Our Eligibility Endpoints

The core business of pVerify is Eligibility.

Realtime Healthcare Claim Status API

Catch denials early to decrease write-offs and improve cash flow with pVerify.

About Realtime Healthcare Claim Status API

 

One of the difficult hurdles in payment collection and account reconciliation is the time lost between submitting claims, receiving responses from payers, resubmitting a claim, and waiting to discover if you will get paid. pVerify’s Claim Status lessens the waiting game and allows billers to check in on claims before the payer has taken action to request more information.

Realtime Healthcare Claim Status API

pVerify’s Realtime Healthcare Claim Status API Calls are calls from a client’s own system, sent to pVerify and through to a payer via one of our redundant connections to obtain the status and details of a specific claim. The API get then returns to pVerify for parsing and then back to the pVerify client, within a matter of seconds.

Why Claim Status Matters

  • Check on the status of a claim to learn what the status is
  • See if payment has been sent, including Check Number and Amount
  • Find out if more information is needed without having to wait for payer communication
  • Learn important details such as Status Code, Description, Remittance Date and MORE

Claim Status Response Includes:

  • Effective Date
  • Payment Amount
  • Check Number
  • Unit #
  • Category Description
  • Patient Account Number
  • Charge Amount
  • Adjudication Finalized Date
  • Procedure Code
  • Service Date Range
  • Status Code
  • Billing Type
  • Remittance Date
  • Payment Amount
  • Category Code
  • Status Description
  • Payer’s Claim Number

The Best Healthcare APIs 

pVerify’s robust APIs are available for the following services

Patient Eligibility 

An Eligibility API Call will verify a patient in real-time with unique parsing of benefits

Inpatient SNF

Discover if a patient is currently admitted to a Hospital or Skilled Nursing Facility (SNF)

Drop-In UI

pVerify’s Drop-in UI offers a pre-built low code solution that allows for easy integration of our Advanced Eligibility and other pVerify Solutions

Experts in APIs

With hands-on and responsive Healthcare Eligibility API Support, pVerify assists with designing your Healthcare API workflow, acts as a hand-on guide throughout development, and remains a go-to expert post development.

Realtime Healthcare API Eligibility API