Insurance Eligibility Verification
Get the most accurate results from our vast payer network
with our exclusive real-time bad plan code detector.
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.
9,000
Live client sites
900
Seamless payer connections
2.9 billion
Eligibility transactions in 2022
How patient eligibility verification and MBI work together
- 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.
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.
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?
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.
*Access our Eligibility solution through the eCare NEXT®, OneSource®, BatchSource®, Premium EDI, or EDI interfaces.
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