Prioritize reimbursements with automated eligibility checks

Between patients taking on more payment responsibility and new regulations like the No Surprises Act, healthcare providers are at higher risk than ever of claim denials, rising AR days, payment delays, and non-compliance.

Plus, the manual process of verifying accurate coverage is error-prone, inefficient, and time-consuming.

Using an automated process to verify coverage at the time of service will help you improve staff productivity while experiencing fewer payment delays and claim denials.

Let us help you verify coverage prior to service, so you can focus on providing the best care for your patients.

Improve cash flow

Reduce claims denials and speed of payments with automated insurance eligibility and benefits data.

Unlock Medicare reimbursement opportunities

Speed up Medicare reimbursements with our automated MBI Lookup Service that returns missing or invalid MBIs along with its Medicare benefit coverage.

Gain staff efficiency

Keep up with increasing patient demand by leveraging automated work queues created with preset or custom alerts.

Reduce bad debt

Lower your risk of bad debt by verifying insurance in real time.

Increase patient satisfaction

Empower your patients with accurate payment estimates and accelerated registration. 

Simplify your workflows

View eligibility responses in an easy-to-read format that notifies you when edits or follow-ups are required.

Client Testimonial: Steinberg Diagnostic Medical Imaging

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


Live client sites


Seamless payer connections

2.9 billion

Eligibility transactions in 2022

How patient eligibility verification and MBI work together

how insurance eligibility works image
  • Eligibility clearinghouse: Connect to 900+ payers, with backup connectivity to minimize payer-specific service interruptions.
  • Normalization: View patient information in eligibility responses across all payers.
  • Data enrichment: Unlock intelligence and detailed responses from payer websites and other accurate sources.
  • Search optimization: Find patient matches with certainty.
  • CAQH COB Smart® data: View primacy information for relevant transactions to increase accuracy and streamline your processes.
  • MBI Lookup Service: Improve Medicare reimbursement rates by automating MBI lookup and eliminating manual inquiries.

Read more for a deep dive into our eligibility process and workflow.

Download product sheet

How to maximize eligibility verification

Read how unprecedented industry changes continue to threaten healthcare provider cash flow and why organizations must focus on eligibility in the patient access process.

Download now

Insurance eligibility resources

hospital administrative desk

4 benefits of health insurance eligibility verification software

An automated solution that eliminates errors and reduces denials could pay big dividends across the revenue cycle. This article breaks down the key revenue-boosting benefits of health insurance eligibility verification software.

doctor looking at chart with patient

How to verify insurance eligibility for patients post-COVID-19

Up to 15 million Americans may find themselves without healthcare insurance when the COVID-19 public health emergency ends. What should providers expect, and how can they help patients navigate the changes?

doctor looking at computer screen

Medicare MBI: COVID-19 and Medicare claims

The southeast division of a national health care system, with 1700+ beds and $1.6B in revenue, needed better ways to find MBIs when Health Insurance Claim Numbers (HICNs) were phased out.

Medicaid coverage at risk

Learn more about Medicaid Redetermination and how you can determine coverage to protect your bottom line.

Related products

Explore other complementary Experian Health products

Coverage Discovery®

At any point in your revenue cycle, find previously unidentified coverage to maximize insurance reimbursement revenue.

Patient Intake Solutions

Enhance patient experience by streamlining intake processes with digitized solutions and touchless quality assurance processing, ensuring accurate registration data every time.

Patient Estimates

Help your patients make informed healthcare decisions with accurate, transparent, and compliant estimates.

Patient Payment Solutions

Increase collections with user-friendly, self-service payment solutions.

*Access our Eligibility solution through the eCare NEXT®, OneSource®, BatchSource®, Premium EDI, or EDI interfaces.

Insurance verification made easy

Complete the form below to learn more about how we can help you verify your patients' insurance eligibility with ease! 

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.