Verisys Eligibility: Where Accuracy Meets Assurance.
Eligibility by Verisys is a turnkey solution for ensuring pre-hire and ongoing workforce compliance. Verify your workforce has up-to-date, compliant status without requiring additional vendors or integrations. Receive near instantaneous results on core data sets including NPI, DEA, Medicare Opt Out, Federal Exclusions, State Exclusions, PECOS, and State Licensing Boards.
The Verisys Eligibility dataset is the Highest Quality & Most Accurate Transactional Data in the Industry
Markets who can benefit from Eligibility by Verisys
Retail Pharmacies
Real-time confirmation of eligible provider at point of prescription fills and immediate alerts to changes in status.
Health Providers
Real-time eligibility screening for ordering and referring providers.
Government
Eligibility Screening at the point of Claim Payment / Reimbursement.
Life Science
Pre-hire screening to ensure applicants have the required licenses and credentials prior to interview.
Health Plans
Real-time confirmation of eligibility at point of claim payment and review of underwriting risk assessment.
Pharmacy Benefit Management
Real-time confirmation of eligibility for government program reimbursement.
Eligibility is designed to reduce organizational risk and improve operations for healthcare organizations.
Avoid Unnecessary Fines
Results are delivered instantaneously and the underlying data is updated and maintained, in accordance with primary source verifications. The Verisys matching process ensures decisions based on this dataset can be made with confidence in the accuracy and timeliness of the data delivered. Partners can provide as little as an NPI number to have results returned.
Manage Risks With Unmatched Visibility
- Pre-Enrollment screening to ensure a provider is eligible to see patients.
- Point of prescription fill eligibility screening to ensure your eligibility to provide medicine.
- Eligibility screening at point of claim payment to help reduce fraud, waste, and abuse.
- Underwriting risk assessment for providers and entities
Empowering Healthcare with Seamless Compliance Solutions.
A New Era of Compliance Efficiency for Retail Pharmacies
Over the past several years, the role of the pharmacist has greatly expanded and the background screening needs have evolved with the role. Eligibility helps with both of these:
- Real-time confirmation of prescription fills and immediate alerts to changes in status.
- Real-time review of prescribing provider status and alerts to potential issues
Real-time screening for Healthcare Providers
Screen and validate the eligibility healthcare providers. Verify that your partners hold the required licenses and maintain a clean record. Mitigate risk by implementing a unified process across your entire organization.
- Real-time transactional pre-employment screening
- Verify providers hold the required licenses and maintain a clean record.
Screen against state & federal exclusions, NPI, license status, DEA, PECOS, and medicare opt out
Accuracy Matters for Payers
Verisys’ Eligibility dataset has payer market in mind helping to solve common pain points:
- Real-time confirmation of eligibility for pre-enrollment screening
- Real-time confirmation of eligibility screen at point of claim payment
- Real-time review of underwriting risk assessment
Optimal Data Quality Ensures Minimal Risk in Pharmaceutical & Life Science Sectors
Verisys is an expert in state and federal regulation compliance, curating the most comprehensive data to support pharmaceutical and life science organizations. Eligibility was created to help solve common pain points:
- Real-time transactional pre-employment screening
- Real-time review of prescribing provider status and alerts to potential issues
Enhance Efficiency and Accuracy in HR Compliance
Streamline hiring with automated credential verification, confirming licensure and/or certification for relevant positions.
- Real-time confirmation of eligibility for pre-enrollment screening
- Automated credential verification
- Promptly confirm licensure and/or certification for relevant positions
Ensuring qualified candidates are swiftly onboarded, minimizing administrative burdens, and fostering a seamless recruitment experience.
%
of Individuals Submitted are Identified
Providers Monitored Annually
%
Verification Accuracy
“The verification process takes too long and is too rigid. We want to break apart the process to be more dynamic and to help save organizations time and money.”
Eligibility is an easy to implement and integrate solution.
- Seamless API integration into existing organizational tech stack to streamline reporting
- Pre-schedule eligibility screening to minimize potential missed screenings
- Minimize the need for additional data to be provided from your organization
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FACIS®
License Verification
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