Healthcare organizations face ongoing pressure to identify every available source of insurance coverage and secure reimbursement for care already delivered. Coverage can change, become active or become discoverable after a patient receives care, creating the risk that eligible claims go unpaid. Providers need a stronger way to uncover missed coverage and protect revenue after the point of service.
Experian Health is helping address this challenge through its acquisition of eInsights, which serves more than 200 U.S. healthcare organizations and has helped clients recover more than $225 million in reimbursements. By expanding Experian Health’s insurance discovery capabilities beyond the front end of the revenue cycle, the acquisition helps healthcare organizations identify coverage that may otherwise be missed and recover reimbursements tied to care already delivered.
Missed insurance coverage can lead to missed reimbursement
For healthcare organizations, insurance information available at registration or billing may not reflect the full picture. A patient’s coverage may change, become active later or be discovered after services have been provided. Without a way to identify those updates, providers may miss opportunities to bill the appropriate payer and recover reimbursement.
This challenge makes post-service insurance discovery an important safety net. It gives providers another opportunity to find valid coverage after care is delivered and reduce the risk that reimbursable services remain unpaid.
“Finding insurance coverage shouldn’t be a one-time event. A patient’s coverage can change or become discoverable after care is delivered, and when that happens, providers can miss reimbursement and patients can end up with bills they shouldn’t have received.”
Jason Considine, President of Experian Health
“Bringing eInsights into Experian Health makes our solution platform even more robust, giving our clients the ability to find coverage from the beginning of the patient journey through the back end of the revenue cycle. As rising costs, regulatory pressures, and operational complexity continue to squeeze margins, healthcare providers can’t afford revenue leakage. Capturing every dollar they are owed helps ensure the financial stability they need to continue delivering exceptional care for their patients,” said Jason.
How expanded insurance discovery can help protect revenue
Insurance discovery capabilities can help healthcare organizations search for coverage beyond the information captured during the initial patient encounter. This supports a more complete view of potential payer responsibility and helps teams pursue reimbursement when coverage is identified later.
| Experian Health will leverage eInsights’ capabilities to help providers: |
| – Find insurance coverage that changes after the initial patient encounter |
| – Identify coverage that becomes active after care is delivered |
| – Discover insurance information that was not previously available |
| – Recover missed reimbursements tied to valid coverage |
“eInsights was built around a simple idea: providers should have every opportunity to find valid insurance coverage, even after care has been delivered,” said John Wester, Executive Chairman and Founder/CEO of eInsights.
“Joining Experian Health allows us to bring that capability to more healthcare organizations and connect insurance discovery across the revenue cycle. That means less manual work for staff, more reimbursement for providers and fewer unexpected bills for patients.”
John Wester, Executive Chairman and Founder/CEO of eInsights
Learn more about how expanded insurance discovery capabilities can help your organization.
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