Eligible

JSON twin: https://www.healthaidb.com/software/eligible.json

Company Name

Eligible

Product URL

https://eligible.com/docs/

Company URL

https://eligible.com

Categories

• administrative Operations
• patient Facing
• Administrative

Summary

Eligible is a healthcare software company offering API solutions for insurance eligibility verification and claims management.

Description

Eligible provides an API platform that enables healthcare organizations to verify insurance eligibility and manage claims efficiently, streamlining administrative processes and reducing errors.

Api Available

yes

Certifications

• SOC 2 Type II
• HITRUST CSF
• CAQH CORE Phase I-IV certification
• EHNAC accreditation

Company Founding

2015

Company Offices

• United States

Compliance

• SOC 2 (Type II)
• HITRUST
• CAQH CORE Phases I-IV
• EHNAC
• NIST 800-53

Customers

Data Residency

United States

Data Standards

• CAQH CORE
• NIST 800-53

Deployment Model

• SaaS

Features

• Insurance eligibility & benefits checks
• Insurance verifications
• Insurance enrollments
• Insurance claims (billing) APIs
• Real-time cost estimates (ML-powered)
• Webhooks/event notifications
• Reporting & analytics
• Enterprise data transfers/ingestion
• API monitoring
• Claims.js JavaScript helper

Id

SW1273

Integration Partners

Integrations

• Insurers (payer networks)

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• ML-powered cost estimation
• Enterprise data transfer/ingestion
• Advanced reporting/analytics
• Enterprise support plan

Os Platforms

• Web
• iOS
• Android
• Windows
• macOS
• Linux

Pricing Details

Contact vendor for pricing information.

Pricing Model

subscription

Privacy Features

• HIPAA-aligned controls (HITRUST)
• BAA available
• Data minimization and confidentiality controls
• Anonymization/pseudonymization capabilities

Product Code

SW1273

Product Name

Eligible

Ratings

Regions Available

• United States

Related Urls

• https://www.ycombinator.com/companies/eligible
• https://compareyourtech.com/listing/eligible/
• https://www.keragon.com/integrations/eligible
• https://elion.health/products/eligible

Release Year

Security Features

• Encryption at rest and in transit (TLS)
• Hardware Security Modules (HSM) for key storage
• Approved cipher suites with PFS (DHE/ECDHE)
• Multi-factor authentication
• Network and host-based firewalls
• Role-based access controls (RBAC)
• 24/7 monitoring and alerting
• Automated vulnerability scanning and patch management
• Audit logging

Specialties

• Insurance Verification
• Claims Management

Support Channels

System Requirements

Target Users

• admins
• patients

Training Options

Type

product

User Reviews

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Eligible",
  "company_name": "Eligible",
  "product_url": "https://eligible.com/docs/",
  "company_url": "https://eligible.com",
  "related_urls": [
    "https://www.ycombinator.com/companies/eligible",
    "https://compareyourtech.com/listing/eligible/",
    "https://www.keragon.com/integrations/eligible",
    "https://elion.health/products/eligible"
  ],
  "product_code": "SW1273",
  "summary": "Eligible is a healthcare software company offering API solutions for insurance eligibility verification and claims management.",
  "description": "Eligible provides an API platform that enables healthcare organizations to verify insurance eligibility and manage claims efficiently, streamlining administrative processes and reducing errors.",
  "categories": [
    "administrative Operations",
    "patient Facing",
    "Administrative",
    "Patient-facing"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "admins",
    "patients"
  ],
  "specialties": [
    "Insurance Verification",
    "Claims Management"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Contact vendor for pricing information.",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2015",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web",
    "iOS",
    "Android",
    "Windows",
    "macOS",
    "Linux"
  ],
  "features": [
    "Insurance eligibility & benefits checks",
    "Insurance verifications",
    "Insurance enrollments",
    "Insurance claims (billing) APIs",
    "Real-time cost estimates (ML-powered)",
    "Webhooks/event notifications",
    "Reporting & analytics",
    "Enterprise data transfers/ingestion",
    "API monitoring",
    "Claims.js JavaScript helper"
  ],
  "optional_modules": [
    "ML-powered cost estimation",
    "Enterprise data transfer/ingestion",
    "Advanced reporting/analytics",
    "Enterprise support plan"
  ],
  "integrations": [
    "Insurers (payer networks)"
  ],
  "data_standards": [
    "CAQH CORE",
    "NIST 800-53"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "SOC 2 (Type II)",
    "HITRUST",
    "CAQH CORE Phases I-IV",
    "EHNAC",
    "NIST 800-53"
  ],
  "certifications": [
    "SOC 2 Type II",
    "HITRUST CSF",
    "CAQH CORE Phase I-IV certification",
    "EHNAC accreditation"
  ],
  "security_features": [
    "Encryption at rest and in transit (TLS)",
    "Hardware Security Modules (HSM) for key storage",
    "Approved cipher suites with PFS (DHE/ECDHE)",
    "Multi-factor authentication",
    "Network and host-based firewalls",
    "Role-based access controls (RBAC)",
    "24/7 monitoring and alerting",
    "Automated vulnerability scanning and patch management",
    "Audit logging"
  ],
  "privacy_features": [
    "HIPAA-aligned controls (HITRUST)",
    "BAA available",
    "Data minimization and confidentiality controls",
    "Anonymization/pseudonymization capabilities"
  ],
  "data_residency": "United States",
  "customers": [],
  "user_reviews": [],
  "ratings": [],
  "support_channels": [],
  "training_options": [],
  "release_year": "",
  "integration_partners": [],
  "id": "SW1273",
  "slug": "eligible",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/eligible.json"
  }
}