PayerLenz
PayerLenz is an American software company providing reimbursement benchmarking and eligibility verification for behavioral health providers.
What's the difference between a VOB and eligibility verification?
“A verification of benefits (VOB) confirms a patient's insurance policy is active and outlines plan details like deductibles and co-pays. Eligibility verification is often used interchangeably with VOB. Neither tells you what a payer is likely to reimburse - that's what PayerLenz's benchmarking answers.”
View in the company profileDoes PayerLenz just confirm coverage, or does it estimate reimbursement too?
“Both. PayerLenz's real-time eligibility check returns coverage status, deductibles, and out-of-pocket maximums the same way a standard VOB does, but it also attaches the expected out-of-network reimbursement for that payer, state, and level of care in the same result.”
View in the company profileHow accurate are PayerLenz's reimbursement benchmarks?
“PayerLenz's benchmarks are estimates, not guarantees. Each benchmark is marked Tight or Wide, so you can see how much the claims behind it agreed, with the trust score one click away in the detailed view, drawn from adjudicated claims across 250 payer groups in 20 states and growing, from a pool of 500,000+ adjudicated claims.”
View in the company profileWhat data powers PayerLenz's benchmarks?
“Adjudicated behavioral health claims data, contributed in part through PayerLenz's Claims Data Contribution Program. Customers can contribute de-identified claims each billing cycle to strengthen the benchmark pool, earning a discount on paid plans or free historical-search credits on the free tier.”
View in the company profile