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Medicare Eligibility Verification


Delivering intelligent eligibility data when you need it.

MedicareMVP is a web-based Medicare eligibility verification tool that allows providers to verify Medicare patients through a batch process or in real time with MVP Live.

Medicare eligibility verification is a critical step in the revenue cycle. Using MedicareMVP in the verification process allows you to verify two types of patient information: 

Personal information: Name, birth date, HIC number validation, gender

Coverage information: Type of coverage (Part A or Part B), deductible data, days information, Medicare HMO and/or Advantage (name, address and phone included), preventative services, home health sessions (PPS episodes), hospice episodes, MSP insurance

Part A and Part B providers can log in to our HIPAA-compliant website and submit a patient’s information for eligibility verification. 

Through our MVP Live service, you can check Medicare eligibility in real time. Use MVP Live by itself or as a complement to MedicareMVP’s batch processing. This lets you get the answers you need, when you need them.

MVP Live also features real-time change reporting. When you submit a new transaction, MVP Live will compare the new transaction to the patient’s most recent transaction processed in the last 90 days. Each field on the Coverage Detail Report is analyzed in real time. When there’s a change, the changed item(s) displays with light gray shading. Additionally, the date of the previous transaction (the one that the new transaction was compared to) is displayed in the header row of the report.

Key Benefits

  • Easily identify HMO and Medicare Advantage data
    Stop wasting valuable time and money submitting claims that a patient’s insurance won’t cover. Now you can know from the start exactly what can be billed.
  • Re-verify HMO, PPS episode and Advantage Plan data
    Our monthly re-verification process performs a full update for all patients, allowing you to see any changes in HMO, PPS episode and Advantage Plan data. By comparing the current coverage to what was last on file, MedicareMVP quickly identifies changes in coverage.
  • Decrease registration errors
    MedicareMVP makes it simple to verify that the information received at your reception desk matches that found in the Medicare system.
  • Increase staff efficiency
    When you verify eligibility up front, your staff spends less time dealing with rejected and denied claims and can concentrate their efforts on more important matters.
  • Increase cash flow
    Submitting fewer claims that will be denied or rejected results in a higher monthly cash flow for your organization.
  • Catch common errors
    Quickly correct patient data, including name, gender, date of birth and HIC number.





MedicareMVP Coverage Detail Report



  • Fast personal and coverage information
  • Eliminates non-covered and unallowed services
  • Indicates expired coverage and data discrepancies
  • Reduce denied claims
  • Improves cash collections
  • Convenient batch or real time processes
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Related Solutions

DME Eligibility Verification: DMELive is our real time, Web-based, Durable Medical Equipment eligibility verification tool, and includes certificate of medical necessity checks and same or similar lookups.

DDE Connection: Medicare Navigator is our Web-based Medicare online connection (DDE or FISS).

Part A Claims Management: MedicareSAM is our Medicare Part A claims management and revenue cycle management tool. It provides workflow automation as well as trending and analysis reporting.

All Payers Eligibility Verification: MVP Live All Payer is our real time, Web-based tool to verify eligibility for your Medicaid and most other major commercial payers.