Eligibility

The core business of pVerify is eligibility.  For 12 years we have successfully helped a wide variety of customers with their API eligibility needs.  Our customer types include:

  • DME
  • Physical Therapy
  • Chiropractic
  • Ophthalmology / Optometry
  • Oncology
  • Dermatology
  • Radiology

The main features of our eligibility endpoints are:

  • Support for EDI and Non EDI payers.
  • Quick parsing of complex data such as copay, coinsurance, PT data, payer change, and more.
  • Excellent support for Medicare eligibility
  • A variety of eligibility endpoints from simple to complex, designed to suite your needs.

Click here to view our Eligibility API documentation

Full Information

View complete information from the payer for any service code.

Tailored to Your Needs

Custom endpoints for specialties such as Chiro, PT, and DME.

Full Support

API support for non EDI payers via our “Back office” team.

Data Transparency

Easily see payer change information and other key data.

The Eligibility API works this way:

 

Start by making a call to the token eligibility call. This will then be used as a parameter to be passed to other eligibility calls.

 

Using the eligibility token, you can then make calls to a variety of Eligibility API calls. To see a full list of Eligibility calls and their descriptions click here.