Coverage Discovery

JSON twin: https://www.healthaidb.com/software/coverage-discovery.json

Company Name

Experian Health

Product URL

https://www.experianhealth.com/products/coverage-discovery

Company URL

https://www.experianhealth.com

Categories

• administrative Operations
• revenue Cycle
• insurance
• Administrative
• Revenue Cycle Management
• Insurance Discovery

Summary

Experian Health's Coverage Discovery is an automated tool that identifies previously unknown insurance coverage for patients, enhancing revenue cycle management by reducing uncompensated care and bad debt.

Description

Coverage Discovery utilizes proprietary databases, including employer information, historical search data, registration history, and demographic validation, to proactively identify billable Medicare, Medicaid, and private insurance options. It integrates with various Electronic Health Record (EHR) systems, such as Epic, Cerner, and Meditech, to streamline the insurance discovery process across the revenue cycle. The tool can be employed at multiple stages: pre-service, point of care, and post-service, ensuring comprehensive coverage identification. In 2024, Coverage Discovery identified over $60 billion in insurance coverage across more than 45 million unique patient cases, converting missed opportunities into paid claims. Additionally, in 2015, it found previously unidentified coverage associated with more than $1.1 billion in charges. The acquisition of Wave HDC in 2023 further enhanced its capabilities, enabling real-time, single-inquiry insurance discovery and verification at the point of patient registration, thereby improving operational efficiency and accelerating reimbursement processes. ([experian.com](https://www.experian.com/healthcare/products/patient-access-registration/check-patient-health-insurance-lookup?utm_source=openai))

Api Available

unknown

Certifications

• FDA 510(k)
• CE/MDR
• ONC
• ISO 9001

Company Founding

1980

Company Offices

• United States

Compliance

• HIPAA
• HITRUST CSF
• SOC 2
• ISO 27001

Customers

Data Residency

US-only

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS

Features

• Automated insurance discovery
• Identification of previously unknown coverage
• Integration with Epic's EMR system
• Real-time insurance verification
• Reduction of bad debt
• Improved revenue cycle management
• Enhanced patient registration process
• Proactive reclassification of uncompensated care
• Advanced analytics for coverage optimization
• Support for Medicare, Medicaid, and commercial plans

Id

SW1333

Integration Partners

Integrations

• Epic EMR

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• MBI Lookup Tool

Os Platforms

• Web

Pricing Details

contact vendor

Pricing Model

subscription

Privacy Features

• BAA available
• Consent management
• Anonymization
• Data minimization

Product Code

SW1333

Product Name

Coverage Discovery

Ratings

Regions Available

• United States

Related Urls

• https://elion.health/products/experian-coverage-discovery

Release Year

Security Features

• Encryption
• RBAC
• SSO/SAML
• Audit logs
• 2FA
• DLP

Specialties

• General Healthcare
• Hospital Services
• Ambulatory Care
• Laboratories
• Physician Groups
• Billing Companies

Support Channels

System Requirements

Target Users

• hospital administrators
• healthcare providers
• billing departments
• revenue cycle managers

Training Options

Type

product

User Reviews

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Coverage Discovery",
  "company_name": "Experian Health",
  "product_url": "https://www.experianhealth.com/products/coverage-discovery",
  "company_url": "https://www.experianhealth.com",
  "related_urls": [
    "https://elion.health/products/experian-coverage-discovery"
  ],
  "product_code": "SW1333",
  "summary": "Experian Health's Coverage Discovery is an automated tool that identifies previously unknown insurance coverage for patients, enhancing revenue cycle management by reducing uncompensated care and bad debt.",
  "description": "Coverage Discovery utilizes proprietary databases, including employer information, historical search data, registration history, and demographic validation, to proactively identify billable Medicare, Medicaid, and private insurance options. It integrates with various Electronic Health Record (EHR) systems, such as Epic, Cerner, and Meditech, to streamline the insurance discovery process across the revenue cycle. The tool can be employed at multiple stages: pre-service, point of care, and post-service, ensuring comprehensive coverage identification. In 2024, Coverage Discovery identified over $60 billion in insurance coverage across more than 45 million unique patient cases, converting missed opportunities into paid claims. Additionally, in 2015, it found previously unidentified coverage associated with more than $1.1 billion in charges. The acquisition of Wave HDC in 2023 further enhanced its capabilities, enabling real-time, single-inquiry insurance discovery and verification at the point of patient registration, thereby improving operational efficiency and accelerating reimbursement processes. ([experian.com](https://www.experian.com/healthcare/products/patient-access-registration/check-patient-health-insurance-lookup?utm_source=openai))",
  "categories": [
    "administrative Operations",
    "revenue Cycle",
    "insurance",
    "Administrative",
    "Revenue Cycle Management",
    "Insurance Discovery"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "hospital administrators",
    "healthcare providers",
    "billing departments",
    "revenue cycle managers"
  ],
  "specialties": [
    "General Healthcare",
    "Hospital Services",
    "Ambulatory Care",
    "Laboratories",
    "Physician Groups",
    "Billing Companies"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "contact vendor",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "1980",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Automated insurance discovery",
    "Identification of previously unknown coverage",
    "Integration with Epic's EMR system",
    "Real-time insurance verification",
    "Reduction of bad debt",
    "Improved revenue cycle management",
    "Enhanced patient registration process",
    "Proactive reclassification of uncompensated care",
    "Advanced analytics for coverage optimization",
    "Support for Medicare, Medicaid, and commercial plans"
  ],
  "optional_modules": [
    "MBI Lookup Tool"
  ],
  "integrations": [
    "Epic EMR"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
  ],
  "api_available": "unknown",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "HITRUST CSF",
    "SOC 2",
    "ISO 27001"
  ],
  "certifications": [
    "FDA 510(k)",
    "CE/MDR",
    "ONC",
    "ISO 9001"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit logs",
    "2FA",
    "DLP"
  ],
  "privacy_features": [
    "BAA available",
    "Consent management",
    "Anonymization",
    "Data minimization"
  ],
  "data_residency": "US-only",
  "customers": [],
  "user_reviews": [],
  "ratings": [],
  "support_channels": [],
  "training_options": [],
  "release_year": "",
  "integration_partners": [],
  "id": "SW1333",
  "slug": "coverage-discovery",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/coverage-discovery.json"
  }
}