Automated medical insurance verification can help your organization do more with less through powerful, trusted automation.

Insurance verification can be complex, with patients taking on more payment responsibility and frequently changing insurance providers. You need to be able to identify coverage fast and reduce the number of claims being denied on the back end due to inactive insurance or non-coverage. When patients and providers are aware of their coverage, co-pays and deductibles at the time of service, you experience fewer payment delays, less confusion, and minimal need for follow-up. Let us help you verify coverage earlier in the billing process, so you can focus on providing the best care for your patients.

Improve cash flow

Access to up-to-date eligibility and benefits data to increase clean claims rates and accelerate reimbursement.

Streamline workflows

Eligibility responses are viewed in a concise and consistent format that improves efficiency and allows notification when edits or follow up are required. 

Boost self-pay revenue

Capitalize on additional reimbursement opportunities by electronically matching self-pay patients against Medicaid and managed Medicaid databases.

Fast-track registration

Validate the accuracy of patient registration information and coverage before claim submission, and even patient arrival.

Empower financial experiences

Accurately calculate patient’s financial responsibility before the time of service. 

Save staff time

Reduce staff time and training with automated eligibility checks and handle a higher volume of patient visits with ease.

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Hear from our clients

Steinberg Diagnostic Imaging Center uses Experian Health’s eligibility products to validate patient coverage in under 30 seconds. 


How our patient eligibility verification solution works

Experian Health’s eligibility solutions have connectivity with over 890 payers and modify payer eligibility responses to show registrars consistent patient information, regardless of payer.

Simplify insurance verification with search optimization functionality, allowing you to execute multiple searches to ensure the highest likelihood of finding a patient match. Leverage data enrichment intelligence from additional data sources, such as payer websites, to create user-friendly and detailed responses.

Proactively address COB instances with CAQH COB Smart ™, reducing errors. 


The importance of eligibility verification throughout the patient access process.

More healthcare eligibility resources


7 ways to prevent costly claim denials

Among the most common reasons for denials are missing or incorrect billing information, non-covered charges for care, and absent authorizations. Thankfully, these are all issues that can be minimized with the right strategies and tools.


How Schneck Medical Center manages denials

To safeguard its revenue, Schneck Medical Center in Indiana, the only hospital serving four counties, wanted a way to optimize claims follow-up by identifying and targeting the claims needing attention as quickly as possible. 


Reduce the time it takes to get claims paid

It’s no secret that claim denials cost healthcare organizations. They take about 16 more days to pay out than claims that have not been denied. On average, this delay in payment equates to one percent of a healthcare organization’s cost structure.

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