNFInquiry requires the standard pVerify credentials and a series of body fields specified in the documentation page.
Response: The response object the expected time to get the SNF response and the request ID used in GetSNFResponse.
Description: This GET call is intended to retrieve the SNF response initiated by the SNFInquiry POST call. By adding the requestId received in the POST call, users can retrieve the SNFInquiry Response.
Request: GetSNFResponse requires the requestId from SNFInquiry to be placed in the URL parameter for the call.
Response: The response object returns the details of the SNFInquiry.
Description: Eligibility summary allows you to populate data based on the Practice Type. While most of the objects are similar to other eligibility calls, there is a new object which is specific to practice type. EligibilitySummary is not supported for back office payers.
Request: This object contains payer and subscriber/dependent information.
Response: We return information related to Copay, Coinsurance and deductible.
Description: GetEligibilitySummary returns the response from the EligibilitySummary POST call using a unique request id provided in the EligibilitySummary response. EligibilitySummary is not supported for back office payers.
Request: RequestId returned in EligibilitySummary response must be in URL.
Response: The Response for GetEligibilitySummary is the same as for EligibilitySummary.
In addition to our RESTfull interfaces, pVerify offers a direct EDI 270/271 interface for those who already have existing EDI connections.
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The pVerify Advantage for DME
DME integrates well with Same/Similar as you can use the patient provided information, test for validity with Eligibility, then use that demographic data to get S/S benefits.
Easy to Interpret
The Eligibility Status and patient demographics from DMS are simple and easy to parse.
The Medicare Wellness HCPCS codes can be also retrieved in a very convenient object format, to determine if the patient is eligible for wellness exams.
Detailed & Specific Reports
We will return specific discrete information regarding TPA / Medicare Advantage (Payer Change)
Use a set of basic information which saves development time for payer mapping and service codes. We have developed specific industry knowledge regarding what most DME companies want returned and have tailored this endpoint for you.